Citation Nr: 21026630
Decision Date: 05/03/21	Archive Date: 05/03/21

DOCKET NO. 16-32 931
DATE: May 3, 2021

REMANDED

Entitlement to service connection for a left shoulder disorder as secondary to the service-connected bilateral knee disabilities is remanded.

Entitlement to service connection for a right shoulder disorder as secondary to the service-connected bilateral knee disabilities is remanded.

Entitlement to service connection for a cervical spine disorder as secondary to the service-connected bilateral knee disabilities is remanded.

REASONS FOR REMAND

The Veteran had active military service from February 1969 to March 1971.

The Board previously remanded this matter in October 2018.  Although the Board regrets further delay, remand is again warranted to ensure compliance with the October 2018 remand directives.  See Stegall v. West, 11 Vet. App. 268, 271 (1998).

1. Entitlement to service connection for a left shoulder disorder as secondary to the service-connected bilateral knee disabilities is remanded.

2. Entitlement to service connection for a right shoulder disorder as secondary to the service-connected bilateral knee disabilities is remanded.

3. Entitlement to service connection for a cervical spine disorder as secondary to the service-connected bilateral knee disabilities is remanded.

The Veteran contends that he suffers from cervical spine (neck) and bilateral shoulder disorders that are caused by or aggravated by his service-connected disabilities of the bilateral knees.  Specifically, the Veteran contends that he had to use crutches for a couple of years due to his knee disabilities, which caused wear and tear of the shoulder and neck problems.  See July 2014 Notice of Disagreement.

Service connection may be established on a secondary basis for a disability that is proximately due to, or the result of a service-connected disease or injury.  38 C.F.R. § 3.310 (a).  Establishing service connection on a secondary basis requires evidence sufficient to show that a current disability exists and that the current disability was either caused by or aggravated by a service-connected disability.  38 C.F.R. § 3.310 (a) (2019); Allen v. Brown, 7 Vet. App. 439 (1995).

Causation and aggravation are independent concepts and should have separate findings and rationales.  Atencio v. O'Rourke, 30 Vet. App. 74 (2018).  An opinion to the effect that one disability "is not caused by or a result of" another disability does not answer the question of aggravation.  El-Amin v. Shinseki, 26 Vet. App. 136, 140-41 (2013).

The October 2018 remand directed the examiner to offer an opinion as to whether any diagnosed bilateral shoulder and cervical spine disorders are caused or aggravated by the service-connected bilateral knee disabilities.

In January 2020, a VA examiner opined that the Veteran's use of crutches did not cause his neck or bilateral shoulder disorders.  However, the January 2020 examiner did not address aggravation.  A remand by the Board confers on the Veteran, as a matter of law, the right to compliance with the remand.  Stegall v. West, 11 Vet. App. 268 (1998).  Remand is again warranted to obtain a VA medical opinion regarding whether the Veteran's neck and shoulder disorders were either caused by or aggravated by his service-connected knee disabilities.

The matters are REMANDED for the following action:

1. Obtain an addendum opinion from an appropriate clinician regarding whether the Veteran's neck and bilateral shoulder disorders were at least as likely as not proximately due to service-connected knee disabilities, or aggravated beyond its natural progression by service-connected knee disabilities, to include use of crutches.

(a.) Separate findings and rationales should be provided for the issues of causation and aggravation.

 

 

JENNIFER HWA

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	C. Casey, 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.