Citation Nr: 21009431 Decision Date: 02/22/21 Archive Date: 02/22/21 DOCKET NO. 17-30 843 DATE: February 22, 2021 ORDER Entitlement to service connection for a bilateral shoulder disability is denied. Entitlement to service connection for a neck disability is denied. Entitlement to service connection for a headache disability is denied. FINDINGS OF FACT 1. The weight of the evidence is against a finding that a bilateral shoulder disability is related to service. 2. The weight of the evidence is against a finding that a neck disability is related to service. 3. The Veteran does not have a diagnosed headache disability. CONCLUSIONS OF LAW 1. The criteria for service connection for a bilateral shoulder disability have not been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.303, 3.307, 3.309. 2. The criteria for service connection for a neck disability have not been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.303, 3.307, 3.309. 3. The criteria for service connection for a headache disability have not been met. 38 U.S.C. §§ 1110, 5107 5107; 38 C.F.R. § 3.303. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran had active duty service with the United States Navy from July to August 1974. These matters come before the Board of Veterans’ Appeals (Board) on appeal of a July 2014 rating decision. In November 2018, the Veteran provided testimony at a hearing before the undersigned Veterans Law Judge. A transcript of the hearing is of record. In May 2019, the Board remanded the claims for further development. The Board finds that the remand directives have been substantially complied with respect to the claims (the Board directed that a VA examination and opinion be obtained with respect to each claim, which has been completed) and therefore will proceed with a decision on the claims.  Service Connection Service connection will be granted for a disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303, 3.304. Service connection generally requires evidence of (1) a current disability; (2) an in-service incurrence or aggravation of a disease or injury; and (3) a nexus between the claimed in-service disease or injury and the present disability. Walker v. Shinseki, 701 F.3d 1331 (Fed. Cir. 2013). For certain chronic disorders service connection may be granted if the disease becomes manifest to a compensable degree within one year following separation from service. 38 U.S.C. §§ 1101, 1112, 1113, 1137; 38 C.F.R. §§ 3.307, 3.309. 1. Bilateral Shoulder Disability The Veteran contends that his current bilateral shoulder disability is directly related to the carrying of a heavy pack and performing long hikes during active duty service. A shoulder disability was not noted on the Veteran’s enlistment examination. However, a Medical Evaluation Board conducted in August 1974 shows that in July 1974, the Veteran reported to sick call complaining of painful shoulders. He related a 10-year history of problems with his shoulder. In an August 1974 Medical Board Evaluation, the Veteran was diagnosed with a subluxated left sternoclavicular joint. The Medical Evaluation Board recommended that the Veteran be discharged from service as he was found to not be a fit for military service. Following a VA examination in March 2010, the VA examiner opined that the Veteran’s current shoulder disabilities, diagnosed as left shoulder impingement syndrome and right AC separation, were unrelated to the subluxation of the left sternoclavicular joint that he experienced during active duty service. The examiner stated that Veteran did not have any complaints regarding this area. Following a VA examination in November 2019, the examiner provided current diagnoses of bilateral osteoarthritis of the glenohumeral and acromioclavicular joints and left shoulder impingement syndrome. The examiner initially noted that the March 2010 VA examiner’s diagnosis of a right acromioclavicular joint separation was made in error as the condition is more descriptive of arthrosis and not separation. The examiner then explained that there is no documentary, historical or clinical evidence of symptomatic bilateral clavicular fractures or recurrent subluxation of the left sternoclavicular joint of this Veteran since military service. With respect to the current diagnoses of bilateral shoulder disabilities, the examiner noted that the service treatment records are negative for these conditions. The examiner noted that the service treatment records show that the Veteran reported pain in the mid-clavicles (collar bones) and was diagnosed with subluxated left sternoclavicular joint. The examiner explained that sternoclavicular joint is the joint between the sternum (breastbone) and the clavicle, which is located in the anterior chest. The Veteran’s current pain is located in the anterior and posterior shoulder, not the anterior chest. The examiner stated that the subluxated left sternoclavicular joint and the current diagnoses of bilateral osteoarthritis of the glenohumeral and acromioclavicular joints and left shoulder impingement syndrome are unrelated. The examiner also opined that the transient subluxated sternoclavicular joint does not have a direct causative effect in the development of bilateral osteoarthritis of the glenohumeral and acromioclavicular joints and left shoulder impingement syndrome. The examiner explained that the degenerative joint of the shoulder joints is related to the aging process and has a strong genetic component. The Board finds that the preponderance of the evidence is against a finding that the Veteran’s a current bilateral shoulder disability is related to service. The November 2019 VA examination was based on upon thorough review of the record and analysis of the Veteran’s entire history. Additionally, the