Case A26037543

S. BUSH · 2026 · Case ID: A26037543

DENIED

Summary

The veteran, who served in the United States Navy from March 2021 to August 2022, appeals the denial of an earlier effective date for service connection for his right shoulder disability and the denial of an increased rating for this condition. The veteran was granted service connection for right shoulder strain, tendinopathy/tendinitis, and SLAP tear with a 20 percent rating, effective June 3, 2024. The veteran sought an earlier effective date prior to June 3, 2024, but the Board found no evidence of an informal or formal claim filed before that date, nor any argument supporting an earlier date, thus denying this claim. For the increased rating claim, the veteran sought a rating higher than 20 percent based on limitation of arm motion. The Board reviewed the VA examination reports from October 2024, which indicated forward flexion to 155 degrees and abduction to 160 degrees, with pain on motion. Despite noting pain and functional limitations, the Board found that the range of motion did not meet the criteria for higher ratings (45 degrees for midway, 25 degrees for maximum limitation). The Board also considered the ameliorative effects of over-the-counter pain relievers and found no indication that the range of motion would be further restricted without them. The Board concluded that the evidence did not support a rating higher than 20 percent and denied the increased rating claim.

Rationale

Range of motion (flexion 150-155, abduction 160) did not meet criteria for higher ratings (45 or 25 degrees); Pain and functional limitations noted but did not further restrict range of motion to warrant higher rating; Ameliorative effects of over-the-counter pain relievers not shown to impact functional impairment beyond pain reduction

Service Branch

NAVY

Special Benefit

NO SPECIAL BENEFIT

Docket No.

250527-549271

Full Decision Text

Citation Nr: A26037543
Decision Date: 04/22/26 Archive Date: 04/22/26

DOCKET NO. 250527-549271
DATE: April 22, 2026

ORDER

Entitlement to an effective date prior to June 3, 2024, for the award of service connection for right shoulder strain, right shoulder tendinopathy/tendinitis and right shoulder superior labrum anterior to posterior (SLAP) tear is denied.

Entitlement to an initial rating in excess of 20 percent for right shoulder strain, tendinopathy/tendinitis and SLAP tear on the basis of limitation of arm motion is denied.

FINDINGS OF FACT

1. The Veteran first submitted a formal claim of entitlement to service connection for a right shoulder disability on June 3, 2024; prior to this date there is no unadjudicated formal or informal claim of service connection for a right shoulder disability.

2. Throughout the appeal period, the Veteran's right shoulder strain tendinopathy/tendinitis and SLAP tear did not result in or more closely approximate limitation of motion midway between side and shoulder or limited to 25 degrees from the side, nor was there ankylosis of the joint, impairment of the humerus, scapula, or clavicle.

CONCLUSIONS OF LAW

1. The criteria for entitlement to an effective date earlier than June 3, 2024 for the award of service connection for right shoulder strain, right shoulder tendinopathy/tendinitis and right shoulder SLAP tear are not met. 38 U.S.C. § 5110; 38 C.F.R. § 3.400.

2. The criteria for entitlement to an initial rating in excess of 20 percent for right shoulder strain, tendinopathy/tendinitis and SLAP tear are not met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.3, 4.7, 4.71a, Diagnostic Code (DC) 5201.

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Veteran served on active duty in the United States Navy from March 2021 to August 2022. This matter comes before the Board of Veterans' Appeals (Board) from an April 2025 rating decision issued by the Department of Veterans' Affairs (VA) Agency of Original Jurisdiction (AOJ).

Initially, the November 2024 rating decision granted service connection for right shoulder strain, tendinopathy/tendinitis and SLAP tear and assigned a 20 percent rating, effective June 3, 2024. The Veteran then requested Higher-Level Review of the November 2024 rating decision, and in the April 2025 Higher-Level Review decision on appeal, the AOJ continued the 20 percent rating for his right shoulder disability and denied the earlier effective date claim. Additionally, the AOJ found a duty to assist error regarding right rotator cuff tear, reverted the claim to the supplemental claim lane, and further developed the claim. Thereafter, in a June 2025 rating decision, the AOJ continued to deny the claims for increased rating and earlier effective date and noted the already-service connected right SLAP tear was claimed as right rotator cuff tear.

