Citation Nr: 25005803 Decision Date: 04/29/25 Archive Date: 04/29/25 DOCKET NO. 09-29 820 DATE: April 29, 2025 REMANDED Entitlement to service connection for a left shoulder disorder is remanded. REASONS FOR REMAND The Veteran served on active duty from October 1995 to October 1998. This matter comes on appeal before the Board of Veterans' Appeals (Board) from a March 2017 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO), hereinafter referred to as the Agency of Original Jurisdiction (AOJ). This appeal was most recently before the Board in February 2024. Pursuant to the Board's remand instructions, the Veteran was provided a VA examination in August 2024 with opinions provided in December 2024. The VA examiner opined that the Veteran's labral tear, adhesive capsulitis, and degenerative joint disease (DJD) were less likely than not incurred in or caused by slipping on a ladder and catching himself with his left arm with continued pain during service or within one year of service. She stated that while it was feasible that braking a boat with tendon lacerations, slipping on a ladder and catching himself with his left arm, and moving heavy equipment could lead to shoulder issues, they should be apparent shortly after injury and not many years later. ? The rationale was based, at least in part, on a lack or absence of documentation in his service treatment records (STRs) of a left shoulder injury while on active duty. A medical opinion is inadequate if it is based solely on the absence of documentation in the record and does not take into account the Veteran's reports of symptoms and history (even if recorded in the course of the examination). See Dalton v. Nicholson, 21 Vet. App. 23 (2007) (examination was inadequate where the examiner did not comment on the appellant's report of in-service injury and instead relied on the absence of evidence in the service medical records to provide a negative opinion). Therefore, the December VA opinion is inadequate to the extent that it is based on the absence of medical records and the examiner did not consider the Veteran's lay statements and report of injury. Additionally, the rationale was based, at least in part, on a lack of documentation of shoulder pain until 2016. However, this is inaccurate as the evidence reflects that the Veteran complained of left shoulder pain in December 2008, not 2016, and reported a left arm injury in 1997. See December 16, 2008, VA treatment record. Moreover, the Board acknowledges the Veteran's request for a board-certified orthopedic specialist as a VA examiner. Therefore, an attempt to obtain an opinion from an appropriate specialist should be made on remand. The matter is REMANDED for the following action: Obtain a VA addendum opinion from an appropriate qualified examiner specifically a board-certified orthopedic specialist in order to evaluate the nature and etiology of the Veteran's left shoulder disorder. The need for any additional examinations or telephonic interviews is left to the discretion of the examiner. If any examination is scheduled and the Veteran fails to report, however, the examiner must still render an opinion as requested below based on review of the claims file. Based upon review of all pertinent documents in the Veteran's claims file, including medical treatment and examination records, lay statements, and examination results, the examiner must opine whether the Veteran's left shoulder disorder, to include left labral tear, left glenohumeral joint osteoarthritis, left acromioclavicular joint osteoarthritis, or left adhesive capsulitis, began during service, within one year of service, or is otherwise the result of military service *The VA examiner should address the Veteran's report of: (a.) A left arm injury in 1997 (see December 16, 2008, VA treatment record); (b.) Braking a boat and cutting the tendons in his arm (See July 2018 Board hearing transcript; June 2019 VA examination report); (c.) Slipping on a ladder and catching himself with his left arm with continued pain since then (see November 2020 examination report); and (d.) An onset in 1995 after moving heavy equipment (see August 2021 VA examination report). The examiner must also consider and address any statements regarding onset of symptomatology and any statements regarding continuity of symptomatology since onset and/or since discharge from military service, to include the Veteran's report of an onset in the 1990s with worsening pain and limited mobility (see August 2024 VA examination report) and in 2000 (see November 2018 VA examination report), as well as a report of symptoms beginning during and worsening since service (see August 2022 brief). The examiner must provide thorough explanations and support for any opinions expressed. MARTIN B. PETERS Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Lee, Jane R. 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.