MAJOR DEPRESSIVE DISORDER

SCOTT W. DALE · 2026 · Case ID: A26033694

MIXED

Summary

The veteran served on active duty from November 2017 to April 2020. The veteran appealed the denial of service connection for hearing loss, visual impairment, and a right shoulder disability, while also seeking service connection for an acquired psychiatric disorder (major depression). The Board granted service connection for major depression, noting that a prior favorable finding by the AOJ was not clearly and unmistakably erroneous and that the Board was bound by this finding. The Board found the June 2024 VA opinions inadequate for major depression as they failed to consider in-service insomnia symptoms and the prior favorable finding. For hearing loss, the Board denied service connection, finding the veteran failed to report for a scheduled VA examination and did not provide good cause. The Board also noted that noise exposure does not constitute a Toxic Exposure Risk Activity (TERA) for VA purposes. For visual impairment, the Board denied service connection, finding the veteran cancelled a necessary examination without good cause and was not competent to opine on the etiology of the disability. For the right shoulder disability, the Board denied service connection, finding no current diagnosis of a right shoulder disability and that the veteran's lay statements were not competent to establish etiology. The Board remanded claims for erectile dysfunction, bilateral knee disabilities, and left shoulder disability for correction of duty-to-assist errors, specifically requiring etiology opinions.

Rationale

Prior AOJ grant of service connection for acquired psychiatric disorder is binding.; Subsequent VA opinions were inadequate for failing to consider in-service insomnia and prior favorable finding.; Board found no clear and unmistakable error in prior AOJ decision.

Special Benefit

NO SPECIAL BENEFIT

Docket No.

250415-537842

Full Decision Text

Citation Nr: A26033694
Decision Date: 04/13/26 Archive Date: 04/13/26

DOCKET NO. 250415-537842
DATE: April 13, 2026

ORDER

Service connection for an acquired psychiatric disorder, diagnosed as major depression, is granted.

Service connection for hearing loss is denied.

Service connection for visual impairment is denied.

Service connection for a right shoulder disability is denied.

REMANDED

The issue of entitlement to service connection for erectile dysfunction is remanded.

The issue of entitlement to service connection for a left knee disability is remanded.

The issue of entitlement to service connection for a right knee disability is remanded.

The issue of entitlement to service connection for a left shoulder disability is remanded.

FINDINGS OF FACT

1. In a December 2025 rating decision, VA found that the Veteran's acquired psychiatric disorder was directly related to active service and there is no evidence of record that identifies a clear and unmistakable error (CUE) in that favorable finding.

2. The evidence of record persuasively weighs against finding that the Veteran has hearing loss that began during active service or is otherwise related to an in-service injury or disease.

3. The evidence of record persuasively weighs against finding that the Veteran has visual impairment that began during active service or is otherwise related to an in-service injury or disease.

4. The evidence of record persuasively weighs against finding that the Veteran has had a right shoulder disability at any time during or approximate to the pendency of the claim.

CONCLUSIONS OF LAW

1. The criteria for service connection for an acquired psychiatric disorder, diagnosed by major depression, are met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.104, 3.303, 20.801(a).

2. The criteria for service connection for hearing loss are not met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.385, 3.655.

3. The criteria for service connection for visual impairment are not met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.655.

4. The criteria for service connection for right shoulder disability are not met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303.

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Veteran served on active duty from November 2017 to April 2020.

This matter comes before the Board of Veterans' Appeals (Board) on appeal from June 2024 rating decisions issued by a Department of Veterans Affairs (VA) Regional Office (RO).

In the April 2025 VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement), the Veteran elected to appeal the issues listed above and requested a direct review of the evidence considered by the RO. Therefore, the Board may only consider the evidence of record at the time of the June 2024 decisions on appeal. 38?C.F.R. § 20.303.