In his May 2025 VA Form 10182, the Veteran requested direct review of the evidence considered by the AOJ. Based upon the selection of the Direct Review option, the Board may only consider the evidence of record as of June 14, 2025 - the date of the rating decision that adjudicated the supplemental claim. See 38 C.F.R. §§ 20.301, 3.2601(f). If the Veteran submitted evidence that was added to the record after June 14, 2025, the Board did not consider it. If the Veteran wishes to have VA consider any evidence that was not considered, a supplemental claim should be submitted identifying such evidence. See 38 C.F.R. § 3.250.

Earlier Effective Dates

1. Entitlement to an effective date prior to June 3, 2024, for the award of service connection for right shoulder strain, right shoulder tendinopathy/tendinitis and right shoulder SLAP tear is denied.

Earlier Effective Dates

In general, the effective date of an award based on an original claim, a claim reopened after final adjudication, or a claim for increase, of compensation, dependency and indemnity compensation, or pension, shall be fixed in accordance with the facts found, but shall not be earlier than the date of receipt of application therefor. 38 U.S.C. § 5110(a). The effective date for an award of service connection is the day following separation from active service or the date entitlement arose, if the claim is received within one year after separation from service; otherwise, the effective date is the later of the date of receipt of the claim or the date entitlement to service connection arose. 38 C.F.R. § 3.400(b)(2).

Moreover, the Court of Appeals for Veterans Claims (Court) has determined that the effective date of an award of service connection is not based upon the date of the earliest medical evidence demonstrating entitlement, but on the date that the application upon which service connection was ultimately awarded was filed with VA. See Lalonde v. West, 12 Vet. App. 377, 380 (1999). ("[T]he effective date of an award of service connection is not based on the date of the earliest medical evidence demonstrating a causal connection, but on the date that the application upon which service connection was eventually awarded was filed with VA.")

The Board notes that on March 24, 2015, VA amended its regulations to require that all claims governed by VA's adjudication regulations be filed on standard forms prescribed by the Secretary, regardless of the type of claim or posture in which the claim arises. See 79 Fed. Reg. 57660 (Sept. 25, 2014). The amendments are effective for claims filed on or after March 24, 2015. As the claim in this case was filed after this date, the amendments are applicable in this instance and will be applied to any filings after March 24, 2015.

Under the old regulations, any communication or action, indicating an intent to apply for one or more benefits under laws administered by VA, from a veteran or his representative, may be considered an informal claim. Such informal claim must identify the benefit sought. Upon receipt of an informal claim, if a formal claim has not been filed, an application form will be forwarded to the claimant for execution. If received within one year from the date it was sent to the veteran, it will be considered filed as of the date of receipt of the informal claim. 38 C.F.R. § 3.155(a) (as in effect prior to March 24, 2015).

Further, for appeals governed by the AMA, as here, 38 C.F.R. § 3.2500(h) controls the assignment of effective dates. Under that provision, the effective date will be the date VA received a veteran's initial claim, or the date entitlement arose, whichever is later, if a veteran continuously pursues an issue by timely filing in succession any of the available review options as specified in § 3.2500(c) within one year of the issuance of the decision. 38 C.F.R. § 3.2500(h). With supplemental claims received more than one year after notice of a decision, the effective date will be fixed in accordance with the date of entitlement arose but will not be earlier than the date of receipt of the supplemental claim. 38 C.F.R. § 3.2500(h)(2).

Here, the Veteran seeks an earlier effective date prior to June 3, 2024 for the award of service connection for his right shoulder disabilities.

In considering the evidence of record under the laws and regulations as set forth above, the Board concludes that an effective date earlier than June 3, 2024 is not warranted. Specifically, the Veteran submitted a formal claim on June 3, 2024, claiming entitlement to service connection for a right shoulder strain and right shoulder rotator cuff tear. Critically, no informal (before March 24, 2015) or formal claims for entitlement to service connection for a right shoulder condition were filed prior to June 3, 2024. Indeed, there is no documentation of record at all prior to June 3, 2024. Notably, neither the Veteran nor the Veteran's attorney has provided argument as to why the Veteran is entitled to an earlier effective date prior to June 3, 202
that an effective date earlier than June 3, 2024 is not warranted. Specifically, the Veteran submitted a formal claim on June 3, 2024, claiming entitlement to service connection for a right shoulder strain and right shoulder rotator cuff tear. Critically, no informal (before March 24, 2015) or formal claims for entitlement to service connection for a right shoulder condition were filed prior to June 3, 2024. Indeed, there is no documentation of record at all prior to June 3, 2024. Notably, neither the Veteran nor the Veteran's attorney has provided argument as to why the Veteran is entitled to an earlier effective date prior to June 3, 2024. Thus, the "date of claim" for his right shoulder disabilities for effective date purposes is June 3, 2024.

