SHOULDER IMPAIRMENT OF

N. RIPPEL · 2025 · Case ID: 25014866

GRANTED

Summary

The veteran, an Army veteran who served from August 2004 to February 2006, including service in Iraq, appeals the denial of service connection for right shoulder, right foot, and left foot conditions. The veteran testified that he injured his right shoulder during basic training while wearing a rucksack, experiencing ongoing issues since then. He also reported losing sensation in his feet and experiencing cold and numb feet since a frostbite incident in service. The Board found the veteran's lay testimony regarding his right shoulder condition to be credible and consistent with the circumstances of his service, despite a negative VA nexus opinion. The Board applied the benefit of the doubt doctrine, finding the evidence approximately balanced, and granted service connection for the right shoulder condition. For the bilateral foot conditions, the Board noted the veteran's testimony about numbness and cold feet since service, along with STRs documenting complaints of cold and numb feet in service. A February 2025 VA medical opinion found the bilateral foot conditions, diagnosed as numbness with a history of frostbite, to be at least 50% related to cold weather injury during service. The Board found this opinion persuasive, granting service connection for both the right and left foot conditions. Service connection for all three conditions was granted.

Rationale

Veteran's lay testimony regarding onset and continuity of symptoms found credible.; Negative VA nexus opinion disregarded due to lack of continuation of care.; Evidence found to be approximately balanced; benefit of doubt applied.

Service Branch

ARMY

Special Benefit

NO SPECIAL BENEFIT

Docket No.

18-27 801

Full Decision Text

Citation Nr: 25014866
Decision Date: 12/12/25 Archive Date: 12/12/25

DOCKET NO. 18-27 801
DATE: December 12, 2025

ORDER

Service connection for right shoulder condition is granted.

Service connection for right foot condition is granted.

Service connection for left foot condition is granted.

FINDINGS OF FACT

1. The Veteran's right shoulder condition had its onset in service and is related to service.

2. The Veteran's right foot condition had its onset in service and is related to service.

3. The Veteran's left foot condition had its onset in service and is related to service.

CONCLUSIONS OF LAW

1. The criteria for service connection for right shoulder condition have been met. 38 U.S.C. §§ 1110, 1154, 4107; 38 C.F.R. §§ 3.102, 3.303.

2. The criteria for service connection for right foot condition have been met. 38 U.S.C. §§ 1110, 1154, 4107; 38 C.F.R. §§ 3.102, 3.303.

3. The criteria for service connection for left foot condition have been met. 38 U.S.C. §§ 1110, 1154, 4107; 38 C.F.R. §§ 3.102, 3.303.

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Veteran served on active duty in the United States Army from August 2004 to February 2006, to include service in Iraq.

These matters come before the Board of Veterans' Appeals (Board) on appeal from a September 2017 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO).

In July 2022, the Veteran testified at a hearing before the undersigned Acting Veterans Law Judge.

These matters were previously before the Board in August 2022, February 2023, and January 2025, in which the Board remanded the matters for further development.

Service Connection

Establishing service connection generally requires evidence of (1) a current disability; (2) an in-service incurrence or aggravation of a disease or injury; and (3) a nexus between the claimed in-service disease or injury and the present disability.? See Shedden v. Principi,?381 F.3d 1163?(Fed. Cir. 2004).????????

Service connection may be granted for any disease initially diagnosed after service, when all the evidence, including that pertinent to service, establishes that the disease was incurred in service. ?38?C.F.R. §?3.303(d).????????

The determination as to whether the requirements for service connection are met is based on an analysis of all the evidence of record and the evaluation of its credibility and probative value. ?38?U.S.C. §?7104?(a); Baldwin v. West,?13?Vet. App.?1?(1999); see?38?C.F.R. §?3.303?(a).??

The United States Court of Appeals for the Federal Circuit (Federal Circuit) has held that "pain in the absence of a presently diagnosed condition can cause functional impairment," which may qualify as a "disability" for VA compensation purposes.? Saunders v. Wilkie, 886 F.3d 1356, 1368 (Fed. Cir. 2018). The Federal Circuit in Saunders, however, cautioned against the notion that "a veteran could demonstrate service connection simply by asserting subjective pain" because, to establish that a disability is present, the veteran "will need to show that... pain reaches the level of a functional impairment of earning capacity." Id. at 1367-68. "Functional impairment," the Federal Circuit noted, is defined as the inability of the body or a constituent part of it "'to function under the ordinary conditions of daily life including employment.'" Id. at 1363 (quoting 38 C.F.R. § 4.10). ??

