SHOULDER IMPAIRMENT OF

Summary

The Veteran, a U.S. Marine Corps Veteran who served from March 2008 to March 2012, appeals the denial of service connection for bilateral shoulder disabilities. The Veteran claimed these shoulder conditions were secondary to his already service-connected lumbar disability. The Board reviewed the evidence, including a November 2024 rating decision that denied the claim, and a subsequent request for higher level review which led to a May 2025 rating decision, the one under appeal. The Board considered the evidence docketed up to the date of the rating decision. The Veteran's claim for secondary service connection for his left and right shoulder disabilities was based on aggravation by his service-connected lumbar disability. The Board found a current diagnosis of left shoulder degenerative arthritis with impingement syndrome and right shoulder impingement syndrome. A VA examiner in April 2024 provided an inadequate opinion, stating the shoulder conditions were less likely than not directly caused by the lumbar disability but failed to address aggravation. Another VA examiner in October 2024 opined that while lumbar strain doesn't directly cause shoulder impingement, it can aggravate shoulder pain due to sleeping positions. A private chiropractor in July 2024 also provided a positive opinion linking the shoulder pain to the low back pain, supported by a medical article. The Board found these latter opinions probative and concluded the weight of the evidence supports that the bilateral shoulder disabilities are caused by the service-connected lumbar disability. Service connection for both left and right shoulder disabilities on a secondary basis was granted.

Rationale

Current left shoulder disability diagnosed as degenerative arthritis with impingement syndrome.; Aggravated by service-connected lumbar disability due to sleeping position.; VA examiner's opinion inadequate for failing to address aggravation.

Full Decision Text

Citation Nr: A25107163
Decision Date: 12/11/25	Archive Date: 12/11/25

DOCKET NO. 250523-545808
DATE: December 11, 2025

ORDER

Entitlement to service connection a left shoulder disability, to include as secondary to the Veteran's service-connected lumbar disability, is granted.

Entitlement to service connection for a right shoulder disability, to include as secondary to the Veteran's service-connected lumbar disability, is granted.

FINDING OF FACT

The most probative evidence of record demonstrates that the Veteran's left and right shoulder disabilities are aggravated by his service-connected lumbar disability.

CONCLUSIONS OF LAW

1. The criteria for service connection for a left shoulder disability, to include as secondary to a service-connected lumbar disability, have been met.  38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.159, 3.303, 3.310.

2. The criteria for service connection for a right shoulder disability, to include as secondary to a service-connected lumbar disability, have been met.  38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.159, 3.303, 3.310.

REASONS AND BASES FOR FINDING AND CONCLUSIONS

The Veteran had active service in the U.S. Marine Corps from March 2008 to March 2012.

The Board notes that the Veteran's service connection claim was denied in a November 2024 rating decision.  In November 2024, the Veteran submitted a request for higher level review, and the AOJ concluded that a difference of opinion occurred and mandated special review.  The AOJ completed development and denied the Veteran's claim again in a May 2025 rating decision, which is the decision on appeal.  Based on the Veteran's selection of the evidence docket, the Board can only consider evidence received up to the date of the rating decision on appeal and evidence received within 90 days of receipt of the VA Form 10182 Notice of Disagreement.  38 C.F.R. § 20.303.

Service Connection

Service connection may be granted for a disability resulting from disease or injury incurred in or aggravated by active service.?38?U.S.C. §?1110;?38?C.F.R. §?3.303(a). To establish a right to compensation for a present disability, 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-the so-called "nexus" requirement.?Holton v. Shinseki, 557 F.3d 1362, 1366 (Fed. Cir. 2009) (quoting?Shedden?v.?Principi, 38 F.3d 1163, 1167 (Fed. Cir. 2004)). The absence of any one element will result in a denial of service connection.