The date of receipt of the claim having been established, and assuming that the disabilities manifested (entitlement arose) prior to the date of claim, there is no mechanism by which to assign an earlier effective date. Lalonde, supra.

Based on a review of the foregoing evidence, and the applicable laws and regulations, the Board finds that the evidence is not in approximate balance regarding the issue of entitlement to an earlier effective date for right shoulder strain, right shoulder tendinopathy/tendinitis and right shoulder SLAP tear; thus, the benefit of the doubt doctrine does not apply and his appeal as to this issue is denied. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102; Gilbert v. Derwinski, 1 Vet. App. 49 (1991); Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021).

Increased Rating

2. Entitlement to an initial rating in excess of 20 percent for right shoulder strain, tendinopathy/tendinitis and SLAP tear on the basis of limitation of arm motion is denied.

I. General Rating Principles

Disability ratings are determined by the application of rating criteria set forth in the VA Schedule for Rating Disabilities (38 C.F.R. Part 4) based on the average impairment of earning capacity. Separate diagnostic codes identify the various disabilities. 38 U.S.C. § 1155.

Where the question for consideration is the propriety of the initial evaluation assigned, evaluation of the medical evidence since the grant of service connection and consideration of the appropriateness of "staged ratings" is required. Fenderson v. West, 12 Vet. App. 119, 126 (1999). Additionally, the primary concern for an increased rating for a service-connected disability is the present level of disability. Although the overall history of the disability is to be considered, the regulations do not give past medical reports precedence over current findings. Francisco v. Brown, 7 Vet. App. 55, 58 (1994). In all claims for an increased disability rating, VA has a duty to consider the possibility of assigning staged ratings. See Hart v. Mansfield, 21 Vet. App. 505 (2007). Staged ratings are appropriate whenever the factual findings show distinct time periods where the service-connected disability exhibits symptoms that would warrant different ratings. Id.

Where there is a question as to which of two evaluations shall be applied, the higher evaluation will be assigned if the disability picture more nearly approximates the criteria required for that rating. Otherwise, the lower rating is assigned. 38 C.F.R. § 4.7. In general, all disabilities, including those arising from a single disease entity, are rated separately, and all disability ratings are then combined in accordance with 38 C.F.R. § 4.25. Pyramiding, the evaluation of the same disability, or the same manifestation of a disability, under different diagnostic codes, is to be avoided. 38 C.F.R. § 4.14.

The Court has emphasized that when assigning a disability rating it is necessary to consider limitation of a joint's functional ability due to flare-ups, fatigability, incoordination, and pain on movement, or when it is used repeatedly over a period of time functional loss due to flare-ups, fatigability, incoordination, and pain on movement. See DeLuca, supra; see also Mitchell v. Shinseki, 25 Vet. App. 32, 44 (2011). In Mitchell, the Court explained that pursuant to 38 C.F.R. §§ 4.40 and 4.45, the possible manifestations of functional loss include decreased or abnormal excursion, strength, speed, coordination, or endurance (38 C.F.R. § 4.40), as well as
limitation of a joint's functional ability due to flare-ups, fatigability, incoordination, and pain on movement, or when it is used repeatedly over a period of time functional loss due to flare-ups, fatigability, incoordination, and pain on movement. See DeLuca, supra; see also Mitchell v. Shinseki, 25 Vet. App. 32, 44 (2011). In Mitchell, the Court explained that pursuant to 38 C.F.R. §§ 4.40 and 4.45, the possible manifestations of functional loss include decreased or abnormal excursion, strength, speed, coordination, or endurance (38 C.F.R. § 4.40), as well as less or more movement than is normal, weakened movement, excess fatigability, and pain on movement (as well as swelling, deformity, and atrophy) that affects stability, standing, and weight-bearing (38 C.F.R. § 4.45). Joints should be tested for pain on both active and passive motion, in weight-bearing and nonweight-bearing and, if possible, with range of motion measurements of the opposite undamaged joint. 38 C.F.R. § 4.59; see also Correia, 28 Vet. App. at 169-170. However, the rating must be assigned in accordance with the schedular rating criteria. Thompson v. McDonald, 815 F.3d 781, 785 (Fed. Cir. 2016) ("[I]t is clear that the guidance of 38 C.F.R. § 4.40 is intended to be used in understanding the nature of the veteran's disability, after which a rating is determined based on the § 4.71a [or 4.73] criteria").

