Citation Nr: 21007294 Decision Date: 02/09/21 Archive Date: 02/09/21 DOCKET NO. 17-24 297 DATE: February 9, 2021 ORDER Service connection for a left shoulder condition is granted. FINDING OF FACT By granting the Veteran the benefit of doubt, it is at least as likely as not, that the Veteran’s left shoulder condition is proximately due to or otherwise caused by his service-connected bilateral knee disabilities. CONCLUSION OF LAW The criteria for service connection for a left shoulder condition have been met. 38 U.S.C. § 1110; 38 C.F.R. § 3.303, 3.310(a). REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty in the U.S. Army from December 2005 to May 2008. The matter is on appeal before the Board from an August 2015 rating decision. The Veteran and his mother provided testimony at a Board hearing in March 2020 before the undersigned Veterans Law Judge. A transcript of the hearing is of record. Service Connection Left Shoulder The Veteran asserts that his left shoulder condition is secondary to his service-connected bilateral knee disabilities. At the Board hearing in March 2020, the Veteran reported that he hurt his left shoulder when his knee gave way and he fell landing on his left shoulder. His mother noted that it was in February 2014 that the Veteran had fallen, and that he had underwent surgery on his left shoulder in November 2014. Additionally, the Veteran’s mother relayed that the Veteran had called her after he had fallen in February 2014, and told her that he had fallen because his knee had given out. Both the Veteran and his mother provided testimony that he has issues with falling due to his knee, and that he has both a brace and a cane due to his knees. It is also noted that the Veteran’s service connected knee disability is rated based on a finding of instability. 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. Service connection requires competent evidence showing: (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 or aggravated during service. Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004). Service connection may also be established on a secondary basis for a disability which is proximately due to, or the result of, a service-connected disability. 38 C.F.R. § 3.310(a). Secondary service connection may also be established for a disability which is aggravated by a service-connected disability. In order to prevail on the issue of secondary service connection, the record must show (1) evidence of a current disability; (2) evidence of a service-connected disability; and (3) medical nexus evidence establishing a connection between the service-connected disability and the current disability. Wallin v. West, 11 Vet. App. 509 (1998). A review of the Veteran’s VA treatment records reflects that on March 5, 2014 the Veteran was seen for physical therapy, at which time he reported that he had fallen when he was putting gas into his car and that his shoulder was hurting. The Veteran relayed that he was not sure if he had tripped or what had happened. The physical therapist assessed the Veteran to have a strain to his left shoulder due to the fall. The Veteran underwent surgery on November 4, 2014 for a left shoulder anterior inferior labral tear and bony Bankart Hill-Sachs lesion. At a post-operative appointment on November 17, 2014, it was noted that the Veteran had concerns pertaining to the manner in which he had hurt his shoulder. He reported that his shoulder injury was secondary to a fall when his knee gave out while he was at a gas station. Prior to the fall, the Veteran noted that he did not have any shoulder pain, however, since the fall he had constant and continuing problems with his shoulder. The Veteran underwent a VA examination in August 2015, however, the VA examiner found that the Veteran’s left shoulder condition was less likely than not (less than 50 percent probability) proximately due to or the result of his service-connected knee disabilities. The examiner noted the report from the March 5, 2014 physical therapy appointment, and pointed out that there was not any mention of either knee instability or “giving out.” The examiner reported surgeries which the Veteran had undergone on both of his knees, and relayed that the Veteran did not have a history of ligament injury, meniscal trauma, or knee structural instability. As such, the examiner found that it was less likely than not that either of the Veteran’s knees were the direct cause of his fall that had resulted in his shoulder injury. The Board notes the negative VA opinion; however, it is clear from the record that the fall caused the Veteran’s left shoulder injury. The question is not whether the Veteran fell and injured his left shoulder, but rather how the Veteran fell. The record reflects that the Veteran has reported occasional instability with his knees, and even occasional falls. The Board finds both the Veteran’s and his mother’s testimony to be credible pertaining to the manner in which he had fallen, that is due to his knee giving way. In addition, the Board notes that the Veteran’s right knee is service-connected for slight instability. Thus, by granting the Veteran the benefit of the doubt, service connection for a left shoulder condition is warranted. As such, service connection for a left shoulder condition as secondary to service-connected bilateral knee disabilities, is granted. MATTHEW W. BLACKWELDER Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board S. Lutgens-Staley, 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.