Citation Nr: 21028749 Decision Date: 05/12/21 Archive Date: 05/11/21 DOCKET NO. 19-08 395 DATE: May 12, 2021 ORDER As new and material evidence has been received, the claim for entitlement to service connection for bilateral hearing loss is reopened; to that extent only, the appeal is granted. As new and material evidence has been received, the claim for entitlement to service connection for a bilateral eye disability, to include vision loss and cataracts, is reopened; to that extent only, the appeal is granted. As new and material evidence has been received, the claim for entitlement to service connection for a left ankle disability is reopened; to that extent only, the appeal is granted. As new and material evidence has been received, the claim for entitlement to service connection for a right ankle disability is reopened; to that extent only, the appeal is granted. As new and material evidence has been received, the claim for entitlement to service connection for a lumbar spine disability is reopened; to that extent only, the appeal is granted. As new and material evidence has been received, the claim for entitlement to service connection for a left knee disability is reopened; to that extent only, the appeal is granted. As new and material evidence has been received, the claim for entitlement to service connection for a right knee disability is reopened; to that extent only, the appeal is granted. As new and material evidence has been received, the claim for entitlement to service connection for a left shoulder disability is reopened; to that extent only, the appeal is granted. As new and material evidence has been received, the claim of entitlement to service connection for a right shoulder disability is reopened; to that extent only, the appeal is granted. Entitlement to service connection for a left ankle disability is denied. Entitlement to service connection for a right ankle disability is denied. REMANDED Entitlement to service connection for bilateral hearing loss is remanded. Entitlement to service connection for a bilateral eye disability is remanded. Entitlement to service connection for a left knee disability is remanded. Entitlement to service connection for a right knee disability is remanded. Entitlement to service connection for a lumbar spine disability is remanded. Entitlement to service connection for a left shoulder disability is remanded. Entitlement to service connection for a right shoulder disability is remanded. FINDINGS OF FACT 1. In an October 2013 rating decision, the RO denied the Veteran's claim for entitlement to service connection for bilateral hearing loss; the Veteran did not submit a Notice of Disagreement (NOD), no new and material evidence was received within one year of the decision, and the decision became final. 2. The evidence received since the October 2013 rating decision is not cumulative or redundant of the evidence of record, does relate to an unestablished fact, and does raise a reasonable possibility of substantiating the Veteran's claim of entitlement to service connection for bilateral hearing loss. 3. In a June 2016 rating decision, the RO denied the Veteran's petition to reopen a claim for entitlement to service connection for an eye disability; the Veteran did not submit a NOD, no new and material evidence was received within one year of the decision, and the decision became final. 4. The evidence received since the June 2016 rating decision is not cumulative or redundant of the evidence of record, does relate to an unestablished fact, and does raise a reasonable possibility of substantiating the Veteran's claim of entitlement to service connection for an eye disability. 5. In a February 2018 rating decision, the RO denied the Veteran's claim for entitlement to service connection for a left ankle disability; the Veteran did not submit a NOD, no new and material evidence was received within one year of the decision, and the decision became final. 6. The evidence received since the February 2018 rating decision is not cumulative or redundant of the evidence of record, does relate to an unestablished fact, and does raise a reasonable possibility of substantiating the Veteran's claim of entitlement to service connection for a left ankle disability. 7. In a February 2018 rating decision, the RO denied the Veteran's claim for entitlement to service connection for a right ankle disability; the Veteran did not submit a NOD, no new and material evidence was received within one year of the decision, and the decision became final. 8. The evidence received since the February 2018 rating decision is not cumulative or redundant of the evidence of record, does relate to an unestablished fact, and does raise a reasonable possibility of substantiating the Veteran's claim of entitlement to service connection for a right ankle disability. 9. In an October 2013 rating decision, the RO denied the Veteran's claim for entitlement to service connection for a lumbar spine disability; the Veteran did not submit a NOD, no new and material evidence was received within one year of the decision, and the decision became final. 