Citation Nr: 21077501 Decision Date: 12/30/21 Archive Date: 12/30/21 DOCKET NO. 17-00 411 DATE: December 30, 2021 ORDER Service connection for a right shoulder disorder is denied. FINDINGS OF FACT 1. The Veteran served on active duty from July 1985 to December 1987; he has been 100 percent disabled since December 2019. 2. A right shoulder disorder was not shown during service or within one year of service, symptoms were not continuous since service, and a right shoulder disorder, diagnosed as shoulder impingement syndrome, adhesive capsulitis, and osteoarthritis (OA) of the acromioclavicular (AC) joint, is not otherwise causally or etiologically related to service. CONCLUSION OF LAW A right shoulder disorder was not incurred in service and may not be presumed to have been incurred therein. 38 U.S.C. §§ 1131, 5103(a), 5103A, 5107 (2012); 38 C.F.R. §§ 3.159, 3.303, 3.307, 3.309 (2021). REASONS AND BASES FOR FINDINGS AND CONCLUSION The matter comes before the Board on appeal of a December 2015 rating decision that reopened and denied a claim for service connection for a right shoulder disorder. In December 2018 and June 2021, the Board remanded the appeal for additional development. It now returns to the Board for appellate adjudication. Turning to the relevant laws and regulations, service connection may be granted on a direct basis as a result of disease or injury incurred in service based on nexus using a three-element test: (1) the existence of a present disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the present disability and the disease or injury incurred in or aggravated by service. See 38 C.F.R. §§ 3.303(a), (d); Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009). Service connection may be granted on a presumptive basis for diseases listed in 38 C.F.R. § 3.309 under the following circumstances: (1) where a chronic disease or injury is shown in service and subsequent manifestations of the same disease or injury are shown at a later date unless clearly attributable to an intercurrent cause; or (2) where there is continuity of symptomatology since service; or (3) by showing that the disorder manifested itself to a degree of 10 percent or more within one year from the date of separation from service. See 38 C.F.R. § 3.307. Turning to the evidence, the first element of service connection a current disability is met. A November 2015 VA examiner diagnosed shoulder impingement syndrome, which was reiterated by the September 2019 VA examiner. The November 2015 VA examiner also found that the Veteran's symptoms could be attributed to adhesive capsulitis. The July 2021 VA examiner diagnosed OA of the acromioclavicular (AC) joint. Next, the second element of service connection an in-service incurrence is also met. Service treatment records (STRs) note complaints of right shoulder pain in February 1986 with a diagnosis of AC joint strain. As to a medical nexus, a November 2015 VA examiner diagnosed shoulder impingement syndrome and adhesive capsulitis. The examiner opined that it is less likely than not that the current diagnosis was caused by the AC joint sprain incurred during service, indicating that adhesive capsulitis is multifactorial in nature. A September 2019 VA examiner found no medical nexus between service and the Veteran's right shoulder adhesive capsulitis based on a lack of treatment since service. However, the opinion was inadequate because the examiner relied solely on the lack of treatment in service as the basis for the negative opinion. Moreover, neither the November 2015 nor September 2019 VA examiner considered the current diagnosis of arthritis shown on 2015 X-ray. Nevertheless, a July 2021 VA examiner diagnosed OA but did not diagnose adhesive capsulitis; however, the examiner indicated that adhesive capsulitis, also known as frozen shoulder, was a disorder characterized by stiffness and pain in the shoulder joint with symptoms gradually worsening and then resolving within one to three years. The examination reflected extensive review of the STRs, documenting findings relevant to the right shoulder strain, and of post-service treatment for the right shoulder. The examiner opined that right shoulder OA, diagnosed approximately 29 years after the in-service right shoulder strain, was less likely than not due to service. The examiner indicated that the acute strain in service was treated and resolved with no evidence of recurrence, progression, chronicity, residuals, or sequelae. There are no contradictory opinions of record. Thus, the medical evidence does not support the claim for service connection on a direct basis. As to presumptive service connection, OA was found in a November 2015 X-ray which reflected mild degenerative changes and is considered a chronic disease under 38 C.F.R. § 3.309. However, while STRs show an acute right shoulder strain, the disorder was not shown to be chronic and resolved without recurrence or residuals. Specifically, the November 1987 separation examination was negative for contemporaneous right shoulder complaint, treatment, or diagnosis. Therefore, the medical evidence does not support presumptive service connection on a "chronic disease or injury shown in service" basis. Next, the medical evidence does not support presumptive service connected based on continuity of symptomatology since service. Specifically, OA was first noted in 2015, some 28 years after discharge. As the Veteran was discharged in 1987 and symptoms were not identified until the Veteran's original claim for service connection in 2010 at the earliest, the medical evidence does not support service connection on a "continuity of symptomatology" basis. Further, the disorder did not manifest itself to a degree of 10 percent or more within one year from the date of separation of service. The Veteran separated from service in 1987 but did not note symptoms until 2010 at the earliest, with OA diagnosed in 2015. This evidence does not support presumptive service connection on a "manifest within one-year from separation" basis. Therefore, the medical evidence does not support presumptive service connection on any basis. The Board has considered the lay statements of the Veteran that he has a right shoulder disorder that was caused by service. He has not provided specific arguments as to the relationship between his current right shoulder disorder and service, but he is competent to report symptoms because this requires only personal knowledge as it comes to him through his senses. However, laypersons are not competent to offer opinions as to the nature and etiology of his current disorder due to the medical complexity of the matters involved. Such competent evidence has been provided by the service records, clinical evidence, and examinations obtained and associated with the claims file. Here, the Board attaches greater probative weight to the clinical findings than to his statements. In light of the above, the preponderance of the evidence is against the claim for service connection and there is no doubt to be otherwise resolved. As such, the appeal is denied. Finally, the Veteran has not raised any other issues, nor have any other issues been reasonably raised by the record, for the Board's consideration. See Doucette v. Shulkin, 28 Vet. App. 366, 369-370 (2017) (confirming that the Board is not required to address issues unless they are specifically raised by the claimant or reasonably raised by the evidence of record). L. HOWELL Veterans Law Judge Board of Veterans' Appeals Attorney for the Board K. M. Schaefer, 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.