If the Veteran would like VA to consider any evidence that was submitted that the Board could not consider, the Veteran may file a supplemental claim (VA Form 20-0995) and submit or identify this evidence. 38 C.F.R. § 3.2501. If the evidence is new and relevant, VA will issue another decision on the claims regarding entitlement to service connection for an acquired psychiatric disorder, hearing loss, visual impairment, and a right shoulder disability, considering the new evidence in addition to the evidence previously considered. Id. Specific instructions for filing a supplemental claim are included with this decision.

However, because the Board is remanding the claims of entitlement to service connection for erectile dysfunction, bilateral knee disabilities, and a left shoulder disability, any evidence the Board could not consider will be considered by the Agency of Original Jurisdiction (AOJ) in the adjudication of those claims. 38 C.F.R. § 3.103(c)(2)(ii).

As the record contains diagnoses of varying psychiatric disabilities, the Board has recharacterized and considered the claim on appeal accordingly. Clemons v. Shinseki, 23 Vet. App. 1 (2009).

SERVICE CONNECTION

Service connection may be established for a disability resulting from personal injury suffered or disease contracted in the line of duty in the active military, naval, or air service. 38 U.S.C. § 1110; 38 C.F.R. § 3
left shoulder disability, any evidence the Board could not consider will be considered by the Agency of Original Jurisdiction (AOJ) in the adjudication of those claims. 38 C.F.R. § 3.103(c)(2)(ii).

As the record contains diagnoses of varying psychiatric disabilities, the Board has recharacterized and considered the claim on appeal accordingly. Clemons v. Shinseki, 23 Vet. App. 1 (2009).

SERVICE CONNECTION

Service connection may be established for a disability resulting from personal injury suffered or disease contracted in the line of duty in the active military, naval, or air service. 38 U.S.C. § 1110; 38 C.F.R. § 3.303(a). In order to prevail on the issue of service connection, there must be competent, credible evidence of (1) a current disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a nexus, or link, between the current disability and the in-service disease or injury and the present disease or injury. See Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004).

An award of service connection requires a finding of a current disability that is related to an injury or disease in service. Watson v. Brown, 4 Vet. App. 309 (1993); Brammer v. Derwinski, 3 Vet. App. 223, 225 (1992); Rabideau v. Derwinski, 2 Vet. App. 141, 143 (1992). Under applicable regulation, the term "disability" means impairment in earning capacity resulting from diseases and injuries and their residual conditions. 38 C.F.R. § 4.1; Hunt v. Derwinski, 1 Vet. App. 292, 296 (1991); Allen, 7 Vet. App. 439; Saunders v. Wilkie, 886 F.3d 1356 (Fed. Cir. 2018) (the term "disability" as used in 38 U.S.C. § 1110 "refers to the functional impairment of earning capacity, not the underlying cause of said disability," and held that "pain alone can serve as a functional impairment and therefore qualify as a disability").

In McClain v. Nicholson, 21 Vet. App. 319, 321 (2007), the United States Court of Appeals for Veterans Claims (Court) held that the requirement of the existence of a current disability is satisfied when a claimant has a disability at the time he files his claim for service connection or during the pendency of that claim, even if the disability resolves prior to adjudication of the claim. However, in Romanowsky v. Shinseki, 26 Vet. App. 289 (2013), the Court held that when the record contains a recent diagnosis of disability prior to a claimant filing a claim for benefits based on that disability, the report of diagnosis is relevant evidence that the Board must address in determining whether a current disability existed at the time the claim was filed or during its pendency.

1. Entitlement to service connection for an acquired psychiatric disorder

The Veteran contends that he has an acquired psychiatric disorder, to include major depression, that began in service.

The Veteran's service treatment records show that in September 2019, he reported difficulty sleeping for the past month. He denied depression. He was assessed with unspecified insomnia. In October 2019, he reported difficulty falling and staying asleep. He was noted to have insomnia.

The Veteran was provided with a VA mental disorders examination in April 2024 where he was diagnosed with major depressive disorder (MDD) and generalized anxiety disorder (GAD). In June 2024 opinions, a VA examiner opined that the Veteran's MDD and GAD were less likely than not due to his service as "there does not appear to be evidence supportive of the Veteran's claimed condition, nor has there been any documented treatment for the disorder."