VA examiner’s opinion is consistent with the Veteran’s documented medical history, which is absent any report of symptomatology consistent with the either shoulder for many years after active service. The examiner determined that the Veteran’s in-service treatment for the left shoulder was transient and was less likely as not related to any current shoulder disability. The Veteran’s report of the onset of shoulder symptoms are considered competent. However, there is no objective report of shoulder pain/symptoms for many years following the Veteran’s separation from service. Further, the objective findings are more credible and more probative than his after-the-fact lay assertions. The Board concludes that the objective findings of the onset of the disability for many years following service are far more probative and credible than the lay evidence submitted in support of a claim for benefits. The Board finds that the Veteran’s statements with regard to a nexus between his bilateral shoulder disability and service to be of minimal probative value and outweighed by the VA opinion, prepared by a skilled neutral professional. The Board also finds that, as the Veteran had no indication of a disability at service, the presumption of soundness attaches. There is also no clear and unmistakable evidence of a preexisting disability to rebut that presumption. Accordingly, the claim for service connection for a bilateral shoulder disability is denied. 2. Neck Disability The Veteran reports the onset of neck pain while performing push-ups and/or sit-ups during service when he heard his neck and shoulder pop. In a March 2015 statement, the Veteran’s brother attested to the Veteran’s complaints of neck pain following activities performed during bootcamp. The service treatment records show no complaints, treatment or diagnoses of a neck condition. Post-service, a VA treatment records show that the Veteran was diagnosed with degenerative joint disease of the cervical spine. Following VA examination in November 2019, the examiner opined that the Veteran’s degenerative joint disease of the cervical spine was less likely than not incurred in or caused by the claimed in-service injury, event or illness. The examiner explained that the medical records are silent for a neck condition during service. The examiner stated that the earliest documentation of neck pain was in January 2013 and the earliest documentation of a history of cervical fusion was in July 2014. Accordingly, the examiner explained that a nexus between the Veteran’s cervical spine disability and military service has not been established and is not supported by the objective medical evidence. The examiner noted that the Veteran’s description of injury to the neck during service did not have result in the development of the current cervical spine disability. As noted above, the Veteran has been diagnosed as having degenerative joint disease of the cervical spine. However, the evidence does not support a finding that he experienced an in-service injury, disease or event to which current neck disability could plausibly be related. In this regard, the November 2019 VA examiner’s opinion is clear - that while the Veteran reported the onset of neck pain during service, there were no ongoing problems relating to the neck and the current neck disability is not related to service. Furthermore, while arthritis is considered a chronic disease under 38 C.F. R. § 3.309, there has been no indication that continuity of symptomatology has been established in this case. The appeal as to service connection for a neck disability must be denied. 3. Headache Disability The Veteran reports that while doing pushups and/or sit-ups during basic training and heard a pop in his neck and shoulders. He stated that he started getting headaches which he treats by lying down and watching television. In a March 2015 statement, the Veteran’s brother attested to the Veteran’s complaints of headaches following activities performed during bootcamp. The Veteran’s service treatment records show no complaints, treatment or diagnoses of headaches. Additionally, a review of the Veteran’s post-service medical records shows no treatment or diagnoses of headaches. Following VA examination in November 2019, the examiner found that the Veteran’s reported headaches were less likely than not incurred in or caused by the in-service injury, event or illness. The examiner explained that the available medical records were silent for a diagnosis of headache symptoms. The examiner acknowledged that the lay statements attesting to headaches; but stated that there was no documentary, historical or clinical evidence of a primary headache condition. The Board accepts that the Veteran has experienced headaches; however, in there is no evidence of a current headache disability. Significantly, the November 2019 VA examiner determined that the Veteran did not have a current headache disability. The only evidence of record that the Veteran has a current headache disability are his own lay statements and that of his brother. In the present case, while the Veteran as a lay person may be competent to report symptoms of headaches, he is not competent to diagnose a chronic headache condition. The diagnosis of a headache disability requires greater medical knowledge and testing to determine a diagnosis, which the Veteran and his brother have not shown he possesses. Thus, the threshold element of a service connection claim (a current disability) has not been met; therefore, service connection for headaches must be denied. Brammer v. Derwinski, 3 Vet. App. 223 (1992). Evan M. Deichert Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board J. Henriquez, 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.