10. The evidence received since the October 2013 rating decision is not cumulative or redundant of the evidence of record, does relate to an unestablished fact, and does raise a reasonable possibility of substantiating the Veteran's claim of entitlement to service connection for a lumbar spine disability. 11. In an October 2013 rating decision, the RO denied the Veteran's claim for entitlement to service connection for a left knee disability; the Veteran did not submit a NOD, no new and material evidence was received within one year of the decision, and the decision became final. 12. The evidence received since the October 2013 rating decision is not cumulative or redundant of the evidence of record, does relate to an unestablished fact, and does raise a reasonable possibility of substantiating the Veteran's claim of entitlement to service connection for a left knee disability. 13. In an October 2013 rating decision, the RO denied the Veteran's claim for entitlement to service connection for a right knee disability; the Veteran did not submit a NOD, no new and material evidence was received within one year of the decision, and the decision became final. 14. The evidence received since the October 2013 rating decision is not cumulative or redundant of the evidence of record, does relate to an unestablished fact, and does raise a reasonable possibility of substantiating the Veteran's claim of entitlement to service connection for a right knee disability. 15. In a February 2018 rating decision, the RO denied the Veteran's claim for entitlement to service connection for a left shoulder disability; the Veteran did not submit a NOD, no new and material evidence was received within one year of the decision, and the decision became final. 16. The evidence received since the February 2018 rating decision is not cumulative or redundant of the evidence of record, does relate to an unestablished fact, and does raise a reasonable possibility of substantiating the Veteran's claim of entitlement to service connection for a left shoulder disability. 17. In a February 2018 rating decision, the RO denied the Veteran's claim for entitlement to service connection for a right shoulder disability; the Veteran did not submit a NOD, no new and material evidence was received within one year of the decision, and the decision became final. 18. The evidence received since the February 2018 rating decision is not cumulative or redundant of the evidence of record, does relate to an unestablished fact, and does raise a reasonable possibility of substantiating the Veteran's claim of entitlement to service connection for a right shoulder disability. 19. The preponderance of the evidence demonstrates that the Veteran does not have a current diagnosis for a left ankle disability. 20. The preponderance of the evidence demonstrates that the Veteran does not have a current diagnosis for a right ankle disability. CONCLUSIONS OF LAW 1. The October 2013 rating decision that denied the claim for entitlement to service connection for bilateral hearing loss is final. 38 U.S.C. § 7105; 38 C.F.R. §§ 19.52, 20.1103. 2. New and material evidence has been received to reopen a claim for entitlement to service connection for bilateral hearing loss. 38 U.S.C. § 5108; 38 C.F.R. § 3.156. 3. The June 2016 rating decision that denied the petition to reopen a claim for entitlement to service connection for an eye disability is final. 38 U.S.C. § 7105; 38 C.F.R. §§ 19.52, 20.1103. 4. New and material evidence has been received to reopen a claim for entitlement to service connection for an eye disability. 38 U.S.C. § 5108; 38 C.F.R. § 3.156. 5. The February 2018 rating decision that denied the claim for entitlement to service connection for a left ankle disability is final. 38 U.S.C. § 7105; 38 C.F.R. §§ 19.52, 20.1103. 6. New and material evidence has been received to reopen a claim for entitlement to service connection for a left ankle disability. 38 U.S.C. § 5108; 38 C.F.R. § 3.156. 7. The February 2018 rating decision that denied the claim for entitlement to service connection for a right ankle disability is final. 38 U.S.C. § 7105; 38 C.F.R. §§ 19.52, 20.1103. 8. New and material evidence has been received to reopen a claim for entitlement to service connection for a right ankle disability. 38 U.S.C. § 5108; 38 C.F.R. § 3.156. 9. The October 2013 rating decision that denied the claim for entitlement to service connection for a lumbar spine disability is final. 38 U.S.C. § 7105; 38 C.F.R. §§ 19.52, 20.1103. 10. New and material evidence has been received to reopen a claim for entitlement to service connection for a lumbar spine disability. 38 U.S.C. § 5108; 38 C.F.R. § 3.156. 11. The October 2013 rating decision that denied the claim for entitlement to service connection for a left knee disability is final. 38 U.S.C. § 7105; 38 C.F.R. §§ 19.52, 20.1103. 12. New and material evidence has been received to reopen a claim for entitlement to service connection for a left knee disability. 38 U.S.C. § 5108; 38 C.F.R. § 3.156. 