11-27 724, 11-27 724

Veteran served multiple active-duty periods including deployment to Iraq (2004–2005); claim arises from alleged elbow injury during a 2005 softball incident and ongoing right elbow pain.
Original RO denial in July 2010; multiple Board remands (2014–2016) for VA exams and addendum opinions.
VA and private treatment records show shoulder complaints in service; no contemporaneous service treatment record for right elbow.
Multiple VA examinations diagnosed right elbow tendonitis (March 2010, Dec 2014, Mar 2015, Oct 2016) and produced conflicting etiological opinions; final addendum (Jan 2017) concluded less likely than not related to service or secondary to service-connected conditions.
Board found VCAA and duty-to-assist satisfied, substantial compliance with remand directives, and relied on the probative January 2017 opinion and lack of in-service elbow records.

Issue	Plaintiff's Argument	Defendant's Argument	Held
Entitlement to service connection for a right elbow disability	Veteran: elbow pain began in Iraq (2004–05) from a softball injury; alternatively, elbow symptoms are secondary to service-connected right shoulder and carpal tunnel	VA: STRs show only shoulder injury in service; objective records lack in-service elbow findings; competent medical opinion finds no nexus and rejects secondary causation	Denied — preponderance of evidence against nexus; service connection not established

Quartuccio v. Principi, 16 Vet. App. 183 (discusses VCAA notice requirements)
Mayfield v. Nicholson, 444 F.3d 1328 (VCAA notice harmless-error standard)
Shedden v. Principi, 381 F.3d 1163 (elements for service connection)
Jandreau v. Nicholson, 492 F.3d 1372 (competency of lay evidence)
Stegall v. West, 11 Vet. App. 268 (requirement of compliance with Board remand directives)