Citation Nr: 22047697 Decision Date: 08/22/22 Archive Date: 08/22/22 DOCKET NO. 16-14 575 DATE: August 22, 2022 ORDER Entitlement to service connection for a right shoulder disability is granted. Entitlement to service connection for a bilateral wrist disability is granted. FINDING OF FACT Resolving reasonable doubt, the Veteran had a right shoulder disability and a bilateral wrist disability that were at least as likely as not related to his active military service. CONCLUSION OF LAW The criteria for service connection for a right shoulder disability and a bilateral wrist disability are met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran had honorable active military service from May 2010 to June 2011, to include service in Afghanistan from August 2010 to March 2011. He died in July 2019. The appellant is the Veteran's surviving spouse and has been substituted as the claimant pursuant to 38 U.S.C. § 5121A; 38 C.F.R. § 3.1010. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a Department of Veterans Affairs (VA) Regional Office (RO)'s November 2015 rating decision. The appellant testified at a hearing before the undersigned Veterans Law Judge in August 2022. A transcript of that hearing has not yet been added to the file, as this decision is being processed under the Board's "One Touch" hearing program. A copy of this transcript will be added to the claims file in the ordinary course of business. 1. Entitlement to service connection for a right shoulder disability 2. Entitlement to service connection for a bilateral wrist disability Service connection may be granted for disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. § 3.303. The three-element test for service connection requires evidence of: (1) a current disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the current disability and the in-service disease or injury. Shedden v. Principi, 381 F.3d 1163, 1166 -67 (Fed. Cir. 2004). The Veteran applied for service connection for a right shoulder disability and a bilateral wrist disability contending that he injured his shoulder and wrists during his deployment to Afghanistan. See VA Form 9. In a July 2016 VA Form 21-4138, the Veteran stated that he injured his wrists while knocking down compounds that were used as hiding places. He also reported that he fell while walking through the debris from one of the destroyed compounds and landed on his wrist. He further reported that his wrists were injured from driving into these compounds to help knock them down as the force of the impact over and over put strain on his wrists. On his notice of disagreement, the Veteran stated that he did not seek treatment for his wrists while in service but he submitted a March 2016 buddy statement from his section's corpsman while he was in Afghanistan who stated that the Veteran requested Ibuprofen from him on occasion for what could be perceived as small aches and pains and that he did not make any notes about this due to it being so sporadic and going away after receiving medicine. Also in support of his claim, the Veteran submitted an April 2015 private treatment note from his treating physician which shows he complained of right shoulder pain and bilateral wrist pain. It is noted he complained of both wrists hurting when it was cold; moving something last year at work caused right wrist pain for six months and wore wrist brace daily; and two weeks ago, someone grabbing his hand wrong at work making his right wrist hurt for three days. It was noted the Veteran worked welding for a mining company. It was also noted that the Veteran reported military service from June 2008 until June 2014 and driving vehicles every day (bumpy) on vehicle mounted patrols and carrying a machine gun on a one-point sling strapped across and pulling on his right shoulder. Physical examination of the wrists was essentially normal. However, physical examination of the right shoulder was positive for crepitus on passive range of motion, painful arc, Empty Can Test and Neer Impingement Test. His physician assessed him to have a "Shoulder Disorders Other Spec" and "Pain Joint Forearm." As to the shoulder, the physician commented that the Veteran had "[right] chronic shoulder pain likely rotator cuff." Regarding the wrists, the physician questioned whether the Veteran had arthritis or overuse on top of chronic injury. The physician stated that the injuries reported by the Veteran were consistent with his history in the service and opined that they are directly related. Initially, the Board notes that the available medical evidence does not set forth a definitive diagnosis of a right shoulder and bilateral wrist disabilities. However, the Federal Circuit has clarified that pain alone resulting in functional impairment of earning capacity can satisfy the current disability requirement for service connection notwithstanding the absence of a diagnosis of an underlying condition. Saunders v. Wilkie, 886 F.3d 1356, 1367-68 (Fed. Cir. 2018). In the present case, the private physician's findings along with the Veteran's and appellant's statements of the Veteran's pain and its impact on his functioning with activities (including reduction in motion and strength) are sufficient to imply the Veteran had functional impairment of earning capacity caused by his right shoulder and bilateral wrist conditions. Therefore, the Board finds that the requirements for a current disability are met. The Veteran's service treatment records are silent for any complaints of, treatment for or diagnosis of any conditions involving the right shoulder or bilateral wrists. Moreover, the Veteran provided negative responses of having any joint problems on his Post-Deployment Health Assessment and subsequent Periodic Health Assessments. However, the Veteran explained in his notice of disagreement that he did not seek treatment in service. Moreover, per the corpsman's statement, he was provided with Ibuprofen on occasion but such was not recorded. Thus, the lack of complaints and treatment in service have been explained. The private physician provided a favorable opinion that the Veteran's current right shoulder and bilateral wrist conditions are consistent with his military service and directly related thereto. The Veteran also provided statements as to how he was injured in service. Based on this, the Board finds that the evidence is at least in approximate balance and, therefore, finds that service connection for the Veteran's right shoulder and bilateral wrist disabilities is warranted. M. C. GRAHAM Veterans Law Judge Board of Veterans' Appeals Attorney for the Board S.M. Kreitlow 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.