Citation Nr: 21024216 Decision Date: 04/22/21 Archive Date: 04/22/21 DOCKET NO. 10-13 292 DATE: April 22, 2021 REMANDED Entitlement to service connection for a right shoulder disorder, to include rotator cuff tendonitis, is remanded. Entitlement to service connection for a left shoulder disorder, to include acromioclavicular joint osteoarthritis, is remanded. REASONS FOR REMAND The Veteran served on active duty in the U.S. Marine Corps from August 1981 to August 2001. The matters come before the Board of Veterans’ Appeals (Board) on appeal from a Department of Veterans Affairs (VA) Regional Office (RO) rating decision in October 2008. In a June 2017 decision, the Board denied the claims of service connection for the Veteran’s right and left shoulder disorders. The Veteran appealed the Board decision to the United States Court of Appeals for Veterans Claims (Court). In June 2018, the Court granted the Joint Motion for Remand (JMR) filed by representatives for both parties, vacating the Board’s decision regarding these issues, and remanding the claim to the Board for further proceedings consistent with the joint motion. The issues were remanded by the Board in November 2018 for further development. The Board also notes that, in January 2016, the Veteran testified at hearing before another Veterans Law Judge (VLJ), who has since left the Board. A transcript of the hearing is of record. In March 2021, the Veteran was notified that the VLJ was no longer employed by the Board and was asked if she wished to have another hearing before another VLJ. In April 2021, the Veteran responded that she did not wish to appear at another hearing. As indicated above, the issues on appeal were most recently remanded by the Board in November 2018. At that time, the Board instructed the Agency of Original Jurisdiction (AOJ) to schedule the Veteran for a VA examination to address her claimed bilateral shoulder disorders, to include tendonitis of the right shoulder and osteoarthritis of the left shoulder. Specifically, the examiner was asked to opine whether the Veteran’s current shoulder disorders were at least as likely as not (50 percent or greater probability) related to military service, including her military occupation specialty as a postal worker and administrative clerk requiring daily lifting up to 80 pounds. The examiner was also asked to comment on the Veteran’s lay statements of continuity of symptomatology, including her assertions of pain, burning, weakness, and limitation of motion accompanying her MOS duties. The Veteran was afforded a VA shoulder examination in November 2019. At that time, the examiner confirmed the Veteran’s diagnosed shoulder disabilities, including rotator cuff tendonitis of the right shoulder and left shoulder osteoarthritis. During the evaluation, the Veteran reported that she developed chronic, bilateral shoulder pain in service, which had persisted since service. In providing a negative nexus opinion, the examiner stated that there was no evidence of chronic shoulder pain during service and immediately following retirement from service. It was further indicated that the Veteran did not report any shoulder problems at service separation, despite having reported other ailments. However, the examiner acknowledged that “it is true that military service and as well the veteran’s job description may increase the risk for shoulder problems, but this does not mean she did, in fact, incur an injury to the shoulders.” The Board finds the November 2019 VA medical opinion inadequate. In this regard, the examiner indicated that it was possible that the Veteran’s MOS increased the risk of shoulder problems; however, the examiner found that the Veteran did not sustain an injury in service. The examiner failed to address service records which appear to show some in-service shoulder complaints. For example, in September 1982, the Veteran sought medical attention for a sharp pain in her left shoulder following physical training. The pain was observed upon movement and coughing. The Veteran was advised to avoid lifting, stretching, and upper torso exercises and told to apply heat to the area. See September 1982 Chronological Record of Medical Care. The Veteran also sought care for a cold in December 1998 resulting in symptoms throughout her body including pain and burning sensation in her left shoulder blade. See December 1998 Chronological Record of Medical Care. The following week, the Veteran reported that pain in the left shoulder, near the scapula, had continued throughout the week. See December 1998 Chronological Record of Medical Care. The physician diagnosed the Veteran with a rhomboid strain and prescribed stretching with no pushups or sit-ups. Further, the examiner did not adequately explain why the Veteran’s shoulder disorders are not related to her MOS duties in service. The examiner specifically indicated that the Veteran’s MOS potentially increased the risk of shoulder problems, but no further explanation was provided. In other words, the examiner did not explain why the Veteran’s duties in service did not result in the development of her shoulder problems following service. The examiner also did not provide an explanation as to the cause of the Veteran’s current shoulder disorders, which is especially noteworthy since there does not appear to be any intervening injury of the shoulders following service separation. Therefore, further clarification is needed regarding whether the Veteran’s bilateral shoulder disorders are related to the duties associated with her MOS in service. Accordingly, an addendum opinion should be obtained. The matters are REMANDED for the following actions: 1. Obtain an addendum VA medical opinion from a VA audiologist regarding the nature and likely etiology of the Veteran’s bilateral shoulder disorders. The claims file, including a copy of this Remand, must be made available to, and be reviewed by, the examiner. If another examination is indicated, one should be provided to the Veteran. After a thorough review of the claims file, the examiner is asked to: (a.) Opine as to whether it is at least as likely as not (50 percent or greater probability) that the Veteran’s bilateral shoulder disorders were incurred in service or are otherwise related to the Veteran’s military service, including her MOS as a postal worker and administrative clerk. **The examiner should specifically address the Veteran’s MOS (which required her to lift up to 80 pounds daily). **The examiner is advised that post-service medical evidence of record does not appear to show any intervening injury of the shoulders following service separation. **The examiner should also discuss service treatment records dated in September 1982, where the Veteran sought medical attention for a sharp pain in her left shoulder following physical training. See September 1982 Chronological Record of Medical Care. The Veteran also sought care for a cold in December 1998 resulting in symptoms throughout her body including pain and burning sensation in her left shoulder blade. See December 1998 Chronological Record of Medical Care. The following week, the Veteran reported that pain in the left shoulder, near the scapula, had continued throughout the week. See December 1998 Chronological Record of Medical Care. The physician diagnosed the Veteran with a rhomboid strain and prescribed stretching with no pushups or sit-ups. (b.) The examiner must provide a complete rationale for all opinions rendered. 2. Then, readjudicate the claims on appeal. S. B. MAYS Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board R. Casadei, 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.