Citation Nr: 22015128 Decision Date: 03/16/22 Archive Date: 03/16/22 DOCKET NO. 19-23 674 DATE: March 16, 2022 ORDER The petition to reopen the previously denied claim of entitlement to service connection for a left shoulder disorder with carpal tunnel syndrome is granted. REMANDED Entitlement to service connection for sleep apnea is remanded. Entitlement to service connection for a left shoulder disorder with carpal tunnel syndrome is remanded. Entitlement to service connection for a right knee disorder, to include arthritis, is remanded. Entitlement to service connection for a left knee disorder, to include arthritis, is remanded. Entitlement to service connection for hypertension is remanded. FINDINGS OF FACT 1. A January 1995 rating decision last denied service connection for left shoulder disorder with carpal tunnel syndrome. 2. Evidence pertaining to the Veteran's left shoulder disorder with carpal tunnel syndrome since the last final rating decision was not previously submitted, relates to unestablished facts necessary to substantiate the claim, is neither cumulative nor redundant, and raises a reasonable possibility of substantiating the claim. CONCLUSIONS OF LAW 1. The January 1995 rating decision that last denied service connection for left shoulder disorder with carpal tunnel syndrome is final. 38 U.S.C. § 7105; 38 C.F.R. § 20.1103. 2. The evidence received since the last final January 1995 rating decision is new and material, and the claim for service connection for left shoulder disorder with carpal tunnel syndrome is reopened. 38 U.S.C. § 7105; 38 C.F.R. §§ 3.156, 20.1103. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty in the United States Air Force from May 1978 to July 1992, followed by service in the Air Force Reserves. The Veteran testified before the undersigned Veterans Law Judge at a September 2021 Board hearing. A transcript has been associated with the claims file. 1. Whether new and material evidence has been received to reopen the claim of entitlement to service connection for left shoulder disorder with carpal tunnel syndrome. The Veteran most recently filed a request to reopen his claim for entitlement to service connection for left shoulder disorder with carpal tunnel syndrome in October 2016. At the time of the last final denial of the Veteran's claim for service connection for left arm disorder with carpal tunnel syndrome in January 1995, evidence of record included the Veteran's application for compensation and service treatment records (STRs). Evidence associated with the claims file since the previous January 1995 denial includes the Veteran's statements, military personnel records, VA treatment records, private treatment records, and September 2021 Board hearing testimony. Based on a review of this new evidence, the Board finds that new and material criteria under 38 C.F.R. § 3.156(a) have been satisfied, and the claim for service connection for left shoulder disorder with carpal tunnel syndrome is reopened. REASONS FOR REMAND Remand is required to obtain a VA examination. In McLendon v. Nicholson, 20 Vet. App. 79 (2006), the United States Court of Appeals for Veterans Claims indicated that there was a four-part test to determine whether an examination was necessary under 38 C.F.R. § 3.159(c)(4). Id. at 81. Under this test, VA will provide a medical examination or obtain a medical opinion where there is (1) competent evidence of a current disability or persistent or recurrent symptoms of a disability; (2) evidence establishing that an event, injury, or disease occurred in service; (3) an indication that the disability or persistent or recurrent symptoms of a disability may be associated with the veteran's service or with another service-connected disability, but (4) insufficient competent medical evidence to make a decision on the claim. Id.; see also 38 C.F.R. § 3.159(c)(4). 2. Entitlement to service connection for sleep apnea is remanded. Here, at the September 2021 Board hearing, the Veteran testified that he experienced symptoms of sleep apnea during service in Germany from 1985 to 1980. Board Hearing Transcript (T.) at 2. The Veteran's wife, a medical provider, testified that the Veteran experienced snoring and frequent gasping during service. T. at 3-4. The Veteran and his wife testified that the Veteran has experienced symptoms of sleep apnea since separation from service. T. at 6. Therefore, the criteria for McLendon have been met. And as a result, the Board cannot make a fully informed decision on the issue of entitlement to service connection for sleep apnea because no VA examiner has opined whether the Veteran's sleep apnea was caused by service. 