13. The October 2013 rating decision that denied the claim for entitlement to service connection for a right knee disability is final. 38 U.S.C. § 7105; 38 C.F.R. §§ 19.52, 20.1103. 14. New and material evidence has been received to reopen a claim for entitlement to service connection for a right knee disability. 38 U.S.C. § 5108; 38 C.F.R. § 3.156. 15. The February 2018 rating decision that denied the claim for entitlement to service connection for a left shoulder disability is final. 38 U.S.C. § 7105; 38 C.F.R. §§ 19.52, 20.1103. 16. New and material evidence has been received to reopen a claim for entitlement to service connection for a left shoulder disability. 38 U.S.C. § 5108; 38 C.F.R. § 3.156. 17. The February 2018 rating decision that denied the claim for entitlement to service connection for a right shoulder disability is final. 38 U.S.C. § 7105; 38 C.F.R. §§ 19.52, 20.1103. 18. New and material evidence has been received to reopen a claim for entitlement to service connection for a right shoulder disability. 38 U.S.C. § 5108; 38 C.F.R. § 3.156. 19. The criteria for entitlement to service connection for a left ankle disability have not been met. 38 U.S.C. §§ 1110, 5103, 5103A, 5107; 38 C.F.R. §§ 3.102, 3.159, 3.303. 20. The criteria for entitlement to service connection for a right ankle disability have not been met. 38 U.S.C. §§ 1110, 5103, 5103A, 5107; 38 C.F.R. §§ 3.102, 3.159, 3.303. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty in the U.S. Army from March 1961 to May 1964. These matters come before the Board of Veterans' Appeals (Board) on appeal from a July 2018 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO). The Veteran testified before the undersigned Veterans Law Judge at a February 2021 Virtual hearing. A transcript of this hearing is of record. The July 2018 rating decision reopened the claims for service connection for bilateral hearing loss, a left shoulder disability, and a right shoulder disability; and denied the claims for service connection for bilateral hearing loss, a left shoulder disability, and a right shoulder disability. Despite the RO's action, the Board must perform its own de novo review of whether new and material evidence has been received to reopen the claims of entitlement to service connection for bilateral hearing loss, a left shoulder disability, and a right shoulder disability before addressing the claims on their merits. See 38 U.S.C. § 7104; see also Barnett v. Brown, 83 F.3d 1380 (Fed. Cir. 1996). In February 2021, the Veteran submitted additional evidence in support of his appeal along with a signed waiver of RO consideration of evidence. The Board accepts this evidence for inclusion in the record. See 38 C.F.R. § 20.1305. Duties to Notify and Assist Pursuant to the Veterans Claims Assistance Act (VCAA), VA has duties to notify and assist claimants in substantiating a claim for VA benefits. 38 U.S.C. §§ 5102, 5103, 5103A, 5107; 38 C.F.R. §§ 3.102, 3.156(a), 3.159. Neither the Veteran nor his representative has raised any issues with the duty to notify or duty to assist. See Scott v. McDonald, 789 F.3d 1375, 1381 (Fed. Cir. 2015) (holding that "the Board's obligation to read filings in a liberal manner does not require the Board . . . to search the record and address procedural arguments when the veteran fails to raise them before the Board."); Dickens v. McDonald, 814 F.3d 1359, 1361 (Fed. Cir. 2016) (applying Scott to a duty to assist argument). New and Material Evidence Rating actions are final and binding based on evidence on file at the time the claimant is notified of the decision and may not be revised on the same factual basis except by a duly constituted appellate authority. 38 C.F.R. § 3.104(a). The claimant has one year from notification of a RO decision to initiate an appeal by filing a notice of disagreement (NOD) with the decision, and the decision becomes final if an appeal is not perfected within the allowed time period. 38 U.S.C. § 7105(b) and (c); 38 C.F.R. §§ 3.160(d), 19.20, 19.21, 19.22, 19.52. If new and material evidence is presented or secured with respect to a claim which has been disallowed, the Secretary shall reopen the claim and review the former disposition of the claim. New evidence means existing evidence not previously submitted to agency decisionmakers. Material evidence means existing evidence that, by itself or when considered with previous evidence of record, relates to an unestablished fact necessary to substantiate the claim. New and material evidence can be neither cumulative nor redundant of the evidence of record at the time of the last prior final denial of the claim sought to be reopened, and must raise a reasonable possibility of substantiating the claim. 