Citation Nr: 21009033 Decision Date: 02/18/21 Archive Date: 02/18/21 DOCKET NO. 18-41 335 DATE: February 18, 2021 ORDER Service connection for a right shoulder condition, to include as secondary to the service-connected left shoulder condition, is granted. FINDING OF FACT The evidence is at least in equipoise as to whether the Veteran’s right shoulder condition is aggravated by his service-connected left shoulder condition. CONCLUSION OF LAW The criteria for service connection for a right shoulder condition have been met. 38 U.S.C. §§ 1110, 1154, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.310. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from January 1968 to December 1969. In February 2021, a videoconference hearing was held before the undersigned Veterans Law Judge (VLJ). At the hearing, the Veteran indicated he would be submitting additional evidence that day consisting of copies of non-precedential Board decisions in support of his contentions and a copy of his private physician’s resume. Although this additional evidence has not yet been associated with the claims file, the Veteran is not prejudiced by the Board’s proceeding with an adjudication in the matter, as the below decision grants the Veteran’s claim in full. Service Connection Service connection may be granted for a disability resulting from disease or injury incurred in or aggravated by active military, naval, or air service. 38 U.S.C. § 1110; 38 C.F.R. § 3.303(a). Secondary service connection is warranted where a disability is proximately due to or the result of a service-connected disease or injury. 38 C.F.R. § 3.310(a). Briefly, the threshold legal requirements for a successful secondary service connection claim are: (1) evidence of a current disability for which secondary service connection is sought; (2) a disability for which service connection has been established; and (3) competent evidence of a nexus between the two. When there is an approximate balance of positive and negative evidence regarding the merits of an issue material to the determination of the matter, the benefit of the doubt in resolving each such issue shall be given to the claimant. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102. When all of the evidence is assembled, VA is responsible for determining whether the evidence supports the claim or is in relative equipoise, with the appellant prevailing in either event, or whether a fair preponderance of the evidence is against the claim, in which case the claim is denied. Gilbert v. Derwinski, 1 Vet. App. 49, 55 (1990). Entitlement to service connection for a right shoulder condition. The Veteran asserts that his right shoulder condition is proximately due to or aggravated by his left shoulder condition. See August 2018 VA Form 9. Considering the pertinent evidence in light of the governing legal authority, and resolving all reasonable doubt in the Veteran’s favor, the Board finds that service connection for a right shoulder condition as secondary to his service-connected left shoulder condition is warranted. In pertinent part, private treatment records show that the Veteran has a current diagnosis of right shoulder osteoarthritis. See July 2016 private treatment records. The Veteran is also service-connected for a left shoulder total replacement, previously rated as left shoulder degenerative joint disease with laxity and instability. Such is sufficient to meet the first and second elements for secondary service connection. With regard to the remaining element of whether a nexus exists between the Veteran’s right shoulder condition and his service-connected left shoulder condition, the Board finds that it does. On January 2017 VA examination, the Veteran was diagnosed with bilateral glenohumeral osteoarthritis. The VA examiner opined that it was less likely than not that the Veteran’s right shoulder condition was proximately due to or aggravated by his left shoulder condition. The VA examiner explained for rationale that the Veteran was right-handed, so his service-connected left shoulder condition was impacting his non-dominant arm. The VA examiner then stated that a non-dominant arm was the “support” arm and would not cause the dominant arm to be overused for daily tasks due to overcompensating for the non-dominant arm. In a private medical opinion received by VA in August 2017, the Veteran’s orthopedic surgeon reported that the Veteran’s right shoulder condition was exacerbated in response to worsening left shoulder symptoms, specifically to include recovery after left shoulder surgery. In a July 2018 VA addendum opinion, the VA examiner opined that there was no clear objective evidence to suggest that it was at least as likely as not that the service-connected left shoulder had aggravated the right shoulder beyond the impairment associated with the primary pathology afflicting the right shoulder, to include prior right shoulder injuries, advanced osteoarthritis, age-related degenerative changes in the right shoulder, and the dominant nature of the right arm. In an August 2018 correspondence, the Veteran reported that he dislocated his right shoulder during military service, but he did not report it at the time because his basic training drill instructor advised against it. In an August 2018 private medical opinion, the Veteran’s private orthopedic surgeon noted that the Veteran experienced severe right shoulder symptoms. The private orthopedic surgeon also noted that the Veteran had had to overcompensate for his left shoulder condition and recovery from left shoulder surgery. The private orthopedic surgeon opined that there was a connection from the right shoulder to the left, stating that it was obvious that the Veteran had overcompensated and had significant right shoulder arthritis that was at least in part due to the left-sided service-connected injury. During the February 2021 Board hearing, the Veteran testified that he believed the severity of his service-connected left shoulder condition had contributed to the overuse of his right shoulder, and that this had been corroborated by his private physician. The Veteran reported that his private physician had told him that he had seen many overuse and overcompensating injuries. The Veteran further reported that he started noticing his right shoulder pain in approximately 2012 and began seeking treatment from his current private orthopedic surgeon in 2016. After reviewing the evidence of record, the Board finds the July 2017 and August 2018 medical opinions from the private orthopedic surgeon to be highly probative. In this regard, the private orthopedic surgeon based the opinions on a thorough review of the Veteran’s medical history and provided well-reasoned rationale. The Board further finds the Veteran’s lay statements of record and hearing testimony to be credible and are afforded much probative value. The Board acknowledges the negative nexus opinions of record from the January 2017 VA examination and July 2018 VA addendum opinion. However, the VA opinions did not address the Veteran’s argument regarding right shoulder overcompensation due to the severity of the left shoulder condition and recovery from a left shoulder replacement. Instead, the examiner based the opinions on the theory that a non-dominant arm condition would not aggravate a dominant arm condition and the absence of medical evidence, but provided no further support for the reliance on that theory. As such, the January 2017 and July 2018 VA medical opinions are afforded little probative value. Accordingly, the Board finds that the evidence is at least in equipoise as to whether the Veteran’s right shoulder condition is aggravated by his service-connected left shoulder condition. Resolving reasonable doubt in the Veteran’s favor, service connection for a right shoulder condition is granted. See 38 U.S.C. § 5107; 38 C.F.R. § 3.102. A. ISHIZAWAR Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board A. Griffin, 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.