Citation Nr: 25009178 Decision Date: 07/14/25 Archive Date: 07/14/25 DOCKET NO. 17-17 277 DATE: July 14, 2025 REMANDED A rating higher than 20 percent for right shoulder traumatic tendonitis prior to November 7, 2019, is remanded. A rating higher than 40 percent for right shoulder traumatic tendonitis from November 7, 2019, to May 17, 2020, is remanded. REASONS FOR REMAND The Veteran honorably served in the U.S. Army from August 1982 to June 1986. This appeal comes to the Board of Veterans' Appeals (Board) from a February 2015 Department of Veterans Affairs (VA) Regional Office (RO) decision. In December 2021, the Board issued a decision denying a rating higher than 20 percent prior to November 7, 2019, and higher than 40 percent from November 7, 2019, to May 17, 2020, for right shoulder tendonitis. The Veteran appealed this decision to the United States Court of Appeals for Veterans Claims (Court). In September 2022, the Veteran's representative and the VA General Counsel filed a joint motion for partial remand (JMPR) as the parties agreed that the Board erred in its reliance on inadequate VA medical examinations to deny the increased rating claims. The Court granted the JMPR in a September 2022 Order, vacating the Board's decision. In January 2023, the Board remanded the right shoulder increased rating claims to the agency of original jurisdiction (AOJ) for additional development. In July 2023, the AOJ continued the prior denials and returned the appeal to the Board. A November 2023 Board decision again denied the claims. The Veteran appealed again to the CAVC where the parties entered an October 2024 Joint Motion for Remand (JMR), agreeing the Board erred in not discussing the ameliorative effects of the Veteran's medications and by not addressing the Veteran's arguments for entitlement to service connection for depression secondary to his right shoulder disability. In a February 2025 Board decision, the claims were again remanded to the AOJ for additional development and consideration of the Veteran's arguments for service connection for depression. After additional development, the claim for secondary service connected adjustment disorder with mixed expression of depression and anxiety was granted, and the claims for increased ratings for right shoulder traumatic tendonitis were denied. The claims are again before the Board. Regrettably, a remand is again necessary to comply with the JMR directives. Right shoulder traumatic tendonitis prior to November 7, 2019, and from November 7, 2019, to May 17, 2020 When the Secretary provides a veteran with a VA medical examination or opinion, it must be adequate. A medical opinion is adequate when it is based upon consideration of the veteran's prior medical history and describes the disability in detail sufficient for the Board's evaluation of the claimed disability to be fully informed. Barr v. Nicholson, 21 Vet. App. 303, 311 (2007); See also Martinak v. Nicholson, 21 Vet. App. 447 (2007). When an examiner states that he or she cannot offer an opinion without resort to speculation, that opinion is adequate only when it is predicated on a lack of knowledge among the medical community at large and not the insufficient knowledge of the specific examiner. Sharp, 29 Vet. App. at 36 (quoting Jones v. Shinseki, 23 Vet. App. 382, 390 (2010)). An opinion that no opinion can be provided is inadequate if it is based on reasons such as an examiner's own lack of expertise, insufficient information, or unprocured testing. See Jones v. Shinseki, 23 Vet. App. 382 (2010). In the March 2025 VA medical opinion, the examiner stated, "medical records provided show chronic pain in the right shoulder that limited activity prior to 17 May 2020. These effects were somewhat masked by pain medications as that is the purpose of pain medications. I cannot opine on the specific [range of motion] but can state that pain medication was prescribed and taken and that the effects of pain medication will typically allow for improved [range of motion] beyond what would be without pain medication" This medical opinion is inadequate because it fails to specify whether the examiner's inability to opine on the specific range of motion of the Veteran's right shoulder without the ameliorative effects of medication are due to the examiner's own lack of expertise, available information, or the general knowledge of the medical community. Therefore, remand is required to obtain a supplemental opinion. The matters are REMANDED for the following action: Obtain a retrospective medical opinion as to whether the range of motion findings for the right shoulder documented in the previous VA examinations considered or discounted the ameliorative effects of medication as reported by the Veteran? And if so, what are the estimated range of motion of the Veteran's right shoulder prior to May 17, 2020, without considering any ameliorative effect of the medications? A complete rationale must be given for all opinions and conclusions expressed. If it is not possible to provide a specific measurement without resorting to mere speculation, the examiner must state whether the need to speculate is due to a deficiency in the state of general medical knowledge (no one could respond given medical science and the known facts), a deficiency in the record (additional facts are required), or the examiner (does not have the knowledge or training). JOHN Z. JONES Veterans Law Judge Board of Veterans' Appeals Attorney for the Board N. Guarnieri, 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.