Citation Nr: 22039167 Decision Date: 07/08/22 Archive Date: 07/08/22 DOCKET NO. 16-50 004A DATE: July 8, 2022 REMANDED Entitlement to service connection for a left shoulder disability is remanded. Entitlement to service connection for a nerve disability of the left upper extremity is remanded. REASONS FOR REMAND The Veteran served on active duty from June 1964 to June 1971. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a February 2015 rating decision issued by a Department of Veterans Affairs (VA) Regional Office (RO). The Veteran testified before the undersigned at a hearing in April 2021. A transcript is of record. The Board remanded these matters in June 2021 and April 2022. The matters are now returned to the Board for further appellate review. This appeal is advanced on the Board's docket pursuant to 38 C.F.R. § 20.902(c) (20 19); 38 U.S.C. § 7107 (a)(2) (2012). 1. Entitlement to service connection for a left shoulder disability is remanded. The Board remanded this issue in April 2022 to obtain clarification of the Veteran's current left shoulder conditions. Specifically, the Board requested the selected clinician address whether the Veteran has had left shoulder acromioclavicular joint osteoarthritis at any point during the appeal period, and, if so, whether it is related to his active-duty service, to include the documented left shoulder complaints in his service treatment records. VA obtained a medical opinion in April 2022. The April 2022 examiner reported the Veteran does have acromioclavicular joint osteoarthritis; however, the examiner did not provide a medical nexus opinion. See Stegall v. West, 11 Vet. App. 268, 271 (1998) (remand by Board confers upon claimant, as a matter of law, the right to compliance with remand order). 2. Entitlement to service connection for a nerve disability of the left upper extremity is remanded. The Board remanded this issue in April 2022 to obtain an opinion addressing whether the Veteran's left upper extremity radiculopathy is related to his active-duty service, to include the documented left shoulder complaints in the Veteran's service treatment records. VA obtained a medical opinion in April 2022. The examiner provided a negative medical nexus opinion, in part, because the Veteran's service treatment records do not contain treatment or evaluation for a left upper extremity nerve condition. The examiner did not address whether the Veteran's left upper extremity nerve condition is related to his documented in-service complaints of left shoulder pain. See Stegall, 11 Vet. App. at 271. The Board notes the April 2022 examiner provided a medical opinion addressing whether the Veteran's left upper extremity radiculopathy preexisted service. The April 2022 examiner reported there is no evidence that the Veteran's left upper extremity radiculopathy existed prior to service; therefore, it is less likely than not that the Veteran's left upper extremity radiculopathy was aggravated beyond its natural progression by service. The Board did not request such opinion nor has the record raised the issue of the Veteran's left upper extremity radiculopathy preexisting his active-duty service. The matters are REMANDED for the following action: 1. Obtain an opinion, preferably from a clinician that has not previously provided an opinion, regarding the etiology of the Veteran's left shoulder acromioclavicular joint osteoarthritis. Schedule the Veteran for an examination only if deemed necessary by the clinician selected to provide the opinion. The selected clinician must provide an opinion addressing whether the Veteran's left shoulder acromioclavicular joint osteoarthritis is at least as likely as not (at least an approximate balance of positive and negative evidence) a result of an in-service event, disease, or injury, to include the documented left shoulder complaints in the Veteran's service treatment records. The examiner is advised the Veteran is competent to report his symptoms and history, and such reports must be specifically acknowledged and considered in formulating any opinion. If the examiner rejects the Veteran's reports, he or she must provide a reason for doing so. The Veteran's report of symptoms capable of lay observation may not be disregarded solely on the basis that they are not recorded in contemporaneous medical treatment records. The selected examiner must provide a full rationale for his or her conclusion. If any of the above issues cannot be resolved without resorting to speculation, then a detailed medical explanation as to why this is so must be provided. 2. Obtain an opinion, preferably from a clinician that has not previously provided an opinion, regarding the etiology of the Veteran's left upper extremity radiculopathy. Schedule the Veteran for an examination only if deemed necessary by the clinician selected to provide the opinion. The selected clinician must provide an opinion addressing whether the Veteran's left upper extremity radiculopathy is at least as likely as not (at least an approximate balance of positive and negative evidence) a result of an in-service event, disease, or injury, to include the documented left shoulder complaints in the Veteran's service treatment records. The clinician must specifically address whether it is at least as likely as not that the left shoulder complaints in the Veteran's service treatment records were the initial manifestations of the current left upper extremity radiculopathy. (Continued on the next page) The examiner must be advised the Veteran is competent to report his symptoms and history, and such reports must be specifically acknowledged and considered in formulating any opinion. If the examiner rejects the Veteran's reports, he or she must provide a reason for doing so. The Veteran's report of symptoms capable of lay observation may not be disregarded solely on the basis that they are not recorded in contemporaneous medical treatment records. The selected examiner must provide a full rationale for his or her conclusion. If any of the above issues cannot be resolved without resorting to speculation, then a detailed medical explanation as to why this is so must be provided. M. HYLAND Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Zachery S.C. Luce, 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.