Citation Nr: 21032622 Decision Date: 05/27/21 Archive Date: 05/27/21 DOCKET NO. 17-67 515 DATE: May 27, 2021 ISSUES 1. Entitlement to service connection for a right shoulder disability. 2. Entitlement to service connection for a left knee disability. 3. Entitlement to service connection for a low back disability. ORDER Entitlement to service connection for a right shoulder disability is granted. Entitlement to service connection for a left knee disability is granted. Entitlement to service connection for a low back disability is granted. FINDINGS OF FACT 1. The Veteran's right shoulder disability began during active duty service. 2. The Veteran's left knee disability began during active duty service. 3. The Veteran's low back disability began during active duty service. CONCLUSIONS OF LAW 1. The criteria for entitlement to service connection for a right shoulder disability have been met. 38U.S.C. §§1110, 5107; 38C.F.R. §§3.102, 3.303. 2. The criteria for entitlement to service connection for a left knee disability have been met. 38U.S.C. §§1110, 5107; 38C.F.R. §§3.102, 3.303. 3. The criteria for entitlement to service connection for low back disability have been met. 38U.S.C. §§1110, 5107; 38C.F.R. §§3.102, 3.303. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from January 2003 to December 2003 and from December 2008 to October 2016. He received many distinctions, to include the Combat Infantry Badge. This case comes to the Board of Veterans' Appeals (Board) on appeal from a March 2017 rating decision a Department of Veterans Affairs (VA) Regional Office (RO). The Veteran testified before the undersigned during a September 2020 Board videoconference hearing. A copy of the transcript is of record. The Veteran Claims Assistance Act of 2000 (VCAA), in part, describes VA's duties to notify and assist a claimant in substantiating a claim for VA benefits. 38 U.S.C. §§ 5100, 5102, 5103, 5103A, 5106, 5107, 5126 (2012); 38 C.F.R. §§ 3.102, 3.156(a), 3.159, 3.326(a) (2017). Given the favorable decision is a full grant of the issues addressed, further explaining how VA has fulfilled the duties to notify and assist is unnecessary. Bernard v. Brown, 4 Vet. App. 384, 394 (1993). Generally, service connection may be granted for disability or injury incurred in or aggravated by active military service. See 38 U.S.C. §§ 1110, 1131 (West 2014); 38 C.F.R. § 3.303 (2017). If the Veteran engaged in combat with the enemy, and it is claimed that a disease or injury was incurred in such combat, VA shall accept as sufficient proof of service connection satisfactory lay or other evidence of service incurrence, if the lay or other evidence is consistent with the circumstances, conditions, or hardships of such service. 38 U.S.C. § 1154 (b); 38 C.F.R. § 3.304 (d). Even where the combat presumption applies, a veteran must still show that a causal relationship exists between the present disability and the in-service injury or disease. Reeves v. Shinseki, 682 F.3d 988, 999 (Fed. Cir. 2012). Every reasonable doubt must be resolved in the Veteran's favor, and service connection of injuries or diseases linked to combat may be rebutted only by clear and convincing evidence. 38 U.S.C. § 1154 (b). In order to establish service connection for the claimed disorder, there must be (1) competent evidence of a current disability; (2) medical, or in certain circumstances, lay evidence of in-service incurrence or aggravation of a disease or injury; and (3) competent evidence of a nexus between the claimed in-service disease or injury and the current disability. See Hickson v. West, 12 Vet. App. 247, 253 (1999). The determination as to whether these requirements are met is based on an analysis of all the evidence of record and the evaluation of its credibility and probative value. See Baldwin v. West, 13 Vet. App. 1, 8 (1999). When positive and negative evidence approximately balance regarding the merits of an issue material to determining the matter, the benefit of the doubt in resolving each such issue shall be given to the claimant. 38 U.S.C. § 5107 (b). Where pain alone results in functional impairment, even if there is no identified underlying diagnosis, it can constitute a disability. However, subjective pain in and of itself will not establish a current disability. Consideration should be given to the impact, or lack thereof, from pain, focusing on evidence of functional limitation caused by pain. Saunders v. Wilke, 886 F. 3d 1356 (Fed. Cir. 2018). The Veteran's DD Form 214 shows that he was awarded, among other commendations, the Combat Infantry Badge and the Parachutist Badge. This evidence demonstrates that the Veteran participated in combat with the enemy. He stated in his June 2017 notice of disagreement and October 2017 formal appeal that as a Captain in the Army infantry, he injured his lower back while deployed to Afghanistan in 2010 and injured his left knee and right shoulder during his second deployment to Afghanistan in 2012. The Veteran's DD Form 