Citation Nr: 21077460 Decision Date: 12/29/21 Archive Date: 12/29/21 DOCKET NO. 14-21 047 DATE: December 29, 2021 ORDER Entitlement to service connection for left shoulder degenerative arthritis is granted. Entitlement to service connection for right shoulder degenerative arthritis is granted. FINDINGS OF FACT 1. The Veteran has a diagnosis of degenerative arthritis of the left and right shoulders. 2. The evidence is at least in equipoise as to whether the Veteran has experienced continuous symptoms of left and right shoulder degenerative arthritis since the time of his active service. CONCLUSIONS OF LAW 1. The criteria for entitlement to service connection for left shoulder degenerative arthritis have been met. 38 U.S.C. §§ 1110, 5107(b); 38 C.F.R. §§ 3.102, 3.303, 3.309. 2. The criteria for entitlement to service connection for right shoulder degenerative arthritis have been met. 38 U.S.C. §§ 1110, 5107(b); 38 C.F.R. §§ 3.102, 3.303, 3.309. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran had active service in the Air Force from September 1967 to September 1971. This matter originates from an appeal of a February 2013 rating decision by a Department of Veterans Affairs (VA) Regional Office (RO) that denied entitlement to service connection for a bilateral shoulder disability. 02/09/2013, Notification Letter. The Board of Veterans' Appeals (Board) denied this claim in February 2016. The Veteran appealed his claim to the Court of Appeals for Veterans Claims (CAVC) and in November 2016 CAVC granting a Joint Motion for Partial Remand (JMPR) and vacated the portion of the February 2016 Board decision denying service connection for the claimed bilateral shoulder disability. The Board then remanded the Veteran's bilateral shoulder claim in June 2017, January 2019, June 2020, December 2020, and October 2021. A remand by the Board confers on the Veteran, as a matter of law, the right to substantial compliance with the remand orders. Stegall v. West, 11 Vet. App. 268, 271 (1998). As the Board is here remanding the Veteran's claims in full, analysis of whether there has been substantial compliance is not necessary. Entitlement to service connection for left shoulder degenerative arthritis and right shoulder degenerative arthritis are granted. Service connection will be granted if the evidence demonstrates that a current disability resulted from an injury or disease incurred in or aggravated by active military service. 38 U.S.C. § 1110; 38 C.F.R. § 3.303(a). Establishing service connection generally requires (1) medical evidence of a current disability; (2) medical or, in certain circumstances, lay evidence of in-service incurrence or aggravation of a disease or injury; and (3) medical evidence of a nexus between the claimed in-service disease or injury and the present disability. See Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004); 38 C.F.R. § 3.303. At his November 2014 Board hearing, the Veteran testified that he was involved in a motor vehicle accident (MVA) during his period of active service. The Veteran also testified that he has experienced shoulder pain since his discharge of active service. The Veteran and his wife are competent to report symptoms and experiences observable by their senses. See Jandreau v. Nicholson, 492 F.3d 1372, 1377 (Fed. Cir. 2007); 38 C.F.R. § 3.159(a). An August 2019 VA examiner documented a diagnosis of degenerative arthritis of the bilateral acromioclavicular joints. 09/03/2019, C&P Exam, p. 1. The Board finds that the current disability element of the criteria for service connection is satisfied. Further, the Board notes that arthritis is among those disabilities for which VA may presume a nexus between an in-service incurrence or event and a current disability provided there is a showing of continuity of symptomatology. 38 C.F.R. §§ 3.303(b), 3.309(a). A January 1970 entry in the Veteran's service treatment records (STRs) reflects that the Veteran was admitted to a field hospital following an MVA. Multiple abrasions and contusions were noted. 11/03/2000, STR Medical, p. 76. As noted above, at his November 2014 Board hearing the Veteran and his wife testified that he has experienced shoulder pain since the time of his discharge from active service. The Veteran also testified that he avoided seeking treatment for his shoulder pain so as not to jeopardize his employment. In April 2018 the Veteran again stated that he avoided seeking treatment for shoulder pain following service so as not to jeopardize his employment. VA has obtained multiple VA examinations to determine the nature and etiology of the Veteran's shoulder disability. The Board has previously addressed the deficiencies in in the examinations obtained in March 2018, September 2019, September 2020, and July 2021 in its reasons for remand. Accordingly, the Board now assigns those examinations minimal probative weight as to the purported relationship between the Veteran's bilateral shoulder degenerative arthritis and his period of active service. An addendum opinion was obtained in October 2021. However, this opinion only addresses the question of whether the Veteran's bilateral shoulder degenerative arthritis has been aggravated by his service-connected cervical spine disability. The October 2021 VA medical opinion is not responsive to the question of a direct relationship between the in-service MVA (or other event, injury, or occurrence) and the Veteran's bilateral shoulder disability. In adjudicating claims for VA benefits, the burden of proof only requires an "approximate balance" of the evidence for and against a claim. 38 U.S.C. § 5107 (b); 38 C.F.R. § 3.102; Gilbert v. Derwinski, 1 Vet. App. 49, 55-56 (1991). This low standard of proof is "unique" to the VA adjudicatory process, and "the nation, 'in recognition of our debt to our veterans,' has 'taken upon itself the risk of error' in awarding such benefits." Wise v. Shinseki, 26 Vet. App. 517, 531 (2014). In evaluating a claim for disability benefits, when there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, VA shall give the benefit of the doubt to the claimant. 38 U.S.C. § 5107. In light of the foregoing, the Board finds that the evidence is at least in equipoise as to whether the Veteran has experienced continuity of symptomatology of bilateral shoulder degenerative arthritis (i.e., shoulder pain) since the time of his active service. As arthritis is a chronic disease under 38 C.F.R. § 3.309(a), service connection may be awarded based solely on continuity of symptomatology. See Walker v. Shinseki, 708 F.3d 1331, 1338-39 (Fed. Cir. 2013). Accordingly, the Board concludes that the criteria for service connection for degenerative arthritis of the right and left shoulders are met, and the same is hereby granted. 38 U.S.C. §§ 1110, 5107(b); 38 C.F.R. §§ 3.102, 3.303, 3.309. Eric S. Leboff Veterans Law Judge Board of Veterans' Appeals Attorney for the Board E. C. Sametshaw 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.