The Board finds that the June 2024 VA opinions are inadequate. The opinions indicated that there was no evidence to support the Veteran's condition and there was no documented treatment for the disorder. However, the Board notes that the Veteran was provided with a VA mental disorders examination in April 2024 which showed a diagnosis for MDD and GAD. Furthermore, the June 2024 opinions did not consider or discuss the Veteran's treatment for insomnia in service and whether this represented early symptoms of his current acquired psychiatric disorder.

The Board notes that in a December 2025 rating decision, the AOJ granted service connection for an acquired mental health disorder on a direct basis based on a December 2025
documented treatment for the disorder."

The Board notes that in a December 2025 rating decision, the AOJ granted service connection for an acquired mental health disorder on a direct basis based on a December 2025 VA examination report that contained a positive nexus opinion. The effective date for the award of service connection is May 7, 2025. The Board is bound by all favorable findings, even those in VA decisions occurring outside the evidentiary window(s), absent a finding of CUE. 38 C.F.R. §§ 3.104(c), 20.801(a). The Board finds no basis in the evidence to find that a CUE has been made in the December 2025 rating decision. Accordingly, the AOJ findings were not clearly and unmistakably erroneous.

Moreover, although the rating decision has already established service connection for the claimed disability, the Board finds a grant of the claim is appropriate so as not to prejudice the Veteran. See Green v. McDonough, 37 Vet. App. 127, 136-48 (2024) (holding that a subsequent AOJ decision cannot divest the Board of jurisdiction over the prior appeal; therefore, an AOJ grant of service connection cannot finally decide the claim of service connection already on appeal to the Board). In this case, the June 2024 rating decision on appeal stems from a January 2024 claim (VA 21-526EZ). As such, this appeal period extends prior to May 7, 2025.

Hence, service connection for an acquired psychiatric disorder, diagnosed as major depression, is granted, and the AOJ should keep the above procedural history in mind when assigning a new effective date for the award of service connection.

2. Entitlement to service connection for hearing loss

The Veteran contends that he has hearing loss as a result of his acknowledged noise exposure in service.

The Board notes that in a July 2025 rating decision, the AOJ confirmed and continued the denial of entitlement to service connection for bilateral hearing loss. In the July 2025 decision, the AOJ made favorable findings that the Veteran has been diagnosed with bilateral hearing loss for VA purposes and that he had participation in a toxic exposure risk activity (TERA) due to his military occupational specialty (MOS) as a motor transport operator which had a moderate probability for hazardous noise exposure. As noted above, the Board is bound by all favorable findings, even those in VA decisions occurring outside the evidentiary window, absent a finding of CUE. 38 C.F.R. §§ 3.104(c), 20.801(a).

The CUE standard applicable to rebuttal of favorable findings is similar to the definition of CUE found in § 3.105(a)(1)(i) and § 20.1403(a) that applies to finally adjudicated issues. In this case, the Board does not find any clear and unmistakable error in the AOJ's finding of a current disability. However, the Board finds that the favorable finding regarding participation in a TERA was clearly and unmistakably erroneous.

As an initial matter, the Board notes that a June 2024 VA memorandum found that the Veteran did not participate in a TERA. The July 2025 rating decision also lists the June 2024 TERA memorandum among the evidence considered and notes that it indicates that the Veteran did not participate in a TERA. In its analysis, the AOJ also notes that the evidence does not show that the Veteran participated in a TERA. Furthermore, the Board notes that noise exposure does not constitute a TERA for VA purposes as TERA is limited to exposure to toxic substances rather than acoustic trauma. As there is no plausible support for the finding in the July 2025 decision finding that the Veteran was exposed to a TERA, the Board finds that the error in this case, as it pertains to that particular finding, is undebatable. Thus, the Board finds that the evidence rebuts the favorable finding that the Veteran had participation in a TERA and the Board is not bound by this finding. Nonetheless, the Board acknowledges that the Veteran was exposed to hazardous noise while in service.

