Citation Nr: 22014644 Decision Date: 03/14/22 Archive Date: 03/14/22 DOCKET NO. 17-40 341 DATE: March 14, 2022 REMANDED Entitlement to service connection for a left shoulder disability is remanded. Entitlement to service connection for a right shoulder disability, to include as secondary to a left shoulder disability is remanded. REASONS FOR REMAND The Veteran served on active duty from July 1985 to November 2005. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a September 2014 rating decision issued by a Department of Veterans Affairs (VA) Regional Office (RO). The Veteran testified before the undersigned Veteran's Law Judge (VLJ) at a December 2019 central office hearing. A transcript of the proceeding has been associated with the record. The Board most recently remanded the case in November 2021 for further development. The matters are now back before the Board. 1. Entitlement to service connection for a left shoulder disability is remanded. 2. Entitlement to service connection for a right shoulder disability, to include as secondary to a left shoulder disability is remanded. The Veteran is seeking to establish service connection for a left shoulder disability and a right shoulder disability. Specifically, the Veteran contends his bilateral shoulder disabilities are etiologically related to active duty service. Alternatively, he contends his right shoulder disability is secondary to his left shoulder disability. Unfortunately, the Board finds that additional development is necessary before a decision may be rendered regarding the issues on appeal. Pursuant to the Board's November 2021 remand, VA addendum opinions were rendered in December 2021. Regarding the Veteran's left shoulder, a VA examiner noted that service treatment records reflected complaints of burning in the left shoulder and arm when running and no indication of pain with range of motion, lifting, or other activities. The examiner determined that the Veteran's reported complaints were inconsistent with a musculoskeletal etiology as there were no reported complaints with use of the arm or shoulder. Therefore, the examiner opined that the Veteran's left shoulder disability was less likely as not related to service. Regarding the Veteran's right shoulder disability, the December 2021 VA examiner noted that Veteran had right shoulder pain in 2006 which resolved and had no chronicity of symptoms. The examiner found there was no evidence to suggest that the Veteran's right shoulder was directly related to service and provided a negative nexus opinion. The Board finds that the December 2021 VA opinion for the left shoulder is inadequate for adjudication purposes. Contrary to the examiner's findings, a March 2005 service treatment record reflects that the Veteran reported intermittent burning of the left shoulder with exertion and on a March 2005 Report of Medical History, the Veteran indicated he experienced a burning sensation and pain in the left shoulder "when using." Further, the examiner failed to address the Veteran's assertion that his military occupational specialty (MOS), a machinist's mate, required that he perform a great amount of heavy lifting, resulting in his current left shoulder disability. The Board similarly finds that the December 2021 VA opinion for the right shoulder is inadequate for adjudication purposes. The examiner determined that the Veteran's right shoulder pain resolved in 2006, as was noted in an October 2006 treatment record. However, a December 2006 treatment record indicated that the Veteran reported chronic right shoulder pain and was assessed with right shoulder impingement. A December 2008 treatment record reflects that the Veteran reported limited mobility of the right shoulder since service and a January 2009 treatment record indicates that the Veteran reported right shoulder pain since 2003. The examiner failed to address these records when finding that the Veteran's right shoulder pain had resolved in 2006 and that there was no evidence to suggest that his right shoulder disability was related to service. Further, the examiner failed to address the Veteran's assertion that his duties as a machinist's mate required that he perform a great amount of heavy lifting, resulting in his current right shoulder disability. For these reasons, the Board finds that remand for new VA addendum opinions is warranted. The matters are REMANDED for the following action: 1. Obtain an addendum opinion from an appropriate clinician, regarding the Veteran's bilateral shoulder disabilities. The claims file and a copy of this remand must be made available to the examiner. The need for an examination of the Veteran is left to the discretion of the clinician selected to write the addendum opinions. The examiner should respond to the following: a) Is it as least as likely as not (50 percent probability or greater) that the Veteran's left shoulder disability is etiologically related to service? Please explain why or why not. b) Is it as least as likely as not (50 percent probability or greater) that the Veteran's right shoulder disability is etiologically related to service? Please explain why or why not. c) Is it as least as likely as not (50 percent probability or greater) that the Veteran's right shoulder disability is caused by his left shoulder disability? Please explain why or why not. d) Is it as least as likely as not (50 percent probability or greater) that the Veteran's right shoulder disability is aggravated by (worsened beyond normal progression) his left shoulder disability? Please explain why or why not. In forming his or her opinion, the examiner should address the Veteran's contentions regarding the onset and continuity of his shoulder disabilities, as well as service and post-service treatment records documenting the Veteran's complaints of bilateral shoulder pain. Specifically, the examiner should address: i) the Veteran's MOS as a machinist's mate and his assertion that associated heavy lifting led to his shoulder disabilities; ii) a March 2005 service treatment record noting intermittent left shoulder burning with exertion; iii) a March 2005 Report of Medical History noting a burning sensation and pain in the left shoulder on use; iv) a December 2006 treatment record noting the Veteran's report of chronic right shoulder pain and an assessment of right shoulder impingement; v) a December 2008 treatment record noting the Veteran's reports of right shoulder limited mobility since the Navy; and vi) a January 2009 treatment record noting that the Veteran reported right shoulder pain since 2003. The examination report must include a complete rationale for all opinions expressed. If the examiner feels that a requested opinion cannot be rendered without resorting to speculation, the examiner must state whether the need to speculate is caused by a deficiency in the state of general medical knowledge (i.e., no one could respond given medical science and the known facts) or by a deficiency in the record or the examiner (i.e., additional facts are required, or the examiner does not have the needed knowledge or training). 2. After completing the above, and any other development as may be indicated by any response received as a consequence of the actions taken in the preceding paragraphs, the Veteran's claims should be readjudicated based on the entirety of the evidence. If any benefit sought remains denied, furnish the Veteran and his representative a supplemental statement of the case (SSOC) and return the case to the Board. KRISTI L. GUNN Veterans Law Judge Board of Veterans' Appeals Attorney for the Board L. Silverblatt, 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.