Citation Nr: 21011061 Decision Date: 02/26/21 Archive Date: 02/26/21 DOCKET NO. 18-13 786 DATE: February 26, 2021 REMANDED Entitlement to service connection for a right shoulder condition is remanded. REASONS FOR REMAND The Veteran served on active duty with the United States Marine Corps from February 1975 to September 1995. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a November 2016 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO). The Veteran testified before the Board at a February 2020 videoconference hearing; a transcript of this hearing is associated with the claims file. This matter was previously before the Board in July 2020, when the matter was remanded for further development. Additionally, a claim of service connection for headaches was reopened and granted; that issue is no longer on appeal. The Veteran contends that his right shoulder condition is secondary to his service-connected left shoulder condition. A November 2020 VA medical opinion addressed secondary service connection, but failed to account for all relevant facts in stating her rationale. She found that the left and right shoulders are separate entities and unrelated. She noted degenerative changes in the right shoulder were consistent with and secondary to aging, as shown by 2013 radiology findings. She also noted the Veteran is right-handed, and so used the shoulder more than the left. However, this rationale relies on dated facts. Since 2013, the Veteran’s left shoulder has increased in severity, progressing to a 30 percent disability. The Veteran has competently and credibly reported that as he has favored the left shoulder and strained the right to a greater degree in daily life and physical therapy, including since the 2013 findings the examiner relies on to state changes are age-related. As the opinion is based on outdated findings, and does not clearly consider or address the Veteran’s reports of additional wear and tear, the opinion is inadequate, and remand is required for correction. For completeness, the role, if any, of the service-connected spine condition should be addressed as well. The matter is REMANDED for the following action: 1. Associate with the claims file updated VA treatment records. 2. Schedule the Veteran for a VA shoulder/arm examination. The claims folder must be reviewed in conjunction with the examination. The examiner must identify all current right shoulder disabilities. For each, the examiner must opine as to whether such is at least as likely as not caused or aggravated by the Veteran’s service-connected left shoulder disability and/or his spine disability. The examiner must secure updated radiographic findings and comment on whether changes remain consistent with aging. The examiner must also address whether worsening of the left shoulder, to include reports of increased reliance and wear and tear on the right, has played a role in the current right shoulder disability. A complete rationale for each opinion is required. If the clinician feels that the requested opinion cannot be rendered without resorting to speculation, the clinician must state whether the need to speculate is caused by a deficiency in the state of general medical knowledge (i.e., no one could respond given medical science and the known facts); by a deficiency in the record (i.e., additional facts are required); or a deficiency in the clinician’s knowledge or training. 3. Then, readjudicate the claim. If the benefit sought on appeal remains denied, issue a supplemental statement of the case and, after appropriate time for response, return the matter to the Board if otherwise in order. WILLIAM H. DONNELLY Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board W. Ripplinger, 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.