Citation Nr: A25035778 Decision Date: 04/17/25 Archive Date: 04/17/25 DOCKET NO. 240729-458709 DATE: April 17, 2025 ORDER Service connection for right shoulder degenerative arthritis impingement syndrome with acromioclavicular joint osteoarthritis is granted. FINDING OF FACT The evidence of record persuasively shows the Veteran's right shoulder degenerative arthritis impingement syndrome with acromioclavicular joint osteoarthritis was caused by his in-service injury. CONCLUSION OF LAW The criteria for service connection for right shoulder degenerative arthritis impingement syndrome with acromioclavicular joint osteoarthritis have been met. 38 U.S.C. §§ 1110, 1111, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.304. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty in the United States Air Force from December 1981 to October 2003. This appeal is being processed under the modernized review system, commonly referred to as the "AMA," as established by the Veterans Appeals Improvement and Modernization Act of 2017. 115 Pub. L. No. 55, 131 Stat. 1105. This matter comes before the Board of Veterans' Appeals (Board) on appeal from an August 2023 rating decision issued by a Department of Veterans Affairs (VA) regional office, an agency of original jurisdiction (AOJ). The Veteran timely initiated an appeal by submitting a July 2024 VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement), and elected the Direct Review docket. Therefore, the Board may only consider the evidence of record at the time the AOJ issued the August 2023 rating decision on appeal. 38 C.F.R. § 20.301. Any evidence submitted after the August 2023 rating decision on appeal has not been considered by the Board. 38 C.F.R. §§ 20.300, 20.301, 20.801. Service Connection Service connection may be granted for a disability resulting from a disease or injury incurred in or aggravated by active service. 38 U.S.C. § 1110; 38 C.F.R. § 3.303. To establish entitlement to service-connected compensation benefits, a veteran must show: (1) the existence of a present disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the present disability and the disease or injury incurred or aggravated during service. Shedden v. Principi, 381 F.3d 1163, 1166-67 (Fed. Cir. 2004). Ordinarily a lay person is?competent?to report symptoms and experiences observable?by their senses; however, a lay person is?usually?not competent?to prove a matter requiring medical expertise. See Jandreau v. Nicholson,?492 F.3d 1372, 1377?(Fed. Cir. 2007); Layno v. Brown,?6 Vet. App. 465, 470?(1994). The issue of entitlement to service connection for a right shoulder disability. The Veteran contends that his shoulder condition is due to his active-duty military service. See February 2022 VA Form 20-0995, Decision Review Request: Supplemental Claim; February 2022 VA Form 21-4138, Statement in Support of Claim. In the August 2023 rating decision, AOJ made the following favorable findings: (1) the Veteran has a diagnosed disability of right shoulder degenerative arthritis impingement syndrome with acromioclavicular joint osteoarthritis; and (2) the Veteran had a qualifying in-service event or injury as the service treatment records (STR) show a profile given due to a shoulder rotator cuff injury. 38 C.FR. § 3.104(c). Additionally, the Board notes that the AOJ also favorably found that new and relevant evidence had been received for readjudication of this claim. No clear and unmistakable error as to these findings have been shown by the evidence of record; therefore, the Board is bound by these findings. Id. Thus, the current disability and in-service incurrence elements of the claim have been met. The only remaining issue is whether there is a nexus between the Veteran's right shoulder disability and his military service. In June 2023, the Veteran was afforded a VA examination. In the associated medical opinion of July 2023, the examiner concluded that the Veteran's right shoulder condition was less likely than not incurred in or caused in service. The opinion relied on a lack of medical encounters noted in the Veteran's service treatment records (STR). However, the Veteran's STRs includes multiple references to a right shoulder injury including an August 9, 1999, entry noting a right shoulder rotator cuff injury which placed the Veteran on restrictions including no pushups, dips, or chin-ups. As the opinion is based on an inaccurate factual premise, it is of no probative value. See Reonal v. Brown, 5 Vet. App. 458, 461 (1993). In August 2023, VA obtained an addendum medical opinion. The examiner opined that it was less likely than not the Veteran's right shoulder symptoms were related to his service because there was only one encounter was noted in September 1999 for right shoulder pain and the next encounter was in June 2023. The examiner stated too much time has passed for it to be causing the same issues. However, there was more than a single report of right shoulder symptoms in service. As noted above, the Veteran's STRs document a right shoulder injury in August 1999 prior to the September 1999 encounter acknowledged by the examiner. Further, the examiner failed to discuss the Veteran's report of right shoulder pain over the course of one and a half months for which physical therapy was ordered for two months. As such, the examiner's opinion is conclusory and provides no explanation as to the significance of the passage of time since the in-service. See Stefl v. Nicholson, 21 Vet. App. 120, 123 (2007) (an opinion is adequate where it is based upon consideration of the veteran's prior medical history and examinations). In March 2023, the Veteran submitted a private medical opinion. February 2023 Private Medical Opinion of C.M.B., PA-C. The private medical opinion concluded that the Veteran's right shoulder disability is at least as likely as not due to, related to, a progression of, and/or a continuation of his right shoulder injury that occurred during active-duty military service. The opinion relied on the Veteran's history of symptoms, including the August 1999 STR injury entry. C.M.B. opined the Veteran's lay statements support the onset of symptoms in service and chronicity since then. C.M.B. stated the current diagnosis is consistent with the mechanism of injury in service and also discussed medical literature documenting that overuse of the shoulder muscles or a prior injury can lead to abnormal shoulder and scapular kinematics which frequently leads to chronic pain and disability with functional loss. The Board finds PA C.M.B.'s positive nexus opinion highly probative as it contains a fully articulated, sound reasoning for the conclusion reached based upon consideration of the relevant evidence of record. See Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 301 (2008). Therefore, the Board finds that the evidence of record persuasively weighs in favor of granting service connection for right shoulder degenerative arthritis impingement syndrome with acromioclavicular joint osteoarthritis. See Lynch v. McDonough, 21 F.4th 776, 781-82 (Fed. Cir. 2021) (en banc). G.J. Suh Acting Veterans Law Judge Board of Veterans' Appeals Attorney for the Board S.M. Disselkamp, 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.