Citation Nr: 21022479 Decision Date: 04/15/21 Archive Date: 04/15/21 DOCKET NO. 13-34 039 DATE: April 15, 2021 ORDER Entitlement to service connection for a right shoulder disability is denied. FINDING OF FACT The preponderance of the evidence is against finding that the Veteran’s right shoulder disability began during active service or is otherwise related to an in-service injury or disease. CONCLUSION OF LAW The criteria for service connection for a right shoulder disability have not been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran had active service from September 1971 to July 1974 in the United States Navy, and from February 2003 to May 2003 in the United States Coast Guard, with additional service in the Coast Guard Reserve. The matter on appeal comes before the Board from a January 2013 rating decision. In October 2016, the Veteran testified before the undersigned Veterans Law Judge. A transcript of the proceeding has been associated with the claims file. This matter was previously before the Board in March 2020, at which time it was remanded for additional development regarding the Veteran’s right shoulder disability. That development having been completed; the claim is once again before the Board. Service connection may be granted for disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. § 3.303. The three-element test for service connection requires evidence of: (1) a current disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the current disability and the in-service disease or injury. Shedden v. Principi, 381 F.3d 1163, 1166-67 (Fed. Cir. 2004). Additionally, where a veteran served for at least 90 days during a period of war, or after December 31, 1946, and manifests certain chronic diseases, such as arthritis, to a degree of 10 percent or more within one year from the date of termination of such service, such disease shall be presumed to have been incurred in or aggravated in service, even though there is no evidence of such disease during the period of service. 38 U.S.C. §§ 1101, 1112; 38 C.F.R. §§ 3.307, 3.309. Except as otherwise provided by law, a claimant has the responsibility to present and support a claim for benefits under laws administered by the Secretary. The Secretary shall consider all information and lay and medical evidence of record in a case before the Secretary with respect to benefits under laws administered by the Secretary. When there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, the Secretary shall give the benefit of the doubt to the claimant. 38 U.S.C. § 5107; see also Gilbert v. Derwinski, 1 Vet. App. 49, 53 (1990). To deny a claim on its merits, the evidence must preponderate against the claim. Alemany v. Brown, 9 Vet. App. 518, 519 (1996), citing Gilbert, 1 Vet. App. at 54. The Veteran claims he has been treated since his release from active service for a shoulder disability that is directly related to repetitive motions performed while on active duty; specifically, the use of a needle gun to remove paint from ships. In his November 2011 claim, he reported that he has had trouble with his shoulder since his active service, and that using the needle gun caused wear and tear on his shoulder, resulting in his present condition. The Board concludes that, while the Veteran has a current diagnosis of right shoulder arthritis, the preponderance of the evidence weighs against finding that the Veteran’s right shoulder disability began during service or is otherwise related to an in-service injury, event, or disease. 38 U.S.C. § 1110; 38 C.F.R. § 3.303(a), (d); Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009). The Veteran’s service treatment records note only one treatment involving his shoulder, when he fainted and presumably fell on his shoulder. The treatment note stated that the Veteran’s right shoulder was within normal limits. His service treatment records were otherwise silent as to any shoulder disability. His exit examination indicated no upper extremity abnormalities, and he was found to have normal strength and range of motion. The Veteran enlisted in the Coast Guard Reserve in 1979. His enlistment exam was silent as to any shoulder disability and noted normal upper extremities and no painful or “trick” shoulder. Additional reports of medical examination and reports of medical history in 1984, 1988, 1992, 1997, and 2002 were also silent as to any shoulder disability. The Veteran has provided statements that indicate he began treatment for his shoulder immediately upon release from active duty. His private treatment records are not available for any time prior to 1998, despite attempts to request the records. A letter was received from the Veteran’s insurer stating that there were no medical records for the dates requested (prior to 1998, dating back to 1975). The Veteran’s available private medical treatment records show he was first diagnosed with a shoulder disability in 1998, nearly 24 years after his release from active duty. He went to the doctor in June 1998 with a complaint of three months of right shoulder pain and stiffness. The Veteran testified that he sought treatment for his shoulder while on active duty, but there is no documentation of those visits in his medical records. He testified that the doctors would give him aspirin but offered no other treatment or diagnosis. Private practitioner L.F. provided a letter in October 2016 regarding the Veteran’s shoulder. He stated that the Veteran has right shoulder osteoarthritis, and noted the Veteran reported that he was assigned to use a needle gun, which is used with one’s arms fully stretched overhead, and that the Veteran began doing this type of work in 1972. The private practitioner did not actually provide any opinion linking the Veteran’s current condition to service. Thus, the Board affords this letter little probative weight. Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 304 (2008); Reonal v. Brown, 5 Vet. App. 458, 460-61 (1993). The Veteran was afforded a VA examination in November 2020. The VA examiner opined that the Veteran’s shoulder disability is not at least as likely as not related to an in-service injury, event, or disease. The rationale was that the Veteran’s shoulder disability did not begin during active service, did not manifest within one year of discharge, and that no symptoms were noted until 1998. The examiner’s opinion is probative, because it is based on an accurate medical history and provides an explanation that contains clear conclusions and supporting data. Nieves-Rodriguez, 22 Vet. App. at 295, 304. To the extent the Veteran believes his right shoulder disability is related to an in-service injury, event, or disease, the Veteran is not competent to provide a nexus opinion regarding this issue. The issue is medically complex, as it requires knowledge of anatomical relationships and interpretation of complicated diagnostic medical testing. Therefore, it is outside the competence of the Veteran in this case because the record does not show that he has the medical training or credentials to make such a determination. Jandreau v. Nicholson, 492 F.3d 1372, 1377 n.4 (Fed. Cir. 2007); see also Kahana v. Shinseki, 24. Vet. App. 428 (2011). Consequently, the Board gives more probative weight to the November 2020 VA examiner’s opinion. (Continued on the next page)   Accordingly, due to a lack of a probative medical nexus between the current right shoulder disability and the Veteran’s active service, as well as the lack of evidence showing right shoulder arthritis in service or within the first year following his separation from service or for many years thereafter, the claim for service connection for a right shoulder disability must be denied. The Board has duly considered the benefit-of-the-doubt doctrine. However, the preponderance of the probative evidence is against the Veteran’s claim, so that doctrine is not applicable. MICHAEL E. KILCOYNE Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board V. Geer, 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.