214 shows that he served in a designated imminent danger pay area in Afghanistan in 2010 and again in 2012 to 2013. The Veteran's service treatment records are replete for complaints of lower back pain, to include back pain during deployment. He also stated in his May 2016 report of medical assessment that his right shoulder had gotten worse as well as his left knee. He stated that he suffered from an injury to his right shoulder and left knee while on active duty for which he did not seek medical care. He also stated that he intended to seek VA disability in pertinent part for his back. The Veteran also submitted four lay "buddy" statements in which it was attested that he complained of back pain, shoulder pain, and knee pain in service. It was noted that the Veteran was not able to sit for over an hour without getting up to stretch and complain about his pain. He would also slouch in his chair to mitigate the pain, would punch his calves or backside, would complain of his calves and backside throbbing with pain after runs or go numb, and that he had knee pain. The Veteran's Company Medic stated that during deployment, the Veteran came to see him after they had been attacked by the enemy; the Veteran described that he was directly engaged by small arms fire and bailed from the tower ladder to avoid getting hit. It was noted that this caused him to break a few ribs, injury his knee, and dislocate his shoulder. It was noted that all that could be done for him was to prescribe anti-inflammatories as the Veteran did not leave to seek additional treatment. Another lay "buddy" statement recounted that the Veteran had a bad landing in a parachute jump while deployed. It was noted that the Veteran later had trouble moving his right arm and also complained of pain stemming from his low back and had running problems due to an injury sustained during deployment. The Board finds that the Veteran's stated injuries are consistent with the circumstances, conditions, or hardships of his combat service. See 38 U.S.C. § 1154 (b); 38 C.F.R. § 3.304 (d). At this point the Board notes that during testimony before the undersigned, the Veteran reported that he went in for therapy for his shoulder right after he got out of service. Private medical records from October 2016 shows that the Veteran reported right shoulder pain. The Veteran was afforded VA-contracted examinations in February 2017 in which the claims folder was not reviewed. The examiner found that for the claimed condition of lower back condition with sciatica and McKenzie posterior derangement syndrome, there was no diagnosis because the condition resolved. However, the Veteran reported pain in his back that flared up when he sat too long at one time. In regards to the left knee, the Veteran reported that the condition began during a combat [jump] when the brunt of landing was with his left leg. The examiner stated that the condition resolved. In regards to the right shoulder, the Veteran reported onset of symptoms of pain in 2012 when he jumped from a guard [tower] to take cover from incoming rounds. The Veteran also stated that his shoulder injury occurred in a parachute jump. Additionally, at the September 2020 Board hearing, the Veteran testified as to his pain that causes functional limitation, to include his knee pain causing him to be less effective; his back pain would cause him limitation in a sitting job causing him to have to get up and punch his rear in order to regain feeling. The Veteran is competent to report pain. This is highly probative evidence in favor of the claims, and there is no evidence in the record to the contrary. The Veteran provided competent lay observations, supported by his service treatment records, credible lay "buddy" statements, and treatment records. Therefore, the Board concludes that the evidence is at least in equipoise that the Veteran has experienced right shoulder, left knee, and low back pain and symptoms thereof, during and since service. See Davidson v. Shinseki, 581 F.3d 1313 (Fed. Cir. 2009); Jandreau v. Nicholson, 492 F. 3d 1372 (2007). In consideration of the evidence of record, the Board finds that the Veteran has right shoulder, left knee, and low back pain attributable to his active service. The Veteran has submitted competent and credible statements and testimony that his right shoulder, left knee, and low back symptoms have continued after service and continue to cause him pain, discomfort, and functional impairment. Saunders, infra. Thus, given these facts, and when resolving doubt in the Veteran's favor, the Board concludes that service connection is warranted for a right shoulder disability, a left knee disability, and a low back disability, and the Veteran's appeal is granted. 38 U.S.C. § 5107 (b); Gilbert v. Derwinski, 1 Vet. App. 49, 53 (1990); 38 C.F.R. §§ 3.102, 3.303(a). MICHAEL A. PAPPAS Veterans Law Judge Board of Veterans' Appeals Attorney for the Board R.M.K., 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.