Citation Nr: 21025859 Decision Date: 04/29/21 Archive Date: 04/29/21 DOCKET NO. 16-22 554 DATE: April 29, 2021 ORDER Service connection for bump on chest, diagnosed as keloid scar, is granted. Service connection for right shoulder disability is granted. REMANDED Service connection for prostate disability, to include residuals of prostate cancer, is remanded. FINDINGS OF FACT 1. Resolving the benefit of the doubt in favor of the Veteran, the Veteran’s bump on the chest, diagnosed as keloid scar, had its onset during active service. 2. The most probative evidence indicates that the Veteran’s right shoulder disability had its onset in active service. CONCLUSIONS OF LAW 1. The criteria for service connection for bump on chest, diagnosed as keloid scar, have been met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.304. 2. The criteria for service connection for right shoulder disability have been met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.304. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty in the U.S. Army from October 1979 to July 1999. These matters come before the Board of Veterans’ Appeals (Board) on appeal from a June 2014 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO). In November 2018, the Veteran testified at a hearing before the undersigned Veterans Law Judge. A transcript of the hearing is associated with the record. During that hearing, the Veteran clarified that he was not seeking service connection for pseudofolliculitis barbae, but for a bump on his chest. Therefore, the issue on appeal has been reframed as shown on the title page of this decision. In addition, the Veteran explained that he was seeking service connection for residuals of prostate cancer and the Board has therefore reframed the issue on appeal as entitlement to service connection for prostate disability to account for all diagnoses. In June 2019, the Board remanded the Veteran’s case for VA medical examinations. The Board also remanded the issue of service connection for a low back disability for additional development. A July 2020 rating decision granted service connection for the claimed low back disability. Because the benefit sought has been granted in full, the issue is no longer before the Board. The remaining matters have been returned to the Board for review. Service Connection Under the relevant laws and regulations, service connection may be granted for a disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. §§ 1110, 1131. Generally, the evidence must show: (1) the existence of a present disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the present disability and the disease or injury incurred or aggravated during service. Shedden v. Principi, 391 F.3d 1163, 1166-67 (Fed. Cir. 2004). Service connection may be granted for any disease diagnosed after discharge, when all of the evidence, including that pertinent to service, establishes that a disease was incurred in service. 38 C.F.R. § 3.303(d). Service connection for bump on chest previously claimed as pseudofolliculitis barbae The current medical evidence of record shows a diagnosis of keloid scar, mid chest. Service medical treatment records do not reflect any notation concerning a bump on the chest or scar. A January 1999 separation report of medical examination does not indicate any skin abnormality. The Veteran did not indicate the presence of a growth or a history of such, but did reply “don’t know” rather than denying such. Following separation from service, a January 2005 treatment record shows that the Veteran complained of a growth on his chest that had grown over the past couple of years. Though the handwriting is somewhat illegible, the record indicated that the condition had been present since 1991. The bump had started very small, but had increased in size through the years. The record indicated the presence of a cyst and that the Veteran should follow up for removal. A December 2012 treatment record shows that the skin examination was positive for a keloid. In November 2019, the Veteran was provided a scars/disfigurement VA examination. The examiner noted the diagnosis of keloid scar, mid chest, unknown etiology. The Veteran reported a large keloid of the mid chest that developed following Desert Storm in the 1990s. The scar was located on the mid chest, mid sternum. The examiner provided a negative etiology opinion, noting that there was no evidence of a keloid scar during service and that there was not enough evidence to report that the current keloid scar of the chest was due to service. In reviewing all evidence of record, the Board finds that the evidence supports service connection. Though the November 2019 VA examiner provided a negative etiology opinion based on the absence of a scar during active service, the Board finds the Veteran competent to report that he noticed a bump on his chest during service because that is a condition within the knowledge and scope of lay witnesses. See Barr v. Nicholson, 21 Vet. App. 303, 307 (2007). The Veteran has competently and credibly reported that the bump grew since service, the medical evidence indicates that the bump was removed thereby manifesting in a scar, and the Board will resolve doubt in favor of the Veteran and grant service connection for keloid