Citation Nr: 22019867 Decision Date: 04/03/22 Archive Date: 04/03/22 DOCKET NO. 18-11 070 DATE: April 3, 2022 ORDER New and material evidence having been received, reopening of the claim of entitlement to service connection for a left shoulder disability is granted. REMANDED Entitlement to service connection for a left shoulder disability is remanded. Entitlement to service connection for bilateral hearing loss is remanded. Entitlement to service connection for tinnitus is remanded. FINDINGS OF FACT 1. An unappealed August 2000 rating decision denied reopening the claim of entitlement to service connection for a left shoulder disability. 2. The evidence associated with the claims file subsequent to the August 2000 rating decision is neither cumulative nor redundant of evidence already of record, and raises a reasonable possibility of substantiating the claim of entitlement to service connection for a left shoulder disability. CONCLUSION OF LAW New and material evidence has been received to reopen the claim of entitlement to service connection for a left shoulder disability. 38 U.S.C. § 5108; 38 C.F.R. § 3.156. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran had active military service from November 1966 to January 1967. This case comes before the Board of Veterans' Appeals (Board) on appeal from a June 2015 rating decision issued by the Department of Veterans Affairs (VA) Regional Office (RO). In connection with this appeal, the Veteran testified at a hearing before the undersigned Veterans Law Judge in January 2022. A transcript of that hearing has been associated with the claims file. New and Material 1. Left shoulder An August 2000 rating decision denied re-opening of the Veteran's claim of entitlement to service connection for a left shoulder disability because the Veteran did not submit evidence demonstrating that his left shoulder dislocation was aggravated during service. The pertinent evidence that has been received since the August 2000 rating decision includes a November 2019 Buddy statement discussing the Veteran's left shoulder disability, and testimony from the Veteran that his left shoulder disability was worsened by his military service. The Board finds that the new evidence obtained is not cumulative or redundant of the evidence previously of record. It also raises a reasonable possibility of substantiating the Veteran's claim. Accordingly, reopening the claim of entitlement to service connection for a left shoulder disability is warranted. To that extent only, the appeal is allowed. REASONS FOR REMAND 1. Left shoulder The Veteran was first afforded a VA general medical examination in June 1993. At that time, the examiner noted that the Veteran had a high school injury of his shoulder, and that he was eventually hospitalized in service for his left shoulder disabilities. The examiner diagnosed the Veteran with a history of chronic dislocations. The Veteran was afforded another VA general examination in July 1999. Similarly, the examiner noted the Veteran's in-service left shoulder dislocations. However, neither VA examiner provided adequate nexus opinions regarding the Veteran's left shoulder disability. Finally, another VA general medical examination was obtained in January 2000. At that time, the examiner did appear to indicate that the Veteran dislocated his shoulder and that it got worse in service. However, the examiner did not explain or provide any rationale as to his statement. See Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 304 (2008) (noting that "most of the probative value of a medical opinion comes from its reasoning"). As such, the Board finds that a new VA examination and opinion should be obtained. 2. Bilateral hearing loss and tinnitus The Board notes that the Veteran has consistently asserted that his bilateral hearing loss, and tinnitus were related to service. In that regard, the Veteran testified that he was exposed to hazardous noise exposure while in service. Specifically, he had rifle range and grenade trainings while in service which caused his asserted hearing loss and tinnitus. Indeed, there appears to be a threshold shift when comparing the Veteran's November 1966 entrance audiogram to his February 1967 separation audiogram. Further, the Veteran's separation examination reflects some degree of hearing loss. In that regard, the threshold for normal hearing is from 0 to 20 decibels; higher thresholds show some degree of hearing loss. Hensley v. Brown, 5 Vet. App. 155, 157. Moreover, the Veteran testified that his tinnitus began shortly after service. In light of the Veteran's statements, an April 2015 treatment note indicating that the Veteran is hard of hearing, and his reported symptoms of tinnitus, the Board concludes that the Veteran should be afforded VA examinations to determine the nature and etiology of any current hearing loss, and tinnitus disability. McLendon v. Nicholson, 20 Vet. App. 79 (2006). The matters are REMANDED for the following action: 1. Identify and obtain any pertinent, outstanding VA and private treatment records and associate them with the claims file. 2. Then, schedule the Veteran for a VA examination to determine the nature and etiology of any currently present left shoulder disability. The claims file must be made available to, and reviewed by the examiner. Any indicated studies must be performed. Based on an examination of the Veteran and a review of the record, the examiner should first identify all left shoulder disabilities present during the pendency of the appeal, or proximate thereto. For each diagnosed left shoulder disability, the examiner should provide an opinion as to whether such disability clearly and unmistakably existed prior to the Veteran's active service, and if so, whether such disability was clearly and unmistakably NOT aggravated by such service. The examiner must note that the Veteran's lay statements alone are not a sufficient basis to support a finding that a disability clearly and unmistakably existed prior to the Veteran's active service. For any identified left shoulder disability NOT found to preexist the Veteran's active service, the examiner should provide an opinion as to whether it is at least as likely as not (50 percent or better probability) that such disability had its onset during the Veteran's active service, or is otherwise etiologically related to such service. The rationale for all opinions expressed must be provided. 3. Then, schedule the Veteran for a VA examination by an examiner with sufficient expertise to determine the nature and etiology of the Veteran's bilateral hearing loss and tinnitus. The examiner should review the claims file and indicate that review in the report. Any indicated studies should be performed. Based upon the examination results and a review of the record, the examiner should provide an opinion as to whether it is at least as likely as not (50 percent or greater probability) that any bilateral hearing loss and tinnitus is etiologically related to service. The rationale for all opinions expressed must be provided. 4. Confirm that the VA examination reports and any opinions provided comport with this remand, and undertake any other development found to be warranted. 5. Then, readjudicate the remaining issues on appeal. If the decision is adverse to the Veteran, issue a supplemental statement of the case and allow appropriate time for response. Cory M. Picton Veterans Law Judge Board of Veterans' Appeals Attorney for the Board I. Cannaday, 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.