38 C.F.R. § 3.156(a). The U.S. Court of Appeals for Veterans Claims (Court) has held that the determination of whether newly submitted evidence raises a reasonable possibility of substantiating the claim should be considered a component of the question of what is new and material evidence, rather than a separate determination to be made after the Board has found that evidence is new and material. See Shade v. Shinseki, 24 Vet. App. 110 (2010). The Court further held that new evidence would raise a reasonable possibility of substantiating the claim if, when considered with the old evidence, it would at least trigger the Secretary's duty to assist by providing a medical opinion. Id. For the purpose of establishing whether new and material evidence has been submitted, the credibility of the evidence is to be presumed. Justus v. Principi, 3 Vet. App. 510, 513 (1992). 1. Whether new and material evidence has been received to reopen a claim for entitlement to service connection for bilateral hearing loss In an October 2013 rating decision, the RO denied the Veteran's original claim for entitlement to service connection for bilateral hearing, because the evidence did not meet VA criteria for defective hearing. That decision is final. Since the Veteran's last prior final denial in October 2013, the record includes an April 2018 VA examination, which reflects a diagnosis for bilateral hearing loss that meets VA standards. The Board finds that this evidence is new as it was not previously of record and tends to relate to an unestablished fact necessary to substantiate the underlying claim of service connection. The April 2018 VA examination will be presumed credible for the purpose of reopening the claim. Consequently, the claim of entitlement to service connection for bilateral hearing loss is reopened. 2. Whether new and material evidence has been received to reopen a claim for entitlement to service connection for a bilateral eye disability, to include vision loss and cataracts In a June 1994 rating decision, the RO denied the Veteran's original claim for entitlement to service connection for an eye disability, because there was no evidence of a diagnosis or treatment for a chronic eye condition and service medical records (SMRs) were negative for complaints or treatment for a chronic eye condition. That decision is final. In a June 2016 rating decision, the RO denied the Veteran's petition to reopen a claim for entitlement to service connection for an eye disability and found that no new and material evidence had been received. That decision is final. Since the Veteran's last prior final denial in June 2016, the record includes December 2017 VA treatment records documenting diagnoses for left eye cataract and bilateral eye transient vision loss. The Board finds that this evidence is new as it was not previously of record and tends to relate to an unestablished fact necessary to substantiate the underlying claim of service connection. The December 2017 VA treatment records will be presumed credible for the purpose of reopening the claim. Consequently, the claim of entitlement to service connection for an eye disability is reopened. 3. Whether new and material evidence has been received to reopen a claim for entitlement to service connection for a left ankle disability 4. Whether new and material evidence has been received to reopen a claim for entitlement to service connection for a right ankle disability In a February 2018 rating decision, the RO denied the Veteran's original claims for entitlement to service connection for a left ankle disability and a right disability, because there was no currently diagnosed disability, no evidence of an in-service event, disease, or injury, and no SMRs with complaints, treatment, or diagnosis for any ankle problems. That decision is final. Since the Veteran's last prior final denial in February 2018, the record includes February 2021 Board testimony in which the Veteran testified that he sustained injuries to his ankles from his parachute jumps and other strenuous physical activity he performed as a paratrooper. The Board finds that this evidence is new as it was not previously of record and tends to relate to an unestablished fact necessary to substantiate the underlying claims of service connection. The February 2021 Board testimony will be presumed credible for the purpose of reopening the claims. Consequently, the claims of entitlement to service connection for a left ankle disability and a right ankle disability are reopened. 5. Whether new and material evidence has been received to reopen a claim for entitlement to service connection for a lumbar spine disability In an October 2013 rating decision, the RO denied the Veteran's original claim for entitlement to service connection for a lumbar spine disability, because there were no complaints, treatment, or diagnosis for back problems in his SMRs, no evidence of an in-service event, injury, or disease, and no link between his current back problems and his military service. That decision is final. Since the Veteran's last prior denial in October 2013, the record includes February 2021 Board testimony in which the Veteran testified that he first noticed his back problems during service after performing a few parachute jumps and that his back problems continued after service. The Board finds that this evidence is new as it was not previously of record and tends to relate to an unestablished fact necessary to substantiate the underlying claim of service connection. The February 2021 Board testimony will be presumed credible for the purpose of reopening the claim. Consequently, the claim of entitlement to service connection for a lumbar spine disability is reopened. 