Citation Nr: 21022868 Decision Date: 04/19/21 Archive Date: 04/19/21 DOCKET NO. 15-39 197 DATE: April 19, 2021 ORDER Service connection for a left shoulder disability is granted. Service connection for a right shoulder disability is granted. Service connection for a right ankle disability is granted. Service connection for a left ankle disability is granted. FINDINGS OF FACT Resolving reasonable doubt in the Veteran’s favor, the evidence indicates that the Veteran has current disabilities of both shoulders and both ankles related to his in-service airborne duties. CONCLUSIONS OF LAW 1. The criteria for service connection for a left shoulder disability are met. 38 U.S.C. §§ 1131, 5107(b); 38 C.F.R. §§ 3.102, 3.303. 2. The criteria for service connection for a right shoulder disability are met. 38 U.S.C. §§ 1131, 5107(b); 38 C.F.R. §§ 3.102, 3.303. 3. The criteria for service connection for a left ankle disability are met. 38 U.S.C. §§ 1131, 5107(b); 38 C.F.R. §§ 3.102, 3.303. 4. The criteria for service connection for a right ankle disability are met. 38 U.S.C. §§ 1131, 5107(b); 38 C.F.R. §§ 3.102, 3.303. REASONS AND BASES FOR FINDING AND CONCLUSIONS The Veteran served on active duty from August 1986 to August 1989. These matters are before the Board of Veterans’ Appeals (Board) on appeal from a July 2017 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO). Jurisdiction of the Veteran’s claims file currently resides with the Los Angeles, California RO. In October 2018, the Veteran testified at a Board hearing before the undersigned. A transcript of the hearing is of record. In April 2019, the Board remanded the issues of entitlement to service connection for bilateral shoulder disabilities, bilateral ankle disabilities, and an acquired psychiatric disorder for further development. Thereafter, in October 2020, a VA RO issued a rating decision granting the Veteran service connection for acquired psychiatric disorders—identified as posttraumatic stress disorder, depression, and anxiety disorder NOS. The Board finds that this grant of service connection constituted a full award of the benefit sought on appeal with respect to that issue. See Grantham v. Brown, 114 F.3d 1156, 1158-59 (Fed. Cir. 1997) (holding that where an appealed claim for service connection is granted during the pendency of the appeal, a second notice of disagreement must thereafter be timely filed to initiate appellate review of the claim concerning “downstream” issues, such as the compensation level assigned for the disability and the effective date). Accordingly, the issue of service connection for an acquired psychiatric disorder is no longer in appellate status. Service Connection Service connection may be established for a disability resulting from disease or injury incurred in or aggravated by service. 38 U.S.C. § 1131; 38 C.F.R. § 3.303. Regulations also provide that service connection is warranted for a disease first diagnosed after discharge when all of the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303(d). Establishing service connection generally requires competent evidence of three things: (1) a current disability; (2) an in-service precipitating disease, injury, or event; and (3) a causal relationship, i.e., a nexus, between the current disability and the in-service event. 38 C.F.R. § 3.303(a); Fagan v. Shinseki, 573 F.3d 1282, 1287 (Fed. Cir. 2009). As indicated above in the Conclusions of Law section, the Board finds that service connection for bilateral shoulder and ankle disabilities is warranted in the instant case. Accordingly, the Veteran’s appeal is granted. In support of this determination, the Board first finds that the Veteran has had current disabilities of the bilateral shoulders and ankles since his claim was received by VA in March 2017. Specifically, regarding the shoulders, the Veteran has received diagnoses of bilateral shoulder impingement syndrome, glenohumeral osteoarthritis, acromioclavicular joint osteoarthritis, degenerative arthritis, shoulder strain, and rotator cuff tears during the appeal period. See November 2020 VA Shoulder and Arm Conditions Examination Report; November 2019 VA Shoulder and Arm Conditions Examination Report; June 2017 VA Shoulder and Arm Conditions Examination Report. Comparatively, regarding the ankles, the Veteran has received diagnoses of bilateral chronic lateral collateral ligament sprain and tendonitis during the appeal period. See November 2020 VA Ankle Conditions Examination Report; October 2019 VA Ankle Conditions Examination Report; June 2017 VA Ankle Conditions Examination Report. Accordingly, the Board concludes that the first service connection requirement of a current disability has been satisfied with respect to each appealed issue. See 38 C.F.R. § 3.303. Turning next to the in-service incurrence requirement, the Board notes that the Veteran has contended that his joints were injuriously impacted by his performance of airborne duties in service. See, e.g., March 2017 VA Form 21-4138. A review of the Veteran’s service personnel records (SPRs) indicates that he was awarded a parachutist badge and, pursuant to orders issued in August 1988, ultimately terminated from parachute duty and designated a medical airborne terminee. Accordingly, the Board finds the in-service incurrence requirement to have been satisfied in this case. Lastly, moving to the remaining nexus requirement, the Board notes that, in November 2020, a VA examiner diagnosed the Veteran with current bilateral shoulder and ankle disabilities and opined that these disabilities were at least as likely as not incurred in or due to service. In support of these conclusions, the November 2020 VA examiner remarked that the Veteran’s current disabilities were injuries consistent with parachuting duties. The Board finds the November 2020 VA examiner’s opinions to be adequate for adjudicative purposes as they (1) were based upon a consideration of the Veteran’s medical history; (2) described the Veteran’s shoulder and ankle disabilities in sufficient detail; and (3) were supported by a rationale. See Stefl v. Nicholson, 21 Vet. App. 120, 124 (2007). Separate from the November 2020 opinions, the Board notes that 3 other VA etiological opinions regarding the shoulders and ankles were provided during the appeal period. Firstly, in June 2017, a VA examiner provided negative opinions concluding that nexuses could not be established regarding the ankles, shoulders, and service. However, these opinions were already deemed inadequate by the Board in April 2019. Comparatively, additional opinions were also provided by a VA medical provider in January 2021. However, the Board deems these opinions of little probative value as they were ultimately inconclusive and directed only at possible activities the Veteran may have experienced immediately after service. Lastly, the Board notes that, in December 2020, another VA medical provider opined that it was less likely as not that the Veteran’s shoulder and ankle disabilities were related to service. The December 2020 opinions were also adequate for adjudicative purposes. See Stefl, supra. Thus, as the case presently stands, the evidence is in relative equipoise as to whether the Veteran’s current bilateral shoulder and ankle disabilities were related to his airborne duties in service. Resolving reasonable doubt in the Veteran’s favor, the Board grants the Veteran’s appeal and concludes that service connection for bilateral shoulder and ankle disabilities is warranted. See 38 C.F.R. §§ 3.102, 3.303. S.C. KREMBS Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board N.S. Pettine, 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.