Citation Nr: 21042204 Decision Date: 07/12/21 Archive Date: 07/12/21 DOCKET NO. 18-09 548 DATE: July 12, 2021 REMANDED Entitlement to service connection for a left shoulder disability, including as secondary to a service-connected right shoulder disability, is remanded. Entitlement to service connection for residuals of a left-hand injury is remanded. REASONS FOR REMAND The Veteran had active duty service from July 1985 to October 1991. These matters come before the Board of Veterans' Appeals (Board) on appeal from a September 2017 rating decision issued by a Department of Veterans Affairs (VA) Regional Office (RO), which, in relevant part, denied service connection for a left shoulder injury and residuals of a left hand injury. The Veteran and his wife testified before the undersigned Veterans Law Judge (VLJ) at a hearing in December 2020. A copy of the transcript has been reviewed and associated with the claims file. 1. Entitlement to service connection for a left shoulder disability, including as secondary to a service-connected right shoulder disability, is remanded; 2. Entitlement to service connection for residuals of a left-hand injury is remanded. The Veteran asserts that he has current left hand and left shoulder pain that are related to injuries incurred in service. He also asserts that his left shoulder disability is secondary to his service-connected right shoulder disability. The Veteran's service-treatment records reveal that he separated his shoulders in 1985 and complained of stiffness. He complained of pain in his left hand in 1986. The Veteran underwent a shoulder VA examination in January 2018, at which time he was assessed with a right shoulder disability. He referenced bilateral shoulder separations during service. The examination report only focused on the right shoulder, however. The Veteran testified at a hearing in December 2020. During the hearing, he indicated that he injured his left shoulder during a competition in service and was told to push through the pain after he went to a field medic in Germany. He self-treated after service and was also taking pain medication due to an unrelated back injury. When he started working for his current employer, he noticed the left shoulder pain. The Veteran also noted that his left hand was injured in service when a fellow soldier accidentally shut the tailgate of a vehicle on his hand. He took Tylenol for pain after the injury. He continues to have pain, pins and needles, and problems gripping objects with his left hand. Given that the Veteran has current complaints of pain that may be related to service, the Board finds that VA examinations are warranted to determine the nature and etiology of any left hand and/or left shoulder disability or pain. See Saunders v. Wilkie, 886 F.3d 1356 (2018) (pain alone can serve as a disability for VA compensation purposes if the pain results in functional impairment that affects earning capacity). Lastly, the Veteran testified at the hearing in December 2020 and indicated that he was receiving care from a healthcare provider outside of VA for his left hand and left shoulder pain. Accordingly, the Board finds that the RO should attempt to obtain these records on remand. The matters are REMANDED for the following actions: 1. Obtain and associate with the claims file the Veteran's updated VA treatment records from February 2018 to the present. 2. Ask the Veteran to identify his private healthcare provider(s) for his left hand and/or left shoulder disabilities and furnish the appropriate release(s) for the medical records. If he fails to furnish the necessary release(s), he or she should be advised to obtain the records and submit them to VA. 3. After completion of #1 and #2, schedule the Veteran for VA examination(s) to determine the nature and etiology of any left hand and/or left shoulder disabilities. The claims file, including a copy of this remand, must be reviewed by the examiner and such review should be noted in the examination report. The examiner should identify all left hand and/or left shoulder disabilities found on examination and/or identified during the pendency of this claim (2016) and respond to the following: A. For any diagnosed left shoulder and/or left hand disability, is it at least as likely as not (probability of at least 50 percent) that they had their onset in and/or are otherwise related to the Veteran's period of active service? B. If there is no diagnosed disability, is it at least as likely as not (probability of at least 50 percent) that any left hand and/or left shoulder disability reaches the level of functional impairment? Describe the impairment caused. If so, is it at least as likely as not (probability of at least 50 percent) that this pain had its onset in and/or is otherwise etiologically related to the Veteran's period of active service? C. With regard to any left shoulder disability or pain, if direct service connection is not found, is it at least as likely as not (probability of at least 50 percent) that the Veteran's left shoulder disability or pain was caused by his service-connected right shoulder disability? If not, is it at least as likely as not (probability of at least 50 percent) that the Veteran's left shoulder disability or pain was aggravated (any incremental increase in disability) by his service-connected right shoulder disability? If aggravation is found, is there medical evidence created prior to the aggravation or between the aggravation and current level of disability that shows a baseline of the Veteran's left shoulder disability prior to aggravation? If so, please identify. The examiner should provide a comprehensive rationale for each opinion provided. The examiner is advised that the Veteran is competent to report his symptoms and history, and such reports are to be considered in formulating any opinion. If any opinion cannot be given without resorting to speculation, the examiner should explain why and state whether the need to speculate is due to a deficiency in the state of general medical knowledge (no one could respond given medical science and the known facts), the record (additional facts are required), or the examiner does not have the knowledge or training. As appropriate, the AOJ should conduct additional development or supplement the record. Eric S. Leboff Veterans Law Judge Board of Veterans' Appeals Attorney for the Board S. Merrick 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.