In light of the fact that the Veteran did not appear for the necessary examination in conjunction with his claim for service connection, the appeal will be decided based on
purposes as TERA is limited to exposure to toxic substances rather than acoustic trauma. As there is no plausible support for the finding in the July 2025 decision finding that the Veteran was exposed to a TERA, the Board finds that the error in this case, as it pertains to that particular finding, is undebatable. Thus, the Board finds that the evidence rebuts the favorable finding that the Veteran had participation in a TERA and the Board is not bound by this finding. Nonetheless, the Board acknowledges that the Veteran was exposed to hazardous noise while in service.

In light of the fact that the Veteran did not appear for the necessary examination in conjunction with his claim for service connection, the appeal will be decided based on the evidence of record. 38 C.F.R. § 3.655(b). Under such circumstances, there is no duty to provide another examination or to obtain an additional medical opinion.

The question for the Board is whether the Veteran has a current disability that began during service or is related to an in-service injury, event, or disease.

With respect to hearing loss, the Board notes that this particular disability is defined by regulation. Specifically, under the laws administered by VA, impaired hearing will be considered to be a disability when the auditory threshold in any of the frequencies 500, 1000, 2000, 3000, or 4000 Hertz is 40 decibels or greater; when the auditory thresholds for at least three of the above frequencies are 26 decibels or greater; or when speech recognition scores using the Maryland CNC Test are less than 94 percent. 38 C.F.R. § 3.385.

The Veteran's service treatment records show that he had bilateral impacted cerumen in August 2019 and in December 2019.

On March 27, 2024, correspondence was sent to the Veteran notifying him of an upcoming hearing loss examination on April 16, 2024. The evidence of record does not indicate that the Veteran did not receive this correspondence as there is no indication that this letter was returned in the mail. The Veteran failed to report for the hearing loss examination on April 16, 2024.

The Board finds that the Veteran had adequate notice of his April 2024 hearing loss examination as he was provided with documentation of the upcoming appointment via the correspondence noted above. This was mailed to his current address on file. Furthermore, the Veteran was mailed a copy of the June 2024 rating decision, where it was noted that he failed to report for his examination and the evidence did not show good cause for his failure to report. The Board notes that the Veteran has not attempted to reschedule this appointment.

If the Veteran misses a scheduled VA examination, the Board must consider (1) whether the examination was necessary to decide the claim and (2) whether the veteran had good cause to miss the examination. Turk v. Peake, 21 Vet. App. 565, 569 (2008). In this case, the examination was necessary to decide the claim as the evidence of record at the time did not contain a diagnosis for hearing loss or a nexus linking the Veteran's hearing loss to his service. The Veteran has not provided good cause for not appearing for his scheduled examination.

To the extent the Veteran contends that he has hearing loss as a result of his service, the Board finds that he is not competent to render such an opinion.

The Board must determine on a case-by-case basis whether a particular medical issue is within the competence of a lay person. Kahana v. Shinseki, 24 Vet. App. 428 (2011). The Veteran in this case is not shown to possess any pertinent medical training or expertise that would make him competent to render an opinion as to the etiology of his hearing loss. Making these determinations requires specific medical testing and training. Thus, to the extent that the Veteran's lay statements express an opinion that his visual impairment is related to service, they are not competent medical opinions, and they cannot be assigned any probative weight.

The Veteran is competent to report on matters observed or within his personal knowledge. See Layno v. Brown, 6 Vet. App. 465, 470 (1994). Although the Veteran is competent to report on symptoms of decreased hearing, he is not competent to provide an opinion on the etiology of this disability.

The Board notes that aside from the Veteran's own statements, the evidence of record does not contain any evidence suggesting a link between his current disability and his active-duty service.

