210519-161665
210519-161665
| Board of Vet. App. | Aug 31, 2021Background:
- Veteran served on active duty Oct 1959–Sep 1961 and sustained a left shoulder injury after a ladder fall in Aug 1961; separation exam in Sep 1961 was normal.
- Current diagnoses: left rotator cuff tear and acromioclavicular (AC) joint osteoarthritis per June 2015 VA exam.
- June 2015 VA examiner opined the shoulder disorder was less likely than not related to the 1961 in‑service injury, with a rationale based on normal separation exam and lack of proximate symptoms.
- Private physician (Aug 2019) provided a conclusory opinion that the condition was "more likely than not" service‑connected but offered no supporting rationale.
- Procedural history: Board denied service connection Aug 2019; Veteran filed a supplemental claim May 2021; AOJ readjudicated and denied; Veteran appealed to the Board via Evidence Submission docket; Board considered evidence up to the May 2021 decision plus any submissions within 90 days.
- Board denied service connection, found no nexus to service and that presumptive chronic disease rules did not apply; benefit of the doubt did not apply.
Issues:
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Nexus: Is the current left shoulder disorder at least as likely as not related to the 1961 in‑service injury? | Veteran: injury in 1961 caused ongoing shoulder disorder. | VA: Lack of continuous symptomatology and VA medical opinion finding nexus less likely than not. | Denied — preponderance against nexus; VA examiner with rationale afforded more weight. |
| Presumptive service connection (chronic disease) for AC joint osteoarthritis | Veteran: arthritis is chronic and attributable to service injury. | VA: Not shown chronic in service, not manifest to compensable degree within presumptive period, no continuity of symptoms. | Denied — criteria for presumptive service connection not met. |
| Evidentiary weight of medical opinions: Is the private opinion sufficient to rebut VA exam? | Veteran: private physician stated >50% probability of service causation. | VA: Private opinion lacks rationale; VA exam is reasoned and based on records. | VA exam given greater probative weight; private opinion entitled to little weight. |
Key Cases Cited
- Shedden v. Principi, 381 F.3d 1163 (establishes three‑element test for service connection)
- Walker v. Shinseki, 708 F.3d 1331 (explains presumptive service connection for chronic diseases and continuity of symptomatology)
- Nieves‑Rodriguez v. Peake, 22 Vet. App. 295 (medical opinions must be based on an accurate history and provide supporting rationale)
- Jandreau v. Nicholson, 492 F.3d 1372 (limits lay evidence competency for medical diagnoses; explains when lay statements are competent)
- Gilbert v. Derwinski, 1 Vet. App. 49 (clarifies application of the benefit of the doubt doctrine)