Citation Nr: 21013379 Decision Date: 03/09/21 Archive Date: 03/09/21 DOCKET NO. 16-48 337 DATE: March 9, 2021 REMANDED The claim of entitlement to service connection for a left knee disability, to include as secondary to service-connected residual right knee internal joint derangement, is remanded. The claim of entitlement to service connection for a right shoulder disability, to include as secondary to service-connected residuals of left shoulder recurrent dislocations, is remanded. The claim of entitlement to service connection for bilateral carpal tunnel syndrome, to include as secondary to bilateral shoulder disabilities, is remanded. REASONS FOR REMAND The Veteran served honorably in the United States Army from October 1992 to October 1996. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a July 2015 rating decision issued by the Department of Veterans Affairs (VA) Regional Office (RO) in San Juan, the Commonwealth of Puerto Rico. The Board previously remanded this matter in April 2019. Although the requested aggravation opinions were obtained, the Board notes that subsequent to the December 2019 examination, the Veteran submitted a statement in support of claim, in February 2020. In this statement, the Veteran contended that he incurred his disabilities as a direct result of being on “jump status” while in service. As related by the Veteran, such status consisted of the Veteran performing parachute jumps from a C-130 aircraft, a C-141 aircraft, and helicopters, in a tactical capacity while at night. In the February 2020 statement, the Veteran also contended that he carried approximately 85 pounds of additional gear (consisting of an M60 machine gun, ammunition, MRE’s, and personal gear) during these jumps. The Veteran added that these jumps were followed by ground missions (sometimes lasting weeks at a time), consisting of patrols, search and rescue, and additional helicopter jumps. To date, these contentions have not been considered insofar as direct service connection is warranted for a left knee condition, right shoulder condition, and bilateral carpal tunnel syndrome. A medical opinion is thereby necessary to consider these contentions. Concerning the Veteran’s bilateral carpal tunnel syndrome, the Board observes that this issue is also inextricably intertwined with the Veteran’s claim for a right shoulder condition, as the Veteran has contended that his carpal tunnel syndrome has been caused or aggravated by his left and right shoulder disabilities. Harris v. Derwinski, 1 Vet. App. 180, 183 (issues are “inextricably intertwined” when a decision on one issue would have a “significant impact” on a veteran’s claim for the second issue). The matters are REMANDED for the following action: 1. Obtain addendum opinions from an appropriate clinician regarding the Veteran’s diagnosed (1) left knee degenerative changes, (2) right shoulder rotator cuff tear status post-surgery, and (3) bilateral carpal tunnel syndrome. If an examination is deemed necessary, one should be conducted, to include via telehealth if feasible. The examiner should opine as to whether: The Veteran’s left knee degenerative changes, right shoulder rotator cuff tear status post-surgery, and bilateral carpal tunnel syndrome are at least as likely as not (i.e., a 50 percent or greater probability) related to an in-service injury, event, or disease, to include tactical, nighttime parachute jumps from a C-130 aircraft, a C-141 aircraft, and helicopters, while wearing approximately 85 lbs. of additional gear and by ground missions (sometimes lasting weeks at a time), consisting of patrols, search and rescue, and additional helicopter jumps. See February 2020 statement. The contents of the entire, electronic claims file, to include a complete copy of this REMAND, must be made available to the designated examiner, and each addendum opinion/examination report should include discussion of the Veteran’s documented history and lay assertions. (Continued on the next page)   The examiner is advised that the Veteran is competent to report his symptoms and history, and that his assertions in this regard must be considered in formulating the requested opinions. If lay assertions in any regard are discounted, the examiner should clearly so state, and explain why. Complete, clearly stated rationales for the conclusions reached must be provided. 2. After the above development, and any additionally indicated development, has been completed, readjudicate the issue on appeal. If the benefit sought is not granted to the Veteran’s satisfaction, send the Veteran and his representative a Supplemental Statement of the Case and provide an opportunity to respond. If necessary, return the case to the Board for further appellate review. Jenna Brant Acting Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board A. Hennessy, 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.