In summary, the Veteran did not appear for the scheduled April 2024 VA examination and did not otherwise provide the evidence necessary to support his claim, despite bearing the burden to substantiate each element of his claim. Fagan v. Shinseki, 573 F.3d 1282, 1287 (Fed. Cir. 2009). See Wood v. Derwinski, 1 Vet. App. 190, 193 (1991) ("The duty to assist is not always a one-way street. If a Veteran wishes help, he cannot passively wait for it in those circumstances where he may or should have information that is essential in obtaining the putative evidence."). When a claimant fails to report for an examination scheduled in conjunction with an original compensation claim, the claim shall be rated based on the evidence of record. 38 C.F.R. § 3.655. Here, following the Veteran's lack of appearance for the examination, the evidence is insufficient to establish that he has hearing loss as a result of his service.

Accordingly, the Board finds that service connection for hearing loss has not been established, and the claim must be denied. As the evidence is against the claim, the benefit of the doubt doctrine is not applicable. 38 U.S.C. § 5107; 38 C.F.R. § 3.10.

3. Entitlement to service connection for visual impairment

The Veteran contends that he has visual impairment as a result of his service.

In light of the fact that the Veteran cancelled the necessary examination in conjunction with his claim for service connection, the appeal will be decided based on the evidence of record. 38 C.F.R. § 3.655(b). Under such circumstances, there is no duty to provide another examination or to obtain an additional medical opinion.

The question for the Board is whether the Veteran has a current disability that began during service or is related to an in-service injury, event, or disease.

The Veteran's service treatment records show that he was noted to have bilateral astigmatism in February 2018. In October 2019, he was noted to have bilateral hypermetropia and unspecified astigmatism.

On April 4, 2024, the Veteran called VA to reschedule his upcoming examination regarding his claim for visual impairment. He stated that he was unable to attend the examination as he would be out of town during that time. He was advised to contact the VA in order to have the examination rescheduled. See April 2024 Report of General Information. The examination was subsequently cancelled pursuant to the Veteran's request. The evidence of record does not show that the Veteran has attempted to reschedule this examination.

The Board finds that the Veteran had adequate notice of his April 2024 visual impairment examination as he was provided with documentation of the upcoming appointment via correspondence sent to his address of record on March 14, 2023. The Veteran called VA and asked to reschedule this appointment because he would be out of town. He was advised to contact VA to reschedule the examination, but the evidence of record does not show that he has attempted to reschedule this appointment.

If the Veteran misses a scheduled VA examination, the Board must consider (1) whether the examination was necessary to decide the claim and (2) whether the veteran had good cause to miss the examination. Turk v. Peake, 21 Vet. App. 565, 569 (2008). In this case, the examination was necessary to decide the claim as the evidence of record did not indicate what kind of visual impairment the Veteran had, and whether this was related to his service. The Veteran has not provided good cause for cancelling his scheduled examination.

To the extent the Veteran contends that he has visual impairment as a result of his service, the Board finds that he is not competent to render such an opinion.

The Board must determine on a case-by-case basis whether a particular medical issue is within the competence of a lay person. Kahana v. Shinseki, 24 Vet. App. 428 (2011). The Veteran in this case is not shown to possess any pertinent medical training or expertise that would make him competent to render an opinion as to the etiology of his visual impairment. Making these determinations requires specific medical testing and training. Thus, to the extent that the Veteran's lay
his service. The Veteran has not provided good cause for cancelling his scheduled examination.

To the extent the Veteran contends that he has visual impairment as a result of his service, the Board finds that he is not competent to render such an opinion.

The Board must determine on a case-by-case basis whether a particular medical issue is within the competence of a lay person. Kahana v. Shinseki, 24 Vet. App. 428 (2011). The Veteran in this case is not shown to possess any pertinent medical training or expertise that would make him competent to render an opinion as to the etiology of his visual impairment. Making these determinations requires specific medical testing and training. Thus, to the extent that the Veteran's lay statements express an opinion that his visual impairment is related to service, they are not competent medical opinions, and they cannot be assigned any probative weight.

The Veteran is competent to report on matters observed or within his personal knowledge. See Layno v. Brown, 6 Vet. App. 465, 470 (1994). Although the Veteran is competent to report on the symptoms of visual impairment, he is not competent to provide an opinion on the etiology of this disability.