In determining whether service connection is warranted for a disability, VA is responsible for determining whether the evidence supports the claim or is in relative equipoise, with the Veteran prevailing in either event, or whether the weight of the evidence is against the claim, in which case the claim is denied.? 38?U.S.C. §?5107.? When there is an approximate balance of positive and negative evidence regarding any issue material to the determination, the benefit of the doubt is afforded the claimant.??

To deny a claim on its merits, the weight of the evidence must persuasively stand against a finding that the evidence is in
Id. at 1363 (quoting 38 C.F.R. § 4.10). ??

To deny a claim on its merits, the weight of the evidence must persuasively stand against a finding that the evidence is in "approximate balance" or "nearly equal" to the evidence that supports the claim.? Lynch v. McDonough,?21 F.4th 776 (Fed. Cir. 2021) (en banc).????????

In making all determinations, the Board must fully consider the lay assertions of record.?? A layperson is competent to report on the onset and recurrence of symptoms.? See Layno v. Brown,?6?Vet. App.?465, 470?(1994) (a Veteran is competent to report on that of which he or she has personal knowledge).? Lay evidence can also be competent and sufficient evidence of a diagnosis or to establish etiology if (1) the layperson is competent to identify the medical condition, (2) the layperson is reporting a contemporaneous medical diagnosis, or (3) lay testimony describing symptoms at the time supports a later diagnosis by a medical professional.?? Davidson v. Shinseki,?581 F.3d 1313, 1316?(Fed. Cir. 2009); Jandreau v. Nicholson,?492 F.3d 1372, 1376-77?(Fed. Cir. 2007).??

The Board is charged with the duty to assess the credibility and weight given to evidence.? Madden v. Gober, 125 F.3d 1477, 1481 (Fed. Cir. 1997), cert. denied, 523 U.S. 1046 (1998); Wensch v. Principi, 15?Vet. App.?362, 367 (2001).? Indeed, in Jefferson v. Principi, 271 F.3d 1072 (Fed. Cir. 2001), the Federal Circuit, citing its decision in Madden, recognized that that Board had inherent fact-finding ability.? Id. at 1076; see also 38 U.S.C. § 7104(a).? Moreover, the United States Court of Appeals for Veterans Claims (Court) has declared that in adjudicating a claim, the Board has the responsibility to weigh and assess the evidence.? Bryan v. West, 13?Vet. App.?482, 488-89 (2000); Wilson v. Derwinski, 2?Vet. App.?614, 618 (1992).??

As a finder of fact, when considering whether lay evidence is satisfactory, the Board may also properly consider internal inconsistency of the statements, facial plausibility, consistency with other evidence submitted on behalf of the Veteran, and the Veteran's demeanor when testifying at a hearing.? See Dalton v. Nicholson, 21?Vet. App.?23, 38 (2007); Caluza v. Brown, 7?Vet. App.?498, 511 (1995), aff'd per curiam, 78 F.3d 604 (Fed. Cir. 1996).??

1. Service connection for right shoulder condition is granted.

The Veteran seeks service connection for his right shoulder condition and urges that his condition is related to service.

In support, the Veteran testified that when wearing his rucksack during basic training, he hurt his right shoulder and has continued to have issues with it since. See July 2022 Hearing transcript. The Veteran further testified that he suffers from a sharp pain sensation in his right arm, that started in service and has continued since the incident in-service. Id.

The Veteran has a current diagnosis of right shoulder bursitis. See February 2024 VA examination.

As the finder of fact,
sharp pain sensation in his right arm, that started in service and has continued since the incident in-service. Id.

The Veteran has a current diagnosis of right shoulder bursitis. See February 2024 VA examination.

As the finder of fact, the Board concludes that the first and second element of service connection can be reasonably conceded. All that remains to be resolved is whether the medical evidence of record establishes a link between the Veteran's service and his conditions.

Relevant to this claim, the Veteran underwent a VA examination for his condition in February 2024, and several VA medical opinions were provided in February 2024, July 2024, and March 2025.

During the February 2024 VA examination, the Veteran reported chronic pain and problems with his right shoulder since service, describing the onset as reported in the July 2022 hearing.

However, the subsequent VA medical opinions, opined that the Veteran's right shoulder condition was less likely than not incurred in or caused by the claimed in-service injury, event, or illness. The examiners' rationales were based on a lack of continuation of care but noting the February 2015 medical treatment records noting a complaint of sharp pain in the Veteran's right shoulder. Here, the VA medical opinions effectively disregarded the Veteran's competent and credible lay account of having issues with his shoulder in and since service.

