Citation Nr: 21024147 Decision Date: 04/22/21 Archive Date: 04/22/21 DOCKET NO. 19-32 682 DATE: April 22, 2021 ORDER Entitlement to service connection for a left shoulder condition is denied. FINDING OF FACT There is no in-service event, injury, or disease, to which Veteran’s left shoulder condition may be related. CONCLUSION OF LAW The criteria for entitlement to service connection for a left shoulder condition are not met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1-4.14, 4.40, 4.45, 4.59, 4.71a. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty in the United States Navy from July 1963 to August 1966. This October 2019 appeal comes before the Board of Veterans’ Appeals (Board) from a March 2018 rating decision issued by the Department of Veterans Affairs (VA) Regional Office (RO) in Hartford, Connecticut. The Board remanded the appeal in July 2020 for additional development including a new VA examination. The RO issued a January 2021 supplemental statement of case (SSOC) continuing the prior denial. The case was then returned to the Board. This appeal has been advanced on docket pursuant to 38 C.F.R. §§ 20.900(c) (2017); 38 U.S.C. § 7107(a)(2) (2012). Service Connection Service connection may be granted for disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. §§ 1110, 1131, 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). The Board will also address presumptive service connection as applicable. 1. Entitlement to service connection for a left shoulder condition The Veteran asserts that his left shoulder condition was caused by a motor vehicle accident during active service. The question for the Board is whether the Veteran has a current disability that began during service or is at least as likely as not related to an in-service injury, event, or disease. The Board finds that, while the Veteran has a diagnosis of left shoulder strain, the preponderance of the evidence is against finding that his left shoulder condition began during active service, or are otherwise related to an in-service injury, event, or disease. While in service in May 1965, the Veteran was involved in a serious motor vehicle accident (MVA) where he was thrown from the vehicle, struck his head, and fell to the ground. See September 2015 STRs. The Veteran reported persistent numbness of the scapula area, however there was no other motor sensory loss. Id. The Veteran was placed in cervical traction and the scapular numbness disappeared. Id. The Veteran was ultimately diagnosed with a cervical spine fracture and underwent surgery on his cervical spine in May 1965. Postoperatively, the Veteran had almost a complete return of range of motion of his cervical spine without any neurologic defect. Id. The STR’s are silent for any diagnosis, complaints, or treatment for any other left shoulder condition. Id. During an August 2005 medical evaluation, the Veteran reported that he had pain on and off in the anterior section of his left shoulder that had started approximately 15 years prior after an electrical shock accident. See March 2018 Medical Treatment Records. The Veteran stated that the pain was worse at night and made it difficult for him to sleep. Id. He was taking prescription medication to treat the pain and indicated he would continue to use it. Id. During a July 2017 medical appointment, the Veteran reported chronic left shoulder pain that had been getting progressively worse, limited range of motion of the shoulder and a tender A/C joint. See January 2018 Medical Treatment Records. During a February 2018 medical appointment, the Veteran indicated that he was still having chronic left shoulder pain. See March 2018 Medical Treatment Records. During a March 2018 VA examination, the Veteran reported that he had pain in the left shoulder, and although he denied flare-ups, he reported that sometimes the pain was worse than other times. He stated he could not reach up or backwards without pain. The VA examiner indicated the Veteran was diagnosed with left shoulder strain, impingement syndrome, rotator cuff tendonitis, and tenosynovitis in 1965, however there are no such left shoulder diagnoses in the medical records. A March 2018 MRI of the Veteran’s left shoulder found no abnormalities. Id. The examiner opined the Veteran’s left shoulder condition was less likely than not caused by service because there was no record of a left shoulder injury due to his cervical spine injury from the 1965 MVA. Id. During a January 2021 VA examination, the Veteran reported pain in his left shoulder when he moved it in the wrong direction or reached up too high, however he was not currently treating the condition. The examiner diagnosed the Veteran with a left shoulder strain and possible rotator cuff condition. The examiner opined that the Veteran’s left shoulder condition was less likely than not related to his military service, or to the MVA in 1965. In support of his opinion he stated that while the STR’s indicate scapula numbness after the accident, the scapula numbness disappeared soon after. The examiner noted the record was silent for any complaint, diagnosis, or treatment for any left shoulder condition until 2005, when the Veteran reported that pain in his left shoulder began after an electric shock accident approximately 15 years prior, in 1990. The VA examiner opined that the Veteran’s current examination was suggestive of a left shoulder rotator cuff condition, which, had it occurred in 1965 after the accident, would have been immediately evident. Further, because the STR’s indicated the Veteran’s scapula numbness disappeared, and since scapula numbness is not a symptom presentation of a rotator cuff condition, the Veteran’s current left shoulder condition was not related to his 1965 MVA. Id. Although the Veteran’s STRs indicate scapula numbness during service after the MVA, the condition disappeared after the Veteran was treated with cervical spine traction, and no neurological defects were noted. The record is silent for any complaints or treatment for a left shoulder condition until a 2005 medical examination, 40 years after service. Further, the Veteran reported during the 2005 examination that the onset of his left shoulder pain was in 1990 as a result of an electric shock accident. Both the March 2018 and January 2021 VA examiners opined that the Veteran’s left shoulder condition was not related to service and the January 2021 examiner provided a detailed analysis in support of their opinion that the Veteran’s condition was not due to the MVA in service. While the Veteran believes that his left shoulder disability is related to his active service, and while he asserts that he had pain in his left shoulder since the MVA in service, the evidence of record does not support his contentions. The Board finds that the March 2018 and January 2021 VA examiner’s opinion, in addition to the Veteran’s STRs and March 2018 medical treatment records, are entitled to more probative value. The Board finds that the preponderance of the evidence shows the Veteran’s left shoulder condition was neither caused nor aggravated by an event, injury, or illness during active service, nor etiologically related to service. The rationale of the March 2018 and January 2021 VA examinations, supported by the service and medical treatment records, simply outweighs the Veteran’s contentions that his left shoulder condition began or was aggravated by service. The Veteran asserted in his October 2019 VA Form 9 that his left shoulder strain with rotator cuff tendonitis “is chronic and a natural consequence of his in service [sic] trauma.” The Veteran offers no support for this proposition, citing no evidence or law. In the year and a half since that filing, and in full awareness of the Board’s July 2020 remand and the reasons therefor, the Veteran has offered no additional argument or evidence in support of his appeal. Such conclusory assertions are of no persuasive value. The Board has considered the benefit-of-the-doubt doctrine; however, the Board does not perceive an approximate balance of positive and negative evidence. The preponderance of the evidence is against an in-service incurrence or aggravation of the disease or injury, and therefore, the claim. The doctrine is not applicable, and the claim for entitlement to service connection for a left shoulder condition must be denied. See 38 U.S.C. § 5107 (b); 38 C.F.R. § 3.102. J. B. FREEMAN Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board C. Aubee, 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.