Citation Nr: 22065131 Decision Date: 11/21/22 Archive Date: 11/21/22 DOCKET NO. 15-34 676 DATE: November 21, 2022 REMANDED Entitlement to service connection for a right shoulder condition is remanded. REASONS FOR REMAND The Veteran served on active duty from February 1982 to June 1989. This matter is on appeal from a March 2012 decision of a Department of Veterans Affairs (VA) Regional Office (RO). In January 2019, a hearing was held before the undersigned. A transcript of the hearing is in the record. The case was previously before the Board in July 2019 and December 2021 when it was remanded for further development. The matter of service connection for carpal tunnel syndrome of the right wrist was previously appealed to the Board. A January 2022 rating decision awarded service connection for carpal tunnel syndrome of the right wrist, evaluated as 10 percent disabling, effective December 14, 2010. As the award of service connection has resolved the appeal that was before the Board, the Board will not further address that matter. Entitlement to service connection for a right shoulder condition is remanded. The Veteran contends that she is entitled to service connection for a right shoulder condition. However, upon review of the record, the Board finds that an additional opinion must be obtained to adequately address the etiology of the Veteran's condition. In this case, VA obtained an additional opinion in January 2022 in which the clinician opined that the Veteran's right shoulder conditions were less likely than not incurred in or caused by service. The clinician stated that the physical examination at the time of separation was negative, and it was highly unlikely that the Veteran had degenerative joint changes at her age at separation. However, the Veteran's service treatment records do not reflect that X-rays or other diagnostic testing of her right shoulder was conducted during the separation examination. Thus, it is unclear upon what evidence the examiner based his conclusion that degenerative changes were not present, and the opinion is inadequate for evaluation purposes. In March 2022, VA obtained an addendum report from another clinician who noted the Veteran's comments regarding persistent pain on separation but stated that the Veteran's lay statements were merely her "lay opinion because such evidence does not constitute medical authority." However, as a layperson, the Veteran is competent to report symptoms such as persistent pain because its manifestations are readily observable. See Jandreau v. Nicholson, 492 F. 3d 1372 (Fed. Cir. 2007). As the examiner's comments make it unclear regarding whether the Veteran's statements in this regard were adequately considered, the Board finds that the March 2022 opinion is inadequate for evaluation purposes. Once VA undertakes the effort to provide an examination or opinion, it must provide an adequate one or, at a minimum, notify the claimant why one will not or cannot be provided. Barr v. Nicholson, 21 Vet. App. 303, 311-12 (2007). An opinion is considered adequate when it describes the disability in sufficient detail so that the Board's evaluation of the claimed disability is a fully informed one. Stefl v. Nicholson, 21 Vet. App. 120, 124 (2007). As these opinions are inadequate for the reasons discussed above, an additional opinion must be obtained. The record also reflects the Veteran receives VA treatment; thus, updated VA treatment records should be associated with the claims file. The matters are REMANDED for the following action: 1. Obtain the Veteran's VA treatment records for the period from December 2021 to the present. 2. After completing the development in item 1, forward the Veteran's claims file to an appropriate clinician, other than the clinicians who provided opinions in January 2022 and March 2022, for the Veteran's claim for service connection for a right shoulder condition. If the reviewing clinician determines that examination of the Veteran is needed in order to respond to the question asked, then an examination (including via telehealth, if necessary) must be scheduled. The reviewing clinician should be requested to provide an opinion (based on a review of the record) to answer the following: Is it at least as likely as not (likelihood is at least approximately balanced or nearly equal, if not higher) that the Veteran's right shoulder condition is related to service, to include as a result of powerlifting and/or the right shoulder contusion diagnosed during service following a motor vehicle accident? In providing an opinion, the examiner is asked to discuss the Veteran's report of persistent pain in the right shoulder during the March 1989 separation examination along with her written statement received at the time of her January 2019 hearing that indicates that she continued to have pain in her right shoulder after service, but did not seek treatment for the pain due to personal matters. The examiner should elicit all necessary information from the Veteran regarding the history of her symptoms and consider her lay statements to reach a fully informed opinion. A complete rationale for all opinions must be provided. If the clinician cannot provide a requested opinion without resorting to speculation, it must be so stated, and the clinician must provide the reasons why an opinion would require speculation. The clinician must indicate whether there was any further need for information or testing necessary to make a determination. Additionally, the clinician must indicate whether any opinion could not be rendered due to limitations of knowledge in the medical community at large and not those of the particular examiner. M. SORISIO Veterans Law Judge Board of Veterans' Appeals Attorney for the Board M. H. White, 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.