Citation Nr: 21029816 Decision Date: 05/17/21 Archive Date: 05/17/21 DOCKET NO. 14-41 565 DATE: May 17, 2021 REMANDED Entitlement to service connection for a left shoulder disability, to include as secondary to service-connected disability, is remanded. Entitlement to an increased rating in excess of 10 percent for patellofemoral syndrome of the left knee with degenerative arthritis is remanded. REASONS FOR REMAND The Veteran had active service from March 1986 to March 1990 and from January 1991 to March 1991. In July 2018, the Veteran testified at a hearing before the undersigned Veterans Law Judge. A transcript of the hearing has been reviewed. These matters were previously remanded for additional development in February 2021. 1. Entitlement to service connection for a left shoulder disability, to include secondary to service-connected disability is remanded. The Veteran contends that he has a left shoulder disability that is related to service. At the Board hearing, he testified that he injured his shoulder using and carrying a 0.50-caliber machine gun that weighed about 70 pounds, and he had dislocations of his shoulder in service. The case was previously remanded for a VA examination. In March 2021, a VA examiner diagnosed left shoulder arthropathy. The examiner opined that the left shoulder disability is less likely than not related to service. The examiner's rationale was that there was an absence of left shoulder complaints during service and at separation. The examiner noted that arthropathy was shown on imaging in 2017 (after 25 years). The examiner concluded that it was not related to service, including firing weapons. The examiner opined that his rotator cuff condition is related to trauma. The March 2021 opinion contains an inaccuracy regarding the Veteran's period of service. The examiner noted that the Veteran had only two months of service, but he actually had more than four years of service. The opinion did not consider a service treatment record dated in January 1990 noting that the Veteran reported bilateral trapezius pain following a rear-end automobile collision. The Veteran is service-connected for cervical radiculopathy of his left upper extremity. A medical opinion regarding secondary service connection has not been obtained. An addendum opinion is necessary to address secondary service connection in addition to the Veteran's complete service treatment records for direct service connection. 2. Entitlement to an increased rating in excess of 10 percent for patellofemoral syndrome of the left knee with degenerative arthritis is remanded. A claim for an increased rating for the patellofemoral syndrome of the left knee was received in June 2015. In February 2021, the case was remanded for an examination to clarify whether the Veteran has a meniscal condition of his left knee. A March 2021 examination indicated that there were no meniscal conditions. The March 2021 examination noted a leg length discrepancy of the left leg. The degree of the leg length discrepancy was not described on the examination. An addendum opinion is necessary to obtain a description of the leg length discrepancy of the left leg. The matters are REMANDED for the following action: 1. Obtain an addendum opinion from an appropriate clinician regarding the Veteran's left shoulder disability. (a) The examiner should provide an opinion as to whether the left shoulder disability is at least as likely as not related to service, including firing weapons in service and the notation of bilateral trapezius pain in January 1990. (b) The examiner should consider the Veteran's statement about his shoulder symptoms in service and his history of more than four years of active service. (c) The examiner should also provide an opinion as to whether his left shoulder disability is proximately due to cervical radiculopathy of the left upper extremity. (d) The examiner should provide an opinion as to whether the left shoulder disability is aggravated beyond its natural progression by cervical radiculopathy of the left upper extremity. Provide a detailed rationale for the opinion. 2. Obtain an addendum opinion from an appropriate examiner regarding the Veteran's left knee disability. The examiner must describe the measurement of the leg length discrepancy of the left leg. The VA examiner should also opine whether any diagnosed left leg length discrepancy disability is proximately due to, the result of, or aggravated by the Veteran's service-connected disabilities, including his service-connected left knee disability. JENNIFER HWA Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Catherine Cykowski 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.