Citation Nr: 21024753 Decision Date: 04/26/21 Archive Date: 04/26/21 DOCKET NO. 17-17 091A DATE: April 26, 2021 REMANDED Service connection for left shoulder condition is remanded. REASONS FOR REMAND The Veteran served on active duty from July 1983 to October 1989. This matter comes before the Board of Veterans’ Appeals (Board) from an August 2015 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO). In August 2019, the Veteran testified before the undersigned Veterans Law Judge at a Central Office hearing. A transcript is of record. The Board remanded the appeal in September 2019 and in May 2020 for further development. Service connection for left shoulder condition is remanded. The Veteran seeks service connection for a left shoulder condition. In compliance with the Board’s September 2019 remand directives, the Veteran underwent a VA examination in December 2019. The May 2020 Board decision found the December 2019 VA examination was inadequate for adjudication because the opinion did not reflect consideration of the lay evidence of in-service incurrence and reports of self-treatment and remanded the matter for an addendum opinion. In compliance with the May 2020 Board remand, an addendum opinion was obtained in November 2020. Unfortunately, the November 2020 VA addendum opinion appears to reflect that the examiner did not give appropriate consideration of the lay evidence. In providing a negative nexus opinion, the examiner noted only that there is no documented shoulder injury in the Veteran’s claims file that ‘connects him to the time of the 1988 MVA vs Pedestrian accident.’ The addendum opinion does not reflect consideration of the lay reports of in-service incurrence and reports of self-treatment of shoulder symptomatology. See Dalton v. Nicholson, 21 Vet. App. 23 (2007). Accordingly, on remand, an addendum opinion must be obtained. The matters are REMANDED for the following action: Obtain an addendum opinion from an appropriate clinician regarding whether the Veteran’s current left shoulder strain is at least as likely as not related to his May 1988 motor vehicle accident and injuries sustained therein. In formation of the opinion and rationale, the examiner should consider the Veteran’s description of his in-service injury and symptoms as well as his post-service symptoms, including his report of self-medicating with over-the-counter pain medications since the 1988 MVA in service. The examiner should note if there is any medical reason to accept or reject the proposition that the Veteran’s reported injury and symptoms in service and thereafter represented the onset of his current left shoulder strain. Stated another way, the examiner should indicate if the Veteran’s subjective reports about his in-service and post-service symptoms, and the objective clinical history as shown in the service treatment records, align with how left shoulder strain is known to develop. Or, on the other hand, if his reported symptoms are generally inconsistent with medical knowledge and/or implausible considering the nature of the MVA event and the cumulative evidence. The examiner is advised that the Veteran sustained a three-inch left posterior shoulder scar as a result of the in-service accident according to a December 1989 VA examination. The service treatment records do not, however, appear to reflect complaints, treatment or diagnosis of a chronic left shoulder condition. The Veteran is currently service-connected for a left scapular scar. D. JOHNSON Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board M.Aoughsten, 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.