Additionally, service connection may be granted on a secondary basis when the evidence establishes (1) that a current disability exists and (2) that the current disability was either (a) caused by or (b) aggravated by a service-connected disability.? See Wallin v. West, 11?Vet. App.?509, 512 (1998); 38?C.F.R. §?3.310.

Service connection must be considered on the basis of the places, types, and circumstances of a veteran's service as shown by his or her service records, the official history of each organization in which he or she served, his or her medical records, and all pertinent medical and lay evidence.? See 38?C.F.R. §?3.303 (a).

Entitlement to service connection for a right and left shoulder disability

The Veteran maintains that his bilateral shoulder disability was caused or aggravated by his service-connected lumbar disability.  The Board agrees and finds that the elements of service connection on a secondary basis have been established. 

With respect to current disability,?the AOJ rendered a favorable finding in the May 2025 rating decision that the Veteran has a current disability of left shoulder degenerative arthritis with impingement syndrome and right shoulder impingement syndrome.  

The remaining question is whether the Veteran's left and right shoulder disabilities were either caused by or aggravated by his service-connected lumbar disability.? The record contains positive and negative medical opinions addressing this question.

In April 2024, a VA examiner concluded that the Veteran's diagnosed shoulder impingement syndrome was less likely than
 that his bilateral shoulder disability was caused or aggravated by his service-connected lumbar disability.  The Board agrees and finds that the elements of service connection on a secondary basis have been established. 

With respect to current disability,?the AOJ rendered a favorable finding in the May 2025 rating decision that the Veteran has a current disability of left shoulder degenerative arthritis with impingement syndrome and right shoulder impingement syndrome.  

The remaining question is whether the Veteran's left and right shoulder disabilities were either caused by or aggravated by his service-connected lumbar disability.? The record contains positive and negative medical opinions addressing this question.

In April 2024, a VA examiner concluded that the Veteran's diagnosed shoulder impingement syndrome was less likely than not directly caused by or a result of the Veteran's service-connected lumbar disability, as they are unrelated.  This opinion is inadequate.  First, it is conclusory and does not contain a full rationale.  Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 304 (2008) ("Neither a VA medical examination report nor a private medical opinion is entitled to any weight in a service-connection or rating context if it contains only data and conclusions.").  Second, the examiner did not fully address the secondary aspect of the Veteran's service connection claim.  Entitlement to service connection on a secondary basis requires a medical opinion as to whether the disability was caused by or aggravated by a service-connected disability. See El-Amin v. Shinseki, 26?Vet. App.?136, 140-41 (2013).  While the examiner addressed whether the Veteran's shoulder disability was caused by the service-connected disability, he did not address aggravation.

Another VA examiner offered an opinion in October 2024.  As to causation, the examiner reasoned that lumbar strain does not directly cause shoulder impingement syndrome or shoulder arthritis.  However, the examiner provided a positive opinion as to aggravation.  The examiner noted the Veteran's reports that lumbar strain caused the Veteran to sleep on his side and resulted in shoulder pain.  The examiner further concluded that sleeping on one's side puts pressure on the shoulder for extended periods of time, which can aggravate and increase shoulder pain. 

A private chiropractor also provided a positive opinion in July 2024.  The chiropractor acknowledged the Veteran's complaints of shoulder pain after beginning to sleep on his side due to his back pain.  Based on these reports, the chiropractor concluded that the Veteran's shoulder pain is the result of his low back pain.  

These opinions are thorough.  They are based on review of the medical record and the Veteran's lay statements, and they are supported by a complete rationale.  In addition to these opinions, the Veteran submitted a medical article demonstrating the sleeping position contributes to shoulder pain, especially in patients with impingement syndrome.  Accordingly, the Board finds that the opinions are highly probative.  

As a result, the Board finds that the weight of the evidence supports a conclusion that the Veteran's bilateral shoulder disability is caused by his service-connected lumbar disability, and service connection is granted on a secondary basis.  38?C.F.R. § 3.310.

 

GAYLE STROMMEN

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	Beech, T.

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.