3. Entitlement to service connection for a left shoulder disorder with carpal tunnel syndrome is remanded. Here, the STRs show the Veteran complained of and was treated for left shoulder pain from June 1991 to August 1991. The STRs show the Veteran was diagnosed with left upper extremity "carpal tunnel" in July 1991. The July 2016 STR from the Veteran's Air Force Reserve service shows the Veteran to have a diagnosis of left shoulder pain. At the September 2021 Board hearing, the Veteran testified that during service his shoulder underwent repetitive use when he removed screws from aircraft. T. at 15. He stated the panels had over 400 screws. Id. He stated that some of the screws were under extreme pressure and difficult to remove. Id. He stated the left shoulder injury included rotating his scapula. Id. He stated he sought treatment in 1984 for a shoulder injury. T. 15. He stated that he sought treatment in 1990 or 1991 for excruciating pain in his arm. Id. He testified that in 1991 he was diagnosed with carpal tunnel syndrome and a disorder in his scapula. Id. The Veteran's wife stated the Veteran's left shoulder pain and numbness continued from 1991. T. at 18. Therefore, the criteria for McLendon have been met. And as a result, the Board cannot make a fully informed decision on the issue of entitlement to service connection for a left shoulder disorder with carpal tunnel syndrome because no VA examiner has opined whether the Veteran's left shoulder disorder with carpal tunnel syndrome was caused by service. 4. Entitlement to service connection for a right knee disorder, to include arthritis, is remanded. 5. Entitlement to service connection for a left knee disorder, to include arthritis, is remanded. Here, the STRs show the Veteran sought treatment for the right knee in a January 1981 record. The July 2016 STR from the Veteran's Air Force Reserve service show the Veteran to have a diagnosis of knee arthritis. At the September 2021 Board hearing, the Veteran testified that he spent extended time on his knees working on engines and aircraft components during service. T. at 9. He stated he had treatment in service and was placed on physical profiles. T. at 10. He contended that the repetitive motion and use of his knees in service caused arthritis. T. at 11. He stated that he began to complain about the knee symptoms immediately prior to his retirement in 2017. Id. He stated the symptoms continued after service and have worsened. T. at 12-14. Therefore, the criteria for McLendon have been met. And as a result, the Board cannot make a fully informed decision on the issue of entitlement to service connection for a bilateral knee disorder because no VA examiner has opined whether the Veteran's bilateral knee disorder began in or was caused by service. 6. Entitlement to service connection for hypertension is remanded. Here, at the September 2021 Board hearing, the Veteran testified that he had blood pressure readings during service that were 145 over 80 or 90. T. at 6. He stated he was a crew chief aircraft mechanic and exposed to jet fuel. Id. He stated this work was "heavy tempo of work environment" and this is when his blood pressure was high. Id. The Veteran stated he was on active duty in the Air Guard when he was diagnosed with hypertension. T. at 7. He stated he had to change medication because he was on flying status. Id. He stated he was diagnosed by a civilian medical provider. Id. He asserts that his blood pressure was persistently high until the time he was diagnosed. Id. Therefore, the criteria for McLendon have been met. And as a result, the Board cannot make a fully informed decision on the issue of entitlement to service connection for hypertension because no VA examiner has opined whether the Veteran's hypertension was caused by service. The matters are REMANDED for the following action: 1. Schedule the Veteran for an examination by an appropriate clinician to determine the nature and etiology of the Veteran's sleep apnea. The examiner must opine as to whether it is at least as likely as not that the disability began in service or is otherwise related to an in-service injury, event, or disease. The examiner must consider the Veteran's statements, the Veteran's wife's statements, and the Board hearing testimony in the context of any negative opinion. 2. Schedule the Veteran for an examination by an appropriate clinician to determine the nature and etiology of the Veteran's left shoulder disorder with carpal tunnel syndrome. The examiner must opine as to whether the disability is at least as likely as not related to an in-service injury, event, or disease. The examiner must specifically consider and discuss the June 1991 to August 1991 STRs treatment of the left shoulder and carpal tunnel, the Veteran's statements and contentions, and the Board hearing testimony in the context of any negative opinion. 3. Schedule the Veteran for an examination by an appropriate clinician to determine the nature and etiology of the Veteran's bilateral knee disorder. The examiner must opine as to whether it is at least as likely as not that the disability began in service, within one year of service separation, or is otherwise related to an in-service injury, event, or disease, including January 1981 STR showing treatment of the right knee. The examiner must consider the Veteran's lay statements and contentions and the Board hearing testimony in the context of any negative opinion. 4. Schedule the Veteran for an examination by an appropriate clinician to determine the nature and etiology of the Veteran's hypertension. The examiner must opine as to whether it is at least as likely as not that the disability began in service, within one year of service separation, or is otherwise related to an in-service injury, event, or disease. The examiner must consider the Veteran's lay statements and contentions and Board hearing testimony in the context of any negative opinion. Caroline B. Fleming Veterans Law Judge Board of Veterans' Appeals Attorney for the Board M. Thompson, 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.