The Board notes that aside from the Veteran's own statements, the evidence of record does not contain any evidence suggesting a link between his current disability and his active-duty service.

In summary, the Veteran cancelled the scheduled April 2024 VA examination and did not otherwise provide the evidence necessary to support his claim, despite bearing the burden to substantiate each element of his claim. Fagan v. Shinseki, 573 F.3d 1282, 1287 (Fed. Cir. 2009). See Wood v. Derwinski, 1 Vet. App. 190, 193 (1991) ("The duty to assist is not always a one-way street. If a Veteran wishes help, he cannot passively wait for it in those circumstances where he may or should have information that is essential in obtaining the putative evidence."). When a claimant fails to report for an examination scheduled in conjunction with an original compensation claim, the claim shall be rated based on the evidence of record. 38 C.F.R. § 3.655. Here, following the Veteran's cancellation of the examination, the evidence is insufficient to establish that he has visual impairment as a result of his service.

Accordingly, the Board finds that service connection for visual impairment has not been established, and the claim must be denied. As the evidence is against the claim, the benefit of the doubt doctrine is not applicable. 38 U.S.C. § 5107; 38 C.F.R. § 3.10.

4. Entitlement to service connection for a right shoulder disability

The Veteran contends that he has a right shoulder disability as a result of his service. Specifically, he claims that he had to carry an 80-pound sack during ruck marches which he believes caused his current disability.

The question for the Board is whether the Veteran has a current right shoulder disability that began during service or is related to an in-service injury, event, or disease.

The Board concludes that the Veteran does not have a current diagnosis of a right shoulder disability and has not had one at any time during the pendency of the claim or recent to the filing of the claim. Romanowsky v. Shinseki, 26 Vet. App. 289, 294 (2013); McClain v. Nicholson, 21 Vet. App. 319, 321 (2007).

The Veteran's service treatment records show that in August 2019, he had shooting pain into his right upper extremity after he fell on his neck playing basketball.

The Veteran was provided with a VA shoulder examination in April 2024 where he reported sharp pain in his left shoulder. He did not report any symptoms in his right shoulder. Range of motion testing was normal and there was no mention of any pain in the right shoulder. The VA examiner noted a diagnosis for left shoulder strain. No diagnosis was provided for a right shoulder disability.

While the Veteran may believe there is a current diagnosis of a right shoulder disability, he is not competent to provide a diagnosis in this case. The issue is medically complex, as it requires specialized medical education. Jandreau v. Nicholson, 492 F.3d 1372, 1377, 1377 n.4 (Fed. Cir. 2007). Consequently, the Board gives more probative weight to the competent medical evidence.

At the April 2024 VA shoulder examination, the Veteran did not indicate that he had any symptoms of a right shoulder disability. The VA examiner did not indicate a diagnosis for a right shoulder disability. Furthermore, the Veteran's VA treatment records throughout the period on appeal do not show any treatment for or a diagnosis of a right shoulder disability. More specifically, the record does not include evidence of the Veteran experiencing right shoulder pain resulting in functional impairment of earning capacity that may serve as a disability for VA purposes under 38 U.S.C. 1110. Saunders v. Wilkie, 886 F.3d 1356 (Fed. Cir. 2018).

In sum, the Board finds that the evidence is against a finding that the Veteran has a right shoulder disability that is due to his service. Accordingly, the Board finds that service connection for a right shoulder disability has not been established, and the claim must be denied. As the evidence is against the claim, the benefit of the doubt doctrine is not applicable. 38 U.S.C. § 5107; 38 C.F.R. § 3.102.

REASONS FOR REMAND

1. Entitlement to service connection for erectile dysfunction

The Veteran contends that he has erectile dysfunction that began while he was in service.

The Veteran was provided with a VA male reproductive organ conditions examination in April 2024 where he reported the onset of his symptoms in 2018, while he was still in service. The VA examiner noted a diagnosis of erectile dysfunction.