6. Whether new and material evidence has been received to reopen a claim for entitlement to service connection for a left knee disability 7. Whether new and material evidence has been received to reopen a claim for entitlement to service connection for a right knee disability In an October 2013 rating decision, the RO denied the Veteran's original claims for entitlement to service connection for a left knee disability and a right knee disability, because there were no complaints, treatment, or diagnosis in his SMRs for knee problems, no evidence of an in-service event, disease, or injury, and no link between his current knee problems and his military service. That decision is final. Since the Veteran's last prior final denial in October 2013, the record includes February 2021 Board testimony in which the Veteran testified that his knee pain began during jump school in 1963 and continued after service. The Board finds that this evidence is new as it was not previously of record and tends to relate to an unestablished fact necessary to substantiate the underlying claims of service connection. The February 2021 Board testimony will be presumed credible for the purpose of reopening the claims. Consequently, the claims of entitlement to service connection for a left knee disability and a right knee disability are reopened. 8. Whether new and material evidence has been received to reopen a claim for entitlement to service connection for a left shoulder disability 9. Whether new and material evidence has been received to reopen a claim of entitlement to service connection for a right shoulder disability In a February 2018 rating decision, the RO denied the Veteran's original claims for entitlement to service connection for a left shoulder disability and a right shoulder disability, because there were no complaints, treatment, or diagnosis in his SMRs for shoulder problems, no evidence of an in-service event, disease, or injury, and no link between his current shoulder problems and his military service. That decision is final. Since the Veteran's last prior final denial in February 2018, the record includes February 2021 Board testimony in which the Veteran testified that his bilateral shoulder problems developed due to his parachute landings and carrying heavy equipment on his shoulders. The Board finds that this evidence is new as it was not previously of record and tends to relate to an unestablished fact necessary to substantiate the underlying claims of service connection. The February 2021 Board testimony will be presumed credible for the purpose of reopening the claims. Consequently, the claims of entitlement to service connection for a left shoulder disability and a right shoulder disability are reopened. Service Connection 10. Entitlement to service connection for a left ankle disability 11. Entitlement to service connection for a right ankle disability The Veteran asserts that his bilateral ankle problems developed during his active service from his duties as a paratrooper. He contends that he twisted his bilateral ankles repeatedly following his parachute jumps, but that he would treat his ankles himself using ankle wraps, heat, and the whirlpool. He also described how his ankles would roll over many times during his long hikes during service. Currently, the Veteran said that he had ankle problems characterized as sometimes rolling over, twisting, turning, and feeling like it was disconnected. He said that his symptoms could last for a week. He said that he treated his ankle symptoms himself. See February 2021 Board hearing transcript. Service connection may be granted for a disability resulting from disease or injury incurred in or aggravated by service. 38 U.S.C. § 1110; 38 C.F.R. § 3.303(a). Generally, service connection requires: (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. See Shedden v. Principi, 381 F.3d 1163, 1166-67 (Fed. Cir. 2004); see also Caluza v. Brown, 7 Vet. App. 498 (1995). Service connection may also be granted for any disease diagnosed after discharge when the evidence establishes that the disease was incurred in service. 