Citation Nr: 21075906 Decision Date: 12/21/21 Archive Date: 12/21/21 DOCKET NO. 17-06 622 DATE: December 21, 2021 REMANDED Entitlement to service connection for a right shoulder disability is remanded. Entitlement to service connection for a left knee disability is remanded. REASONS FOR REMAND The Veteran had active military service in the United States Army from June 1993 to July 2001. These matters are on appeal from a March 2015 rating decision. A hearing was held before the Board in July 2020. A transcript of the hearing is associated with the record. In an October 2021 letter, the Veteran was advised that the Veterans Law Judge (VLJ) who conducted the July 2020 hearing was no longer employed by the Board and he had the right to an additional hearing before a different VLJ. 38 U.S.C. § 7107(c), 38 C.F.R. § 20.707. The letter instructed if the Veteran did not respond within 30 days, the Board would assume the Veteran does not want another hearing and proceed with a decision on the appellate record. In a December 2021 response, the Veteran has not indicated that he wishes to have an additional hearing. As such, the Board may proceed with adjudication. In November 2020, the Board remanded the case for further development by the originating agency. 1. Right shoulder In November 2020, the Board remanded the Veteran's claim of service connection for a right shoulder disability for an examination and etiological opinion as to whether the onset of any identifiable right shoulder disability was related to the Veteran's service. The examiner was asked to discuss the Veteran's in-service treatment for a right shoulder separation shortly before his discharge from service and whether it caused the onset of his present right shoulder arthritis. In an April 2021 VA medical opinion an examiner opined that the Veteran's right shoulder disability was less likely than not related to his service. The examiner considered the Veteran's 2001 separation examination which noted a normal X-ray and range of motion of the upper extremities; a 2015 X-ray which was negative for fracture or dislocation, but indicated degenerative changes; and a June 2016 MRI of the right shoulder which indicated right shoulder pain due to acromioclavicular arthritis which was resolved. The examiner opined that the Veteran's physically demanding occupation was the most likely factor in his shoulder disability. However, the examiner failed to consider in-service treatment for a right shoulder separation shortly before his discharge from service and the Veteran's reports regarding the onset of his right shoulder disability, as requested in the remand directives. Accordingly, in light of the foregoing and deficiencies in the April 2021 VA medical opinion, an addendum should be obtained. Barr v. Nicholson, 21 Vet. App. 303, 312 (2007); Stegall v. West, 11 Vet. App. 268 (1998). 2. Left knee disability In November 2020, the Board also remanded the Veteran's claim of service connection or a left knee disability for an examination and etiological opinion as to whether the onset of any identifiable left knee disability was related to the Veteran's service. The examiner was asked to discuss whether the Veteran's in-service left knee osteochondroma removal surgery severed or injured the main nerve inside of his left knee and whether it caused the onset of his chronic left knee flare-ups, numbness, and illness. In an April 2021 medical opinion, the VA examiner opined that the Veteran's medical records did not support a finding that the left knee disability is related to his service. The examiner noted that records document a 2001 medical board examination which noted good strength and range of motion of the lower extremities. However, there were no records documenting continued complaints, diagnosis, or treatment for a left knee disability since separation. The examiner noted that the Veteran underwent osteochondroma surgery in 1994 and a bone scan in 1998 which was negative for evidence of stress fracture or recurrent osteochondroma. Regarding whether the Veteran's in-service left knee osteochondroma removal surgery severed or injured the main nerve inside of his left knee and caused the onset of his chronic left knee flare-ups, numbness, and limpness, the examiner opined that there was no medical evidence to support this assertion. The examiner stated that the Veteran's current examination revealed a small area of numbness adjacent to the surgical scar which was a common finding post-operatively due to the risk of superficial cutaneous nerve injury during service. The examiner also stated that there were no records documenting continued complaints, diagnosis, or treatment for a left knee disability since service. However, the examiner failed to consider or address the Veteran's complaints of flare-ups and limpness as requested in the remand directives. Accordingly, in light of the foregoing and deficiencies in the April 2021 VA medical opinion, an addendum should be obtained. Barr, supra.; Stegall, supra. The matters are REMANDED for the following action: Obtain an appropriate addendum by an examiner, other than the April 2021 VA examiner, regarding the nature and etiology of the Veteran's claimed right shoulder and left knee disabilities. Unless the examiner finds that a new examination is required, the Veteran need not be examined again. The claims file, including a copy of this remand, must be made available to the examiner for review who should indicate that the claims file was reviewed. The examiner should provide the following opinion(s): Right shoulder disability Is it at least as likely as not (50 percent or more probability) that any right shoulder disability had its onset in or is etiologically-related to the Veteran's active duty service? The examiner is asked to consider and discuss as necessary the pertinent evidence of record to include the Veteran's lay statements, complaints, and hearing testimony concerning the onset of his right shoulder disability, including those made to medical providers. The examiner should also consider and discuss, the Veteran's in-service treatment for a right shoulder separation shortly before his discharge from service and whether it caused the onset of his present right shoulder arthritis. Left knee disability Is it at least as likely as not (50 percent or more probability) that any left knee disability had onset in or is etiologically-related to the Veteran's active duty service? The examiner is asked to consider and discuss as necessary the pertinent evidence of record to include the Veteran's lay statements, complaints, and hearing testimony concerning the onset of his left knee disability, including those made to medical providers. The examiner is also asked to consider and discuss the Veteran's in-service left knee osteochondroma removal surgery and address whether the Veteran's in-service left knee osteochondroma removal surgery severed or injured the main nerve inside of his left knee and caused the onset of his chronic left knee flare-ups, numbness, and limpness. The Board, by this remand, makes no determination, expressed or implied, concerning the credibility of any statements on file. The addendum should include the complete rationale for all opinions expressed. KELLI A. KORDICH Veterans Law Judge Board of Veterans' Appeals Attorney for the Board T. Adams, Counsel The Board's decision in this case is binding only with respect to the instant matter decided. This decision is not precedential and does not establish VA policies or interpretations of general applicability. 38 C.F.R. § 20.1303.