II. Applicable Rating Criteria

The Veteran's right shoulder strain, tendonitis/tendinopathy, and SLAP tear are currently rated under DC 5201. 38 C.F.R. § 4.71a, DC 5201.

When rating shoulder disabilities, different ratings are available for the dominant (major) and non-dominant (minor) side. The evidence shows that the Veteran is right-hand dominant, and therefore the ratings for the major side will be used. See October 2024, April 2025, and May 2025 examination reports.

Under DC 5201, limitation of motion of the arm at shoulder level warrants a 20 percent evaluation for the major extremity, midway between side and shoulder warrants a 30 percent rating for the major extremity, while a maximum 40 percent rating is assigned for limitation of motion of the arm to 25 degrees from side for the major extremity. 38 C.F.R. § 4.71a, DC 5201.

Normal range of motion of the shoulder is flexion and abduction from 0 to 180 degrees, and internal and external rotation each to 90 degrees. 38 C.F.R. § 4.71, Plate I.

The criteria of DC 5201 were amended effective February 7, 2021, but only to specify "at shoulder level" refers to flexion and/or abduction limited to 90 degrees, "midway between side and shoulder level" refers to flexion and/or abduction limited to 45 degrees, and the maximum 40 percent refers to flexion and/or abduction limited to 25 degrees from side.

III. Analysis

The Veteran is currently assigned a 20 percent rating from June 3, 2024 for his service-connected right shoulder strain, tendonitis/tendinopathy and SLAP tear. The appeal period is from June 3, 2024, the date of award of service connection for his right shoulder disability.

Throughout the appeal period, the Veteran has complained of right shoulder pain and limited range of motion. See VA examination reports throughout the appeal period.

The Veteran was afforded a VA examination in October 2024, the Veteran reported the onset of right shoulder pain during active duty and that since that time, he has experienced worsening pain and limitation of motion in the shoulder treated with ibuprofen, physical therapy, and ice. Currently, he reported soreness and sharp pain with limited range of motion and throbbing pain. He reported flare ups occurring three times per week that are characterized by increased soreness and limited range of motion and that he is unable to lift objects or exercise. He also reported functional loss described as stiffness in the right shoulder that further limits his range of motion. Physical examination results revealed forward flexion to 155 and abduction to 160 degrees and external rotation and internal rotation to 70 degrees. The examiner noted pain that causes functional loss and limited range of motion. The Veteran was unable to perform repetitive
, he has experienced worsening pain and limitation of motion in the shoulder treated with ibuprofen, physical therapy, and ice. Currently, he reported soreness and sharp pain with limited range of motion and throbbing pain. He reported flare ups occurring three times per week that are characterized by increased soreness and limited range of motion and that he is unable to lift objects or exercise. He also reported functional loss described as stiffness in the right shoulder that further limits his range of motion. Physical examination results revealed forward flexion to 155 and abduction to 160 degrees and external rotation and internal rotation to 70 degrees. The examiner noted pain that causes functional loss and limited range of motion. The Veteran was unable to perform repetitive use testing as he deferred due to fear of further injury. DeLuca factors, pain, were noted as contributing significantly to functional ability with repeated use over time and during flare-ups, and the examiner described in terms of range of motion in degrees as forward flexion to 155 degrees, abduction to 160 degrees, and external rotation and internal rotation to 65 degrees with repeated use over time and forward flexion to 150 degrees, abduction to 160 degrees, and external rotation and internal rotation to 60 degrees. Additional contributing factors were disturbance of locomotion and less movement than normal. No muscle atrophy, crepitus, ankylosis, AC, clavicle or scapula, humerus, or deformity conditions were found. Hawkins Impingement test, Empty Can test, and Crank Apprehension and Relocation test were positive. The examiner noted suspected rotator cuff condition and indicated mechanical symptoms. The examiner did not endorse instability, dislocation or labral pathology. No scars or surgeries were noted. The examiner noted the Veteran had a magnetic resonance imaging (MRI) done in January 2022 and the impression was of a SLAP tear of the superior labrum. No assistive devices were indicated. The Veteran's ability to work was described as impacted due to interference with lifting and carrying objects and exercising.