The issue of entitlement to service connection for erectile dysfunction is remanded to correct a duty-to-assist error that occurred prior to the June 2024 rating decision on appeal. The AOJ obtained an April 2024 VA examination but did not obtain an etiology opinion regarding the Veteran's erectile dysfunction. As the Veteran has alleged the onset of his symptoms in service, the AOJ should have obtained an etiology opinion in this case. As such, the Board finds that the issue must be remanded to obtain a medical opinion.

2. Entitlement to service connection for a left knee disability

3. Entitlement to service connection for a right knee disability

The Veteran contends that he has a bilateral knee disability that began while he was in service. Specifically, he claims that while rucking in service, he fell and injured his knees.

The Veteran was provided with a VA knee examination in April 2024 where he reported the onset of his symptoms in 2018, while still in service. The VA examiner noted a diagnosis of bilateral patellofemoral pain syndrome.

The issues of entitlement to service connection for left and right knee disabilities are remanded to correct a duty-to-assist error that occurred prior to the June 2024 rating decision on appeal. The AOJ obtained an April 2024 VA examination but did not obtain an etiology opinion regarding the Veteran's bilateral knee disability. As the Veteran has alleged the onset of his symptoms in service, the AOJ should have obtained an etiology opinion in this case. As such, the Board finds that the issues must be remanded to obtain a medical opinion.

4. Entitlement to service connection for a left shoulder disability

The Veteran contends that he has a left shoulder disability as a result of his service. Specifically, he claims that he had to carry an 80-pound sack during ruck marches which he believes caused his current disability.

The Veteran was provided with a VA shoulder examination in April 2024 where he reported the onset of his left shoulder symptoms in 2018, while still in service. The VA examiner noted a diagnosis of left shoulder strain.

The issue of entitlement to service connection for a left shoulder disability is remanded to correct a duty-to assist-error that occurred prior to the June 2024 rating decision on appeal. The AOJ obtained an April 2024 VA examination but did not obtain an etiology opinion regarding the Veteran's left shoulder disability. As the Veteran has alleged the onset of his symptoms in service, the AOJ should have obtained an etiology opinion in this case. As such, the Board finds that the issue must be remanded to obtain a medical opinion.

The matters are REMANDED for the following actions:

1. Obtain a medical opinion from an appropriate clinician as to the etiology of the Veteran's erectile dysfunction. The claims file
.

The matters are REMANDED for the following actions:

1. Obtain a medical opinion from an appropriate clinician as to the etiology of the Veteran's erectile dysfunction. The claims file should be reviewed by the clinician. Physical examination is not required unless deemed necessary by the clinician providing the opinion.

The clinician should provide an opinion as to the following:

Is the Veteran's erectile dysfunction due to his service?

A rationale for any opinion expressed should be provided, and a discussion of the facts and medical principles involved would be of considerable assistance.

2. Obtain a medical opinion from an appropriate clinician as to the etiology of the Veteran's bilateral knee disability. The claims file should be reviewed by the clinician. Physical examination is not required unless deemed necessary by the clinician providing the opinion.

The clinician should provide an opinion as to the following:

a) Is the Veteran's left knee disability due to his service?

b) Is the Veteran's right knee disability due to his service?

A rationale for any opinion expressed should be provided, and a discussion of the facts and medical principles involved would be of considerable assistance.

3. Obtain a medical opinion from an appropriate clinician as to the etiology of the Veteran's left shoulder disability. The claims file should be reviewed by the clinician. Physical examination is not required unless deemed necessary by the clinician providing the opinion.

The clinician should provide an opinion as to the following:

Is the Veteran's left shoulder disability due to his service?

A rationale for any opinion expressed should be provided, and a discussion of the facts and medical principles involved would be of considerable assistance.

3. Thereafter, the AOJ must readjudicate the Veteran's appealed issues in light of the totality of evidence of record. If any benefit sought is not granted to the fullest extent, the AOJ must provide the Veteran and his

representative with a copy of the readjudication and afford them an appropriate period to respond.

Scott W. Dale

Acting Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board S. Morrad, 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.

Analyze in VA Law Explorer