Citation Nr: 21005656 Decision Date: 02/02/21 Archive Date: 02/02/21 DOCKET NO. 14-27 374 DATE: February 2, 2021 REMANDED Entitlement to service connection for right rotator cuff tear secondary to service-connected bilateral shoulder dislocation is remanded. Entitlement to service connection for left shoulder bursitis secondary to service-connected bilateral shoulder dislocation is remanded. Entitlement to an evaluation in excess of 20 percent for left shoulder dislocation is remanded. Entitlement to an evaluation in excess of 20 percent for right shoulder dislocation is remanded. REASONS FOR REMAND The Veteran served on active duty from September 2002 to March 2005. This appeal comes before the Board of Veterans’ Appeals (Board) from a June 2010 rating decision by a Veterans Affairs (VA) Regional Office (RO). The matter originally came before the Board in June 2018 but was remanded to obtain any outstanding private or VA treatment records as well as a new examination to assess the current severity of the Veteran’s left and right shoulder disabilities. The Board finds that the issues for entitlement to secondary service connection for left shoulder bursitis and right shoulder rotator cuff tear are raised by the record and are part and parcel of the increased rating claims on appeal. See Morgan v. Wilkie, 31 Vet. App. 162, 164 (2019) (schedular rating concepts such as secondary service connection are critical components of VA’s duty to maximize benefits). The Veteran was afforded a VA examination in August 2019 where he was diagnosed with a right rotator cuff tear and left shoulder bursitis. Subsequently, the RO sought an addendum opinion as to whether the new conditions were caused or aggravated by the Veteran’s service-connected bilateral shoulder conditions. In a September 2020 opinion addendum, the clinician states that there was not enough information in the chart to definitively find whether rotator cuff tears are caused by the service-connected dislocations without speculating. The opinion uses an incorrect standard for opinions on secondary service-connected disabilities as well as fails to address aggravation and thus is inadequate. Barr v. Nicholson, 21 Vet. App. 303 (2007). As such, the Board finds a remand for a new medical opinion is warranted. The issues pertaining to increased ratings for residuals of right and left shoulder dislocation are inextricably intertwined with the secondary service connection issues remanded herein. In other words, the award of service connection for additional shoulder conditions may impact the severity of the Veteran’s bilateral shoulder disabilities. See Harris v. Derwinski, 1 Vet. App. 180 (1991). The matters are REMANDED for the following actions: 1. Schedule the Veteran for a VA shoulder examination to address the nature and severity of his bilateral shoulder disabilities. The examiner is asked to address the following: (a.) The examiner shoulder complete a thorough physical examination of the Veteran’s shoulders and address the severity of the disabilities. (b.) Then, state whether it is at least as likely as not (50 percent or better probability) the Veteran’s diagnosed right rotator cuff tear and/or left shoulder bursitis are caused or aggravated by his service-connected bilateral shoulder disabilities. *The examiner is advised that a recent precedent case clarified that secondary service connection does not require “permanent” worsening of the condition being claimed by the service-connected disability and requires considering whether there has been any worsening, no matter how incremental, so even if not above and beyond the condition’s natural progression. See Ward v. Wilkie, 31 Vet. App. 233 (2019). (c.) All opinions must be thoroughly explained and a complete and detailed rationale for any conclusions reached should be provided. 2. Then, readjudicate the claims on appeal. Romina A. Casadei Acting Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Lee Feldman, Attorney Advisor 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.