Citation Nr: 22019790 Decision Date: 04/03/22 Archive Date: 04/03/22 DOCKET NO. 09-34 297 DATE: April 3, 2022 REMANDED Entitlement to service connection for a right shoulder disability, to include as secondary to a service-connected disability, is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Army from March 1983 to March 1986, from September 1990 to June 1991, and from March 2003 to December 2004, with additional service in the Army Reserve. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a November 2009 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO) in San Juan, Puerto Rico. In May 2013, June 2018, and October 2020, the Board remanded the Veteran's claim for additional development. The Veteran also appealed the issue of entitlement to service connection for a left shoulder disability. In a December 2021 rating decision, the RO granted service connection for a left shoulder disability, which constitutes a full award of the benefits sought on appeal. See Grantham v. Brown, 114 F. 3d 1156, 1158 (Fed. Cir. 1997). Thus, that matter is no longer in appellate status. The Veteran contends that his right shoulder disability was incurred in service or was caused or aggravated by a service-connected disability. The Veteran's case was last remanded, in pertinent part, to obtain a VA examination and etiology opinion. The Veteran was afforded a VA examination in September 2021 at which time he was diagnosed with right shoulder impingement syndrome. The examiner concluded that the right shoulder disability was less likely than not related to the Veteran's military service. The examiner's rationale was that the right shoulder symptoms did not manifest until 2009, six years after the Veteran left service. The examiner indicated that it was her opinion that the right shoulder disability was more likely than not related to the natural aging process and the soft tissue pain was in her opinion part of parcel of the service-connected fibromyalgia symptom. The examiner provided no explanation as to how she came to her conclusions which was specifically requested in the prior remand. Moreover, the examiner failed to provide an opinion as to whether the right shoulder disability was due to any service-connected disability and instead focused only on the left shoulder. The examiner also stated, "there is no evidence of aggravation of this condition beyond the natural progression. The Veteran maintained more or less the same range of active motion through the years and no surgical treatment was needed." It is unclear whether the examiner was referring to the right or left shoulder in rendering the opinion regarding aggravation. As a result, because the examiner provided an inadequate rationale for direct service connection and provided an inadequate opinion with regard to secondary service connection, the examination was incomplete. A remand by the Board confers on the Veteran, as a matter of law, the right to compliance with the remand. Stegall v. West, 11 Vet. App. 268 (1998). When VA undertakes to either provide an examination or to obtain an opinion, it must ensure that the examination or opinion is adequate. Barr v. Nicholson, 21 Vet. App. 303 (2007). In light of the above, the Board finds that a VA addendum opinion should be obtained regarding the etiology of the right shoulder disability. The matters are REMANDED for the following action: 1. Forward the Veteran's claims file to an examiner with sufficient expertise to provide an addendum opinion regarding the nature and etiology of the Veteran's right shoulder disability. The examiner must review the claims file, and note that review in the report. Based on the review of the record, the examiner must provide an opinion as to whether it is at least as likely as not (50 percent probability or greater) that the Veteran's right shoulder disability was incurred in or caused by service. The examiner should also provide an opinion as to whether it is at least as likely as not (50 percent probability or greater) that the Veteran's right shoulder disability was caused or aggravated by a service-connected disability. A full and detailed rationale for all opinions expressed must be provided. Another VA examination of the Veteran should only be conducted if deemed necessary by the examiner providing the requested medical opinion. 2. Confirm that all medical opinions obtained comport with this remand, and undertake any other development determined to be warranted. (Continued on the next page) 3. Then, readjudicate the issue on appeal. If a decision is adverse to the Veteran, issue a supplemental statement of the case and allow appropriate time for response. Then, return the case to the Board. Kristin Haddock Veterans Law Judge Board of Veterans' Appeals Attorney for the Board A. Cryan, 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.