38 C.F.R. § 3.303(d). The question before the Board is whether the Veteran has a current diagnosis for a left ankle disability and a right ankle disability. Based on a careful review of all the subjective and clinical evidence, the preponderance of the evidence weighs against finding service connection for a left ankle disability and a right ankle disability is warranted. The Veteran's service treatment records do not document any findings related to any complaints, treatment, or diagnosis for any ankle problems. At his April 1964 separation examination, the Veteran's lower extremities and feet clinical evaluation results were normal, and no pertinent symptomatology was reported on his associated report of medical history. A review of the Veteran's private and VA treatment records do not show that he sought any treatment or reported any complaints for left or right ankle problems. Notably, October 1999 and November 2002 private treatment records reflect that the Veteran had normal ankles upon clinical evaluation. No further treatment records document any ankle problems. The Board recognizes that in Saunders v. Wilkie, 886 F.3d 1356 (Fed. Cir. 2018), the U.S. Court of Appeals for the Federal Circuit (Federal Circuit) held that pain can constitute a disability under 38 U.S.C. § 1110. However, the Federal Circuit did not hold that the veteran could demonstrate service connection simply by asserting subjective pain. Rather, to establish a disability, the veteran's pain must amount to a functional impairment. The Federal Circuit held that to establish the presence of a disability, the veteran will need to show that his or her pain reaches the level of a functional impairment of earning capacity. Id. at 1363. A recent decision by the U.S. Court of Appeals for Veterans Claims (Court) in Wait v. Wilkie, 33 Vet. App. 8 (2020) provided further guidance on the Saunders test for establishing pain as a disability. Under Wait, the Court found that a disability under Saunders requires competent evidence demonstrating that the symptoms result in functional impairment that in fact affects the veteran's earning capacity. In determining whether a veteran's impairment rises to a level affecting earning capacity, VA can consider manifestations of similar severity, frequency, and duration as those VA has determine by regulation would cause impaired earning capacity in an average person. The rating schedule may serve as a guide to determine whether certain symptoms may impair earning capacity; however, it is not dispositive. Id. at 17. In this case, the Board finds that the Veteran has not presented any competent evidence that his bilateral ankle symptoms result in functional impairment that in fact affects his earning capacity. Rather, the Veteran has testified that he treated his ankle problems himself, and he has not reported any ankle problems to his physicians, despite seeking treatment for other medical problems. These actions suggest that the Veteran's ankle problems were not of such severity, frequency, or duration that his earning capacity was affected. Furthermore, the Veteran has not reported any functional impairment specifically associated with his bilateral ankles. Accordingly, the Board finds that the Veteran's bilateral ankle problems do not rise to disability under Saunders and Wait. The Veteran is certainly competent to report his history of symptoms of bilateral ankle problems. Layno v. Brown, 6 Vet. App. 465, 470 (1994). However, the Veteran has not presented any competent and credible evidence of a current diagnosis for a left ankle disability or a right ankle disability, and the available evidence does not support that the Veteran has any persistent symptomatology that would suggest that he has an underlying chronic disability. No underlying disability has been clinically diagnosed during the appeal period or proximate thereto. McClain v. Nicholson, 21 Vet. App. 319 (2007); Romanowsky v. Shinseki, 26 Vet. App. 289 (2013). In summary, the preponderance of the evidence weighs against finding in favor of the Veteran's service connection claims for a left ankle disability and a right ankle disability. Therefore, the benefit-of-the-doubt rule does not apply, and the service connection claims must be denied. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102; Gilbert v. Derwinski, 1 Vet. App. 49 (1990). REASONS FOR REMAND 1. Entitlement to service connection for bilateral hearing loss is remanded. In an April 2018 VA opinion, the VA examiner opined that the Veteran's bilateral hearing loss was less likely than not caused by or a result of military noise exposure. In making that determination, the VA examiner found that the Veteran's hearing was "normal on separation with thresholds too low for any permanent significant shift in hearing thresholds to have occurred from entrance." Further, the VA examiner noted that there was no report of decreased hearing in claims file or at separation. Finally, the VA examiner conceded the Veteran's noise exposure and explained that the relationship between noise, auditory damage and hearing loss is well-documented. However, the VA examiner concluded that auditory damage and hearing loss are not conceded based on noise alone, so a nexus was not established. The Board finds that the April 2018 VA examiner's opinion is inadequate. First, the VA examiner relied, in part, on the finding that the Veteran had normal hearing upon separation. The Court has held that, even though disabling hearing loss may not be demonstrated at the time of separation from service, a veteran may nevertheless establish his entitlement to service connection for a current hearing loss disability by having evidence that the current disability is related to his military service and not the result of intervening or other unrelated factors or causes. See Hensley v. Brown, 5 Vet. App. at 155 (1993); Ledford v. Derwinski, 3 Vet. App. 87, 89 (1992). Notably, the VA examiner did not provide another cause for the Veteran's hearing loss, given that the Veteran denied any post-service noise exposure. Second, the VA examiner indicated that the record did not include any evidence of decreased hearing loss during service. However, at his February 2021 Board hearing, the Veteran testified that he experienced hearing loss during service. Because the April 2018 VA examiner's opinion does not take into consideration the Veteran's reports of the onset and continuity of his hearing loss and relies on a finding of normal hearing upon separation, the Board finds that a remand is required to obtain a supplemental VA opinion. 