Given the totality of the evidence, the Board finds a rating in excess of 20 percent is not warranted at any point during the appeal period, as the Veteran's right shoulder disability has not resulted in limitation of motion of the arm midway between side and shoulder level (limited to 45 degrees) or limited to 25 degrees from side (abduction), even when considering additional functional loss due to symptoms such as pain, fatigue, weakness, lack of endurance, or incoordination, or as a result of repetitive motion and flare-ups. In this regard, even when considering DeLuca factors, the Veteran's right shoulder motion was, at its worst, manifested by flexion to 150 degrees and abduction to 160 degrees. See October 2024 VA examination report. Furthermore, while the Board acknowledges that the Veteran reported functional impairments, such as difficulty driving, getting dressed, eating brushing teeth, typing, writing, lifting, and exercising, the competent evidence does not show that such symptoms cause further functional loss that more nearly approximates limitation of motion of the arm to midway between side and shoulder (limited to 45 degrees in abduction) or 25 degrees from the side. In fact, the Veteran's range of motion results do not even amount to shoulder level (limited to 90 degrees) which corresponds with the 20 percent rating as currently assigned; however, due to painful motion of the right shoulder, the AOJ awarded the minimal compensable rating under DC 5201 which is 20 percent. 38 C.F.R. §§ 4.40, 4.45, 4.59; Burton v. Shinseki, 25 Vet. App. 1 (2011) (painful motion is entitled to at least the minimum compensable rating); see also Sowers v. McDonald, 27 Vet. App. 472, 481-82 (2016) (noting in dicta that while there is a 10 percent rating available for the shoulder across all diagnostic codes, a 20 percent rating is the minimum compensable rating for the shoulder for limitation of motion). As such, a rating in excess of 20 percent under DC 5201 is not warranted at any time during the appeal period.

Additionally, the evidence demonstrates that the Veteran takes Advil and Tylenol to treat his symptoms, and the Board is obligated to discount the beneficial effects of medications taken for a disability and evaluate the baseline severity of the disability. See Ingram v. Collins, 38 Vet. App. 130 (2025). The Board presumes the prescribed over-the-counter pain relievers reduce his right shoulder pain. However, because the Veteran's flexion was to 150 degrees and abduction to 160 degrees at worst,
20 percent rating is the minimum compensable rating for the shoulder for limitation of motion). As such, a rating in excess of 20 percent under DC 5201 is not warranted at any time during the appeal period.

Additionally, the evidence demonstrates that the Veteran takes Advil and Tylenol to treat his symptoms, and the Board is obligated to discount the beneficial effects of medications taken for a disability and evaluate the baseline severity of the disability. See Ingram v. Collins, 38 Vet. App. 130 (2025). The Board presumes the prescribed over-the-counter pain relievers reduce his right shoulder pain. However, because the Veteran's flexion was to 150 degrees and abduction to 160 degrees at worst, there is no indication in the record that range of motion would be further restricted to a level corresponding with higher 30 or 40 percent ratings without the use of medications. Therefore, the ameliorative effects of medications are not shown in this record to have any impact on functional impairment beyond reduction of pain.

Additionally, the Board has considered whether higher or separate ratings are warranted under alternate diagnostic codes. However, there is no indication of ankylosis, impairment of clavicle or scapula, or humerus conditions. As such, ratings under DCs 5200, 5202, and 5203 are precluded.

For the above reasons, the evidence of record persuasively weighs against the Veteran's appeal for a rating in excess of 20 percent for right shoulder disability. As the evidence of record persuasively weighs against a rating in excess of 20 percent and is neither evenly balanced nor approximately so in this regard, the benefit-of-the-doubt rule does not apply. Thus, entitlement to an initial rating in excess of 20 percent for right shoulder strain, tendonitis/tendinopathy, and SLAP tear is denied. 38 U.S.C. § 5107 (b); 38 C.F.R. §§ 4.3, 4.7; Lynch, supra.

S. BUSH

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board Asante, Ruby

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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