Citation Nr: 21021292 Decision Date: 04/12/21 Archive Date: 04/12/21 DOCKET NO. 16-11 162 DATE: April 12, 2021 ORDER Entitlement to service connection for a left shoulder disability is denied. FINDING OF FACT The Veteran’s left shoulder disability was not caused or aggravated by a service connected disability, and is not otherwise related to service. CONCLUSION OF LAW The criteria for entitlement to service connection for a left shoulder disability have not been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.304, 3.310. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from May 1973 to May 1975. He died in August 2017 and the appellant is his surviving spouse. This matter comes to the Board of Veterans’ Appeals (Board) on appeal from a July 2012 rating decision of the Department of Veterans Affairs (VA) RO in New Orleans, Louisiana which, inter alia, denied service connection for left shoulder disability. In June 2013, the Veteran filed his notice of disagreement, was issued a statement of the case in January 2016, and in March 2016 perfected his appeal to the Board. As previously noted, the Veteran died in August 2017, and in June 2018, the RO granted the appellant her request for substitution. Since the Veteran had perfected his appeal by timely submitting his Form 9 prior to his death, there were claims pending before VA at the time of his death. See 38 C.F.R. § 3.1010 (g)(1)(ii). In February 2020, the appellant appeared at a videoconference hearing before the undersigned Veterans Law Judge. A copy of the transcript is of record. In August 2020, the Board, among other things, remanded the appellant’s claim for service connection for a left shoulder disability for a new VA examination. For the reasons indicated in the discussion below, the examination that the Board instructed the agency of original jurisdiction (AOJ) to obtain was in fact obtained and is adequate to decide the claim on appeal. Thus, the AOJ complied with the Board’s remand instructions. Stegall v. West, 11 Vet. App. 268, 271 (1998). Service Connection Service connection will be granted if the evidence demonstrates that current disability resulted from an injury suffered or disease contracted in active military, naval, or air service. 38 U.S.C. §§ 1110; 38 C.F.R. § 3.303(a). Establishing service connection generally requires competent evidence of three things: (1) current disability; (2) in-service injury or disease; and (3) a relationship between the two. Saunders v. Wilkie, 886 F.3d 1356, 1361 (Fed. Cir. 2018). Consistent with this framework, service connection is warranted for a disease first diagnosed after service when all the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303(d). Service connection is also warranted for disability proximately due to or the result of a service-connected disease or injury. 38 C.F.R. § 3.310 (a). Such secondary service connection is warranted for any increase in severity of a nonservice-connected disability that is proximately due to or the result of a service-connected disease or injury. 38 C.F.R. § 3.310 (b). LEFT SHOULDER CONDITION In a June 2016 statement, the Veteran’s representative reported that as the Veteran’s joints are not aligned due to his shorter left leg, he has suffered shoulder problems. Additionally, during the appellant’s February 2020 Board hearing, she indicated that the Veteran’s service connected left leg disability caused pain in other parts of his body, as he was forced to favor one leg over the other creating an imbalance. December 2011 VA treatment records reflect the Veteran was treated for left shoulder pain, and indicated that there was an AC joint space narrowing and spurring. In a December 2011 VA examination report, the examiner noted a diagnosis of left shoulder strain from 1974, but the Veteran reported no specific history of injury, and no pain with the shoulder at the time of the motor vehicle accident. The Veteran reported infrequent flare-ups which were triggered with specific movements, such as reaching over head, and/or some lifting. The examiner noted left acromioclavicular joint arthropathy, and opined that the disability was less likely than not (less than a 50 percent probability) incurred in or caused by the claimed in-service injury, event, or illness. The examiner noted that the Veteran did sustain a shoulder injury at the time of the accident, but he now has arthropathy that involves both shoulders suggesting that he has arthritic changes in relation to time and aging, and not just due to trauma from the in-service accident. An August 2017 VA examination report indicated that the Veteran’s left leg was one and a half centimeters shorter than his right leg, and reflected that he used a crutch for balance. In a February 2021 disability benefits questionnaire (DBQ), the examining physician opined that the Veteran’s left shoulder disability was less likely than not (less than a 50 percent probability) proximately due to, or the result of his service connected disability, and was not at least as likely as not aggravated beyond its natural progression by a service connected disability. The physician stated that the Veteran’s left shoulder strain is secondary to joint aging and chronic overuse over the duration of many years and is independent of the Veteran’s left leg disability. For the following reasons, service connection for left shoulder disability is not warranted. The December 2011 examiner indicated that while the Veteran sustained a shoulder injury at the time of his in-service accident, he noted that the Veteran’s arthropathy suggests arthritic changes in relation to time and aging to support his opinion that the Veteran’s left shoulder disability was less likely than not due to service. Additionally, the February 2021 physician also indicated that the Veteran’s left shoulder disability was due to chronic overuse and aging, and not caused or aggravated by a service connected disability. Both the December 2011 examiner and February 2021 physician provided thorough rationales to support their opinions, and based their opinions on an accurate characterization of the evidence of record. Therefore, the December 2011 and February 2021 opinions are afforded significant probative weight. See Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 304 (2008) (most of the probative value of a medical opinion comes from its reasoning). There are no contrary opinions as to the etiology of the Veteran’s left shoulder disability in the evidence of record. Moreover, the Veteran did not indicate, and the evidence of record does not otherwise suggest, that he experienced continuous left shoulder symptoms in and since service. Therefore, neither the lay nor medical evidence suggests that the Veteran had a left shoulder disability that manifested in service and has continued since service, or is otherwise related to service. The Board acknowledges the appellant’s contention that the Veteran’s left shoulder disability was due to a service connected disability. While the appellant is competent to provide testimony or statements relating to symptoms or facts of events that she has observed and are within the realm of her personal knowledge, she is not competent to testify as to complex medical questions such as the nature and etiology of the Veteran’s left shoulder disability. Jandreau v. Nicholson, 492 F.3d 1372, 1376, n. 4 (Fed. Cir. 2007) (“sometimes the layperson will be competent to identify the condition where the condition is simple, for example a broken leg, and sometimes not, for example, a form of cancer”). The appellant’s statements in this regard are therefore not competent. For the foregoing reasons, entitlement to service connection for a left shoulder disability is not warranted. As the preponderance of the evidence is against the claim, the benefit of the doubt doctrine is not for application. 38 U.S.C. § 5107 (b); 38 C.F.R. § 3.102. Jonathan Hager Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board R. Maddox, 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.