2. Entitlement to service connection for a bilateral eye disability is remanded. The Veteran asserts that his bilateral eye disability developed from the use of flash grenades during night parachute jumps and training exercises at night. He contends that these actions led him to have poor eyesight. He also testified that he boxed in the U.S. Army and was hit in his left eye. He said that he had to stop boxing, because he had blurry vision and at times, he could not see anything. He currently experienced extreme sensitivity to light. The record includes a February 2021 private opinion from the Veteran's private treating ophthalmologist, Dr. S.S. In that opinion, Dr. S.S. described how the Veteran had previously undergone right eye cataract surgery in 2004 and left eye cataract surgery in 2018. The Veteran currently had posterior vitreous detachments in both eyes. Dr. S.S. opined that "it is likely that his condition was caused by his duty as a Paratrooper." No underlying rationale was provided for the opinion. As a result, the Board finds that the February 2021 private opinion is conclusory, and thus, it is insufficient for adjudicative purposes. See Nieves-Rodriguez, 22 Vet. App. 295 (2008). Because the record does not include any other etiological opinions for the Veteran's bilateral eye disability, a remand is required to obtain a VA opinion. 3. Entitlement to service connection for a left knee disability is remanded. 4. Entitlement to service connection for a right knee disability is remanded. In April 2013, the Veteran was afforded a VA examination for his bilateral knee disability. After conducting an objective evaluation, the VA examiner determined that no diagnosis had been established. The VA examiner did not provide an explanation for this determination. Moreover, a review of the April 2013 VA examination report shows that the Veteran's bilateral knees displayed abnormal findings throughout the examination. Based on these clinical findings, the Board finds that the April 2013 VA examination is inadequate, because no diagnosis was provided for the Veteran's bilateral knee disability. See Barr v. Nicholson, 21 Vet. App. 303, 312 (2007). The record does not include any evidence of a current diagnosis for the Veteran's left or right knees. Accordingly, on remand, the Veteran should be provided another VA examination to confirm his current bilateral knee diagnosis and to provide an etiological opinion. 5. Entitlement to service connection for a lumbar spine disability is remanded. At an April 2013 VA examination, the Veteran was diagnosed with lumbar spine degenerative joint disease (DJD). The VA examiner opined that the Veteran's lumbar spine disability was less likely than not incurred in or caused by service. The VA examiner noted that parachuters sustained wear and tear to their back; however, because the Veteran's records did not contain any medical visits or complaints of low back pain, the VA examiner could not determine when the disc disease developed. Noting that the Veteran was diagnosed with DJD in 2003, the VA examiner found that it was not possible to note when it started. At the February 2021 Board hearing, the Veteran testified that he had back problems during service and that they continued after service. Because the VA examiner relied solely on the lack of medical documentation to find that there was no relationship between the Veteran's current lumbar spine disability and military service, the Board finds that the April 2013 VA examiner's opinion is inadequate. Accordingly, a remand is required to provide a supplemental VA opinion. 6. Entitlement to service connection for a left shoulder disability is remanded. 7. Entitlement to service connection for a right shoulder disability is remanded. At a May 2018 VA examination, the Veteran was diagnosed with bilateral acromioclavicular joint ostearthritis. The VA examiner opined that the Veteran's bilateral shoulder disability was less likely than not incurred in or caused by service. In making that determination, the VA examiner relied solely on the finding that there was a "[l]ong interval without evaluation, imaging or treatment." The VA examiner did not address the Veteran's specific assertions that his bilateral shoulder problems began during service from his parachute jumps and his wearing heavy equipment on his shoulders during jumps. Accordingly, the Board finds that the May 2018 VA examiner's opinion is inadequate, thus, a remand is required to obtain a supplemental VA opinion. The matters are REMANDED for the following actions: 1. Obtain all the outstanding treatment records for the Veteran's bilateral hearing loss, bilateral eye disability, lumbar spine disability, bilateral knee disability, and bilateral shoulder disability that are not currently of record. 