scar of the mid chest. See 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102. Service connection for right shoulder disability The Veteran contends that he experienced injuries to his right shoulder during active service and that his pain has continued to this time. The current medical evidence of record shows that the Veteran has been diagnosed with shoulder strain, shoulder impingement, and glenohumeral joint osteoarthritis, and acromioclavicular joint osteoarthritis. Service treatment records show treatment for the right shoulder in 1988. The January 1999 separation report of medical history shows a report of a painful or trick shoulder or elbow and did not specify which shoulder. The separation examination report did not reflect whether reexamination of the upper extremities was normal or abnormal. Post-service treatment records show many complaints and treatment referring to the left shoulder. However, a June 2010 VA treatment record also indicated that the Veteran had pain in the right shoulder as well as the left shoulder. In July 2015, the Veteran reported shoulder problems, but did not specify which shoulder. The Veteran has provided statements concerning his chronic right shoulder pain since service. He is considered competent to report the nature, onset, and course of his pain since service. Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007). In November 2019, the Veteran was provided a VA examination. The report shows a diagnosis of shoulder strain, shoulder impingement, and glenohumeral joint osteoarthritis, and acromioclavicular joint osteoarthritis. The Veteran stated that his condition onset in the 1980s. He explained that he suffered injuries during air assault training and that he experienced chronic right shoulder pain. The examiner provided a negative etiology opinion. The examiner explained that there was evidence of acute shoulder pain in 1988, but no evidence of continuity of care or chronic right shoulder pain during service. There was no evidence of a shoulder condition on separation examination and not enough evidence to support that the Veteran’s right shoulder disability was due to service. Here, the Board acknowledges the November 2019 VA examiner’s negative etiology opinion. However, the examiner did not address the Veteran’s reports of chronic pain since his documented injury during service. See Buchanan v. Nicholson, 451 F.3d 1331, 1336 (Fed. Cir. 2006). Further, the examiner did not discuss that the separation report of medical history indicated a trick or painful shoulder. While the Veteran did not specify which shoulder was the trick or painful shoulder on separation from service, the Board may not presume to find that the Veteran meant the left as opposed to the right shoulder. Therefore, the examiner’s opinion is entitled to little probative value. Given the Veteran’s consistent report of right shoulder pain that began during service as documented in 1988, the Veteran’s competent and credible statements concerning his continued right shoulder pain since service, the Board finds that the Veteran’s right shoulder disability had its onset in active service. Service connection for right shoulder disability is warranted. REASONS FOR REMAND Service connection for prostate disability, to include residuals of prostate cancer is remanded. First, the Veteran reported during his VA examination that he received treatment from Walter Reed Medical Center and that he was told that his prostatitis may cause prostate cancer. Remand is required to obtain these identified records. In addition, review of the record indicates that the Veteran may have been provided a VA examination for prostate cancer in August 2020. There is no copy of any such examination report in the record. On remand, updated VA treatment records, to include any August 2020 VA examination report, must be obtained. Finally, given the additional development ordered in this case, the Board finds that an addendum opinion should be obtained as to the etiology of any prostate disability present. The matters are REMANDED for the following action: 1. Request the Veteran’s treatment records from Walter Reed National Military Medical Center. 2. Request updated VA treatment records, including the copy of any August 2020 VA examination report provided for prostate cancer. If an examination report cannot be located, such must be documented in the record. 3. Then, request an addendum opinion from a suitably qualified examiner concerning the etiology of any prostate disability present. The claims folder must be made available for review. The examiner must opine whether it is at least as likely as not (50 percent probability or higher) that any current prostate disability, to include residuals of prostate cancer, is related to active service, to include the Veteran’s in-service diagnosis of prostatitis and Southwest Asia service. A full and complete rationale must be provided for any opinion reached. 4. Then, adjudicate the issue on appeal. If the benefit sought remains denied, issue a supplemental statement of the case and return the matter to the Board, if otherwise in order. WILLIAM H. DONNELLY Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board J. Seay, 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.