The Board notes that the Veteran's reports are consistent with the circumstances of his service.? 38?U.S.C. §?1154; 38?C.F.R. §?3.303(a).? Thus, the lay and medical evidence shows that the Veteran's right shoulder pain and symptoms, which have been linked to the current diagnosis, had their onset in service and have been recurrent since that time and thus service connection is warranted.??

The evidence shows that the Veteran's right shoulder condition is related to service, thus, service connection is warranted.? See Flynn v. Brown, 6?Vet. App.?500, 503 (1994) (noting that "the element of cause and effect has been totally by-passed in favor of a simple temporal relationship between the incurrence of the disability and the period of active duty"); see also 38?C.F.R. §?3.303(a) (Service connection connotes many factors but basically it means that the facts, shown by evidence, establish that a particular injury or disease resulting in disability was incurred coincident with service in the Armed Forces).??

The Board acknowledges the negative VA nexus opinion of record; however, because the Board finds the Veteran's report that his right shoulder symptoms started in service, and has been recurrent since, to be credible, service connection is warranted.? The competent and credible evidence is at least approximately balanced, and benefit of the doubt doctrine applies.? 38?U.S.C. §?5107(b); see Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021) (en banc).??

In light of the foregoing, and after resolving any doubt in the Veteran's favor, the Board finds that service connection for right shoulder condition is warranted.? See Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021) (en banc).??

2. Service connection for right foot condition is granted.

3. Service connection for left foot condition is granted.

The Veteran seeks service connection for his bilateral feet conditions and urges that his conditions are related to service. Specifically, the Veteran testified that while on active duty, he had to stay out all night, and that he lost the sensation on the tips of his feet. See July 2022 Hearing transcript. In addition, the Veteran's STRs provide that in April 2003, the Veteran complained of cold and numb feet. As he received treatment, it was noted that his feet were cold to the touch.

Here, as explained below, the Board finds that all three elements of direct service connection are established by the competent and credibly lay and medical evidence of records as to the Veteran's bilateral feet conditions. 38 U.S.C. § 1110; 38 C.F.R. § 3.303; Shedden v. Principi, 381 F.3d 1163, 1166-67
lost the sensation on the tips of his feet. See July 2022 Hearing transcript. In addition, the Veteran's STRs provide that in April 2003, the Veteran complained of cold and numb feet. As he received treatment, it was noted that his feet were cold to the touch.

The Veteran has a current diagnosis of bilateral feet numbness, with a history of frostbite injury. See March 2022 VA treatment records; see also February 2025 VA medical opinion; March 2025 VA examination.

As the finder of fact, the Board concludes that the first and second elements of service connection can be reasonably conceded. All that remains to be resolved is whether the medical evidence of record establishes a link between the Veteran's service and his conditions.

While the Board acknowledges the negative nexus opinions of record, the Board emphasizes the rationale behind the February 2025 VA medical opinion. Specifically, in the February 2025 VA medical opinion, the examiner opined that the Veteran's claimed bilateral foot conditions related to frost bite injury with residual numbness and tingling bilaterally is at least 50% or more due to cold weather injury during service in 2003. The examiner noted that the Veteran reports numbness in toes and stinging pain when it gets cold, which has been occurring since 2003. The examiner provided that according to medical literature, individuals who have experienced frostbite may have residual numbness and tingling in their feet later in life. This can occur due to nerve damage caused by the frostbite, leading to long-term sensitivity issues in the affected areas.

For the above reasons, the evidence is, at worst, evenly balanced or approximately so with regard to whether the Veteran's bilateral feet conditions had its onset during service.? See Flynn v. Brown, 6?Vet. App.?500, 503 (1994) (noting that "the element of cause and effect has been totally by-passed in favor of a simple temporal relationship between the incurrence of the disability and the period of active duty"); see also 38?C.F.R. §?3.303(a) (Service connection connotes many factors but basically it means that the facts, shown by evidence, establish that a particular injury or disease resulting in disability was incurred coincident with service in the Armed Forces).?????

In light of the foregoing, and after resolving any doubt in the Veteran's favor the Board finds that service connection for bilateral feet conditions, diagnosed as bilateral feet numbness with a history of frostbite, is warranted. See Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021) (en banc).

N. Rippel

Acting Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board S. Nettles, 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.

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