Citation Nr: 21075972 Decision Date: 12/22/21 Archive Date: 12/22/21 DOCKET NO. 18-25 822 DATE: December 22, 2021 ORDER Service connection for right shoulder impingement syndrome (right shoulder disability) is granted. FINDING OF FACT The Veteran's right shoulder disability is related to his in-service right shoulder pain. CONCLUSION OF LAW The criteria for service connection for a right shoulder disability have been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from February 2010 to May 2013. This matter comes before the Board of Veterans' Appeals (Board) on appeal from an August 2016 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO). In August 2021, the Veteran presented testimony before the undersigned Veterans Law Judge. In August 2021, the appeal was remanded for additional development. Service Connection Service connection will be granted if the evidence demonstrates that current disability resulted from an injury suffered or disease contracted in active military, naval, or air service. 38 U.S.C. § 1110; 38 C.F.R. § 3.303(a). Establishing service connection generally requires competent evidence of (1) current disability; (2) in-service injury or disease; and (3) a relationship between the two. Saunders v. Wilkie, 886 F.3d 1356, 1361 (Fed. Cir. 2018). Consistent with this framework, service connection is warranted for a disease first diagnosed after service when all the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303(d). Service connection for a right shoulder disability. The Veteran seeks service connection for a right shoulder disability. For the following reasons, service connection for a right shoulder disability is warranted. The Veteran has a current right shoulder disability, namely right shoulder impingement syndrome. See, e.g., VA examination report (August 2021). Accordingly, a current disability has been demonstrated. With respect to the in-service injury, the Veteran contends that his right shoulder pain is related to heavy lifting and stress during his time on active duty. See Notice of Disagreement (July 2017). Further, he asserts that he first noticed his right shoulder pain during service, in 2012, when he did push-ups for physical fitness. The Board notes that during the August 2021 Board hearing, the Veteran asserted that an in-service motor vehicle accident, that occurred in March 2013, may have contributed to or worsened his current right shoulder disability. See Board hearing transcript pg. 6 (August 2021). With respect to the Veteran's in-service motor vehicle accident, the evidence suggests that that the motor vehicle accident may have been the result of the Veteran's own willful misconduct involving alcohol. See 38 C.F.R. § 3.301(c)(2); see also 38 C.F.R. § 3.1(n). For example, a May 2013 enlisted performance report shows that the Veteran received a Letter of Reprimand "for being arrested for driving with a blood alcohol content above the legal limit." See DPRIS report received March 6, 2018. Moreover, the Veteran's DD Form 214 reflects that he was administratively discharged for a pattern of misconduct; his character of service reflects that he was discharged under honorable conditions. Regardless, throughout the appeal period, the Veteran reported, including to his VA treatment providers, that his right shoulder pain had its onset prior to his motor vehicle accident in 2013, and that his right shoulder pain began during service in 2012 when he performed push-ups for physical fitness. See, e.g., Board hearing transcript (August 2021). Additionally, there is no evidence in this case to support that the Veteran's right shoulder disability was the result of the 2013 motor vehicle accident. To this extent, although the Veteran's service treatment records (STR) do not appear to show that he had right shoulder pain, he has consistently reported throughout the appeal, that he had right shoulder pain in service. See, e.g., Board hearing transcript (August 2021). A veteran is competent to report symptoms that he or she experiences at any time because this requires personal knowledge as it comes to him through his or her senses. Layno v. Brown, 6 Vet. App. 465 (1994); Barr v. Nicholson, 21 Vet. App. 303, 309 (2007). In this case, there is no evidence to the contrary or evidence to find that the Veteran is not credible. In fact, during an April 2017 orthopedics surgery consult, the Veteran reported that he had right shoulder pain for the past three to five years. As such, the Veteran's reports to his private treatment provider demonstrate that the Veteran's right shoulder pain began during service. See Fed. R. Evid. 803(4) (noting that statements made to physicians for the purposes of diagnosis and treatment are exceptionally trustworthy and not excluded by the hearsay rule because the declarant has a strong motive to tell the truth in order to receive proper care); Rucker v. Brown, 10 Vet. App. 67, 73 (1997) ("[R]ecourse to the [Federal] Rules [of Evidence] is appropriate where they will assist in the articulation of the Board's reasons")). Therefore, the Veteran's statements that he had right shoulder pain during service is competent and credible and the in-service disease or injury element has been met. The remaining question is whether the Veteran's right shoulder disability had its onset during service or is related to his military service. There is one VA medical opinion, dated in August 2021, of record, which provides a positive nexus opinion between the Veteran's current right shoulder disability and his military service. Specifically, an August 2021 VA opinion shows that a VA examiner reviewed the Veteran's claims file, interviewed him, and opined that the Veteran's right shoulder disability is at least as likely as not due to his service. The examiner reasoned in May 2016 the Veteran sought treatment for right shoulder pain and that a February 2017 x-ray report showed a diagnosis of right shoulder impingement syndrome. The examiner concluded that as the Veteran had a continuation of right shoulder pain throughout service and upon examination of his right shoulder, his right shoulder disability was at least as likely as not due to his service. The Board finds that the August 2021 VA opinion is entitled significant probative weight, as the examiner explained the reasons for the conclusions based on an accurate characterization of the evidence of record. See Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 304 (2008) (most of the probative value of a medical opinion comes from its reasoning). Importantly there is no opinion to the contrary. Notably, three years after the Veteran was separated from service, in May 2016, he submitted a claim of service connection for a right shoulder and indicated that his right shoulder pain began during service. Crucially, during the August 2021 Board hearing, the Veteran testified that he treated his right shoulder pain with over-the-counter medications, as he was unable to seek medical treatment for his right shoulder pain following service due to lack of health insurance. In light of the Veteran's credible reports that he had right shoulder pain during service, his reports that he treated his right shoulder disability with over-the-counter medications following service, and the positive nexus opinion, the Board finds that the Veteran's right shoulder disability is related to his military service. Therefore, service connection for a right shoulder disability is granted. 38 U.S.C. § 5107 (b); 38 C.F.R. § 3.102. Tiffany Dawson Veterans Law Judge Board of Veterans' Appeals Attorney for the Board A. Castillo, 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.