2. Obtain an addendum opinion from an appropriate clinician regarding whether the Veteran's bilateral hearing loss is at least as likely as not related to his in-service noise exposure. In providing the above opinion, the clinician should address the Veteran's reports of in-service exposure to noise from firing weapons during qualification and training exercises and on the rifle range. The clinician must also consider the Veteran's statements regarding any post-service occupational or recreational noise exposure, or lack thereof. To the extent that the examiner finds that the Veteran's hearing was normal during military service, the examiner must opine as to whether any post-service noise exposure or any other factor caused his current bilateral hearing loss. Moreover, the examiner must consider the Veteran's statements regarding the onset and continuity of his hearing loss symptoms. A complete rationale with discussion of medical literature for any opinion expressed must be provided. If an opinion cannot be expressed without resort to speculation, discuss why this is the case. 3. Obtain an opinion from an appropriately qualified clinician to determine whether the Veteran's bilateral eye disability, to include vision loss and cataract, is at least as likely as not related to his active duty service. In providing the above opinion, the examiner should address the Veteran's report of vision problems during service from exposure to flash grenades and boxing in the Army. The examiner should also address the February 2021 private opinion by Dr. S.S. A complete rationale with discussion of medical literature for any opinion expressed must be provided. If an opinion cannot be expressed without resort to speculation, discuss why this is the case. 4. Schedule the Veteran for an examination by an appropriately qualified clinician to determine the nature and etiology of his bilateral knee disability. To the extent that the examiner cannot establish a diagnosis for the Veteran's bilateral knee disability, the examiner must explain why any abnormal clinical findings found during the examination are not sufficient to establish a diagnosis. The examiner must opine as to whether the Veteran's bilateral knee disability is at least as likely as not related to his active duty service. In providing the above opinion, the examiner should address the Veteran's reports that his bilateral knee disability was caused by his duties as a paratrooper, to include his parachute jumps. The examiner should also consider the Veteran's assertions regarding the onset and continuity of his bilateral knee pain. A complete rationale with discussion of medical literature for any opinion expressed must be provided. If an opinion cannot be expressed without resort to speculation, discuss why this is the case. 5. Obtain an addendum opinion from an appropriately qualified clinician to determine whether the Veteran's lumbar spine disability is at least as likely as not related to his active duty service. In providing the above opinion, the examiner must address the Veteran's assertions regarding the onset and continuity of his back symptoms and his reports of back problems following parachute jumps in service and from carrying heavy equipment in his backpack during jumps. A complete rationale with discussion of medical literature for any opinion expressed must be provided. If an opinion cannot be expressed without resort to speculation, discuss why this is the case. 6. Obtain an addendum opinion from an appropriately qualified clinician to determine whether the Veteran's bilateral shoulder disability is at least as likely as not related to his active duty service. In providing the above opinion, the examiner must address the Veteran's assertions regarding the onset and continuity of his bilateral shoulder symptoms and his reports of bilateral shoulder problems following parachute jumps in service and from carrying heavy equipment in his backpack during jumps. A complete rationale with discussion of medical literature for any opinion expressed must be provided. If an opinion cannot be expressed without resort to speculation, discuss why this is the case. 7. After the above development has been completed, readjudicate the issues on appeal. If the benefits sought are not granted to the Veteran's satisfaction, send the Veteran and his representative a supplemental statement of the case and provide an opportunity to respond. If necessary, return the case to the Board for further appellate review. LESLEY A. REIN Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Journet Shaw, 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.