Citation Nr: 21014046 Decision Date: 03/11/21 Archive Date: 03/11/21 DOCKET NO. 15-15 189 DATE: March 11, 2021 REMANDED The issue of service connection for a left shoulder disability as secondary to a service-connected disability is remanded. REASONS FOR REMAND The Veteran served on active duty from June 1967 to October 1968. This case is before the Board of Veterans’ Appeals (Board) on appeal from an April 2013 rating decision from a Department of Veterans Affairs (VA) Regional Office (RO). The Board remanded this matter for further development in December 2018. A Board remand confers on the Veteran, as a matter of law, the right to compliance with the remand orders. Stegall v. West, 11 Vet. App. 268, 271 (1998). Unfortunately, although the Veteran was provided with an additional VA examination, there has not been substantial compliance with the Board’s previous remand directives regarding the issue of service connection for a left shoulder disability as secondary to a balance disturbance caused by a service-connected disability. The examiner did not address the Veteran’s secondary contentions regarding whether service-connected left foot disability causes balance issues and instability, which caused him to fall and resulted in his current left shoulder disability. Another remand is required. The December 2019 VA examiner opined the Veteran’s left shoulder disability is less likely than not proximately due to or the result of the Veteran’s service-connected back disability, bilateral lower radiculopathy, bilateral hip disability, bilateral thigh disability, left foot disability, bilateral hearing loss, or tinnitus. The examiner provided the rationale that there is no documented evidence to support that the progression and or aggravation of the left shoulder disability is due to the Veteran’s service-connected disabilities. The examiner noted he could not find the operative report and the records leading to the left shoulder surgery for review or find any documented evidence to indicate that the left shoulder condition leading to the surgery was due to any of the Veteran’s service-connected disabilities. He found there is currently insufficient objective documented evidence to associate the Veteran’s left shoulder disability to any of his service-connected disabilities; thus, his opinion is that the Veteran’s left shoulder disability is less likely as not proximately due to or the result of the Veteran’s service-connected back disability, bilateral lower radiculopathy, bilateral hip disability, bilateral thigh disability, left foot disability, bilateral hearing loss, or tinnitus. The December 2019 VA examiner’s opinion is incomplete because it does not address the Veteran’s contention that his service-connected foot disability causes instability which caused him to fall and injure his left shoulder resulting in a left shoulder disability. Accordingly, a new addendum opinion is necessary to analyze whether a nexus exists between the Veteran’s left shoulder disability and his service-connected disabilities, including his left foot disability. The matters are REMANDED for the following action: Schedule a VA examination (or telehealth interview, review of the record, etc., if an in-person examination is not feasible). Whether an in-person examination is necessary should be determined by the examiner. The examiner must address the following and provide a rationale for all opinions as to a) Whether the Veteran’s service-connected disabilities, including his left foot disability, result in instability or balance issues. b) Whether the Veteran’s fall resulting in a left shoulder injury is causally linked to his current service-connected disabilities, including his left foot disability. c) Whether the Veteran’s current left shoulder disability is at least as likely as not due to the fall resulting in a left shoulder injury. If the examiner cannot give an opinion without resorting to speculation, the examiner should explain why and state whether the need to speculate is due to a deficiency in the state of general medical knowledge (no one could respond given medical science and the known facts), the record (additional facts are required), or the examiner (does not have the knowledge or training). JAMES L. MARCH Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board S. Costa, 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.