Citation Nr: 21006923 Decision Date: 02/05/21 Archive Date: 02/05/21 DOCKET NO. 14-16 386 DATE: February 5, 2021 REMANDED Entitlement to service connection for a left shoulder condition is remanded. REASONS FOR REMAND The Veteran served on active duty with the Army from February 12, to May 1, 2008 and from October 1999 to December 2000. He also has periods of active duty for training with the Army Reserves from June 12, to August 7, 1996 and from December 5, to December 19, 1998. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a January 2014 rating decision issued by the Department of Veterans Affairs (VA) Regional Office (RO). The claim for a left shoulder disability was previously remanded by the Board in December 2014, July 2016, February 2018, and, most recently, in January 2020. In the January 2020 remand, the Board requested an addendum opinion. As discussed below, the Board finds the addendum opinion inadequate, and so further development is needed to properly adjudicate the Veteran’s claim. See Stegall v. West, 11 Vet. App. 268 (1998). Entitlement to service connection for a left shoulder condition is remanded. Although the Board regrets the additional delay, another remand is necessary to ensure that due process is followed and that there is a complete record upon which to decide the Veteran’s claim so that he is afforded every possible consideration. 38U.S.C. §5103A; 38 C.F.R. §3.159. VA’s duty to assist includes a duty to provide a medical examination or obtain a medical opinion where it is deemed necessary to decide on the claim. 38U.S.C. §5103A (d); 38C.F.R. §3.159(c)(4); Duenas v. Principi, 18 Vet. App. 512 (2004); Robinette v. Brown, 8 Vet. App.69(1995); McLendon v. Nicholson, 20Vet. App.79 (2006). In addition, once VA undertakes the effort to provide an examination when developing a service connection claim, even if not statutorily obligated to do so, it must provide an adequate one or, at a minimum, notify the claimant why one will not or cannot be provided. Barr v. Nicholson, 21 Vet. App.303, 311 (2007). For the below noted reasons, the Board finds that, while the Veteran underwent a VA examination in October 2018 followed-up with addendum opinions in November 2018 and April 2020, an updated addendum opinion regarding his claim for service connection for a left shoulder disability is necessary. In its January 2020 remand, the Board directed the RO to obtain a VA examiner to opine on the etiology of the Veteran’s left shoulder disability. Specifically, the Board directed the VA examiner to consider and discuss the February 2004 disability services evaluation where the Veteran first reported left shoulder pain and popping. In April 2020, a VA examiner provided an addendum opinion that it was less likely than not that the Veteran’s left shoulder disability was the result of his military service primarily because it occurred between November 2012 and February 2013 based on MRIs showing a small SLAP tear of the superior glenoid labrum and a suspected tearing of the long biceps during that timeframe. The examiner indicated that the Veteran was not seen for a left shoulder issue until seeing a physical therapist in October 2011. The Board finds that the April 2020 addendum opinion is still inadequate because it did not address the February 2004 evaluation note indicating the Veteran reported difficulty working due to bilateral shoulder popping and pain. At that time, an examination revealed popping and reports, but no objective evidence, of pain. The Board also notes a March 2006 examination revealing very mild bilateral shoulder tenderness. In April 2007, the Veteran presented for an initial evaluation regarding shoulder pain. In February 2014, the Veteran reported to his physician that his left shoulder pain began in the military. The Board notes statements made for the purpose of medical diagnosis or treatment are considered to be exceptionally trustworthy because the declarant has a strong motive to tell the truth in order to receive a proper diagnosis or treatment. White v. Illinois, 502 U.S. 346, 356 (1992). The matters are REMANDED for the following action: Obtain an addendum opinion from an appropriate clinician regarding whether the Veteran’s left shoulder condition is at least as likely as not related to an in-service injury, event, or disease. The AOJ may also consider the need for an updated examination of the Veteran. The examiner is also asked to opine whether the Veteran’s left shoulder disability at least as likely as not (1) began during active service, (2) manifested within one year after discharge from service, or (3) was noted during service with continuity of the same symptomatology since service. When rendering an opinion, the examiner is asked to consider all evidence of record, including: (a.) The Veteran’s lay statements from October 2012, February 2014, January 2015, and November 2015, where he stated that his left shoulder pain started in service due to his performance of his duties as a military policeman. (b.) His statements regarding not seeking treatment for his conditions until 2006 due to not having health insurance. (c.) The February 2004 disability services evaluation report discussed above. Any opinion expressed should be accompanied by a complete rationale. L. M. BARNARD Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board M.D. Taylor, Associate 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.