SHOULDER IMPAIRMENT OF

CHRISTOPHER SEPPANEN · 2026 · Case ID: A26039636

MIXED

Summary

The Veteran, who served in the United States Navy from January 1969 to December 1972 and April 1974 to February 1990, appeals the denial of service connection for a right shoulder disability and the remand of a heart disability claim. The Board found that the Veteran had a current diagnosis of right shoulder impairment and that service treatment records reflected complaints of shoulder pain, satisfying the first two elements for service connection. However, the Board determined that the weight of the competent evidence did not support a nexus to service. A VA examiner provided a negative opinion, noting that while the Veteran received treatment for shoulder pain during service, subsequent health changes, including falls and a diagnosis of Parkinson's Disease, were more likely causes for the current impairment. The Board gave greater probative weight to the VA examiner's opinion due to its clear conclusions and reasoned medical explanation. Lay statements regarding etiology were given little weight due to the complexity of the medical issue. Service connection for the right shoulder was denied. The heart disability claim was remanded for a new VA opinion to determine if it was related to service, specifically considering in-service complaints of chest pain and toxic exposure risk activity.

Rationale

Weight of competent evidence does not support nexus; VA examiner opinion found current impairment not related to service; Subsequent health changes (falls, Parkinson's) more likely cause

Service Branch

NAVY

Special Benefit

NO SPECIAL BENEFIT

Docket No.

260331-642315

Full Decision Text

Citation Nr: A26039636
Decision Date: 04/28/26 Archive Date: 04/28/26

DOCKET NO. 260331-642315
DATE: April 28, 2026

ORDER

Service connection for right shoulder disability is denied.

REMANDED

Service connection for heart disability is remanded.

FINDING OF FACT

The Veteran's right shoulder disability is not causally or etiologically related to any disease, injury, or incident in service.

CONCLUSION OF LAW

The criteria for entitlement to service connection for right shoulder disability have not been met. 38 U.S.C. §§ 1110, 1112, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309, 3.310.

REASONS AND BASES FOR FINDING AND CONCLUSION

The Veteran served on active duty in the United States Navy from January 1969 to December 1972 and April 1974 to February 1990.

In October 2025, the Veteran submitted a VA Form 20-0996, Decision Review Request: Higher-Level Review (HLR), and requested review of an October 2025 rating decision which denied service connection for a right shoulder disability. In November 2025, the Veteran submitted a VA Form 20-0996, Decision Review Request: Higher-Level Review (HLR), and requested review of a November 2025 rating decision which denied service connection for a heart disability. In February 2026, the Agency of Original Jurisdiction (AOJ) issued the HLR decision on appeal, which considered the evidence of record at the time of the prior rating decisions.

In the March 2026 VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement), the Veteran elected the Direct Review docket. Therefore, the Board may only consider the evidence of record at the time of the respective AOJ decisions. 38 C.F.R. § 20.301. If evidence was submitted during the period after the AOJ issued the decisions, the Board did not consider it in its decision. 38 C.F.R. §§ 20.300, 20.301, 20.801. Any evidence submitted after the AOJ decisions on appeal cannot be considered by the Board. 38 C.F.R. §§ 20.300, 20.301, 20.801.

Service Connection

The Veteran contends that service connection is warranted a right shoulder disability.

Service connection is warranted where the evidence of record establishes that a particular injury or disease resulting in disability was incurred in the line of duty in the active military service or, if pre-existing such service, was aggravated thereby. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303(a).

Generally, in order to prove service connection, there must be competent, credible evidence of (1) a current disability, (2) in-service incurrence or aggravation of an injury or disease, and (3) a nexus, or link, between the current disability and the in-service disease or injury. See, e.g., Davidson v. Shinseki, 581 F.3d 1313 (Fed. Cir. 2009); Pond v. West, 12 Vet. App. 341 (1999).

A layperson is generally incapable of opining on matters requiring medical knowledge. Routen v. Brown, 10 Vet. App. 183, 186 (1997), aff'd sub nom., Routen v. West, 142 F.3d 1434 (Fed. Cir. 1998). However, lay evidence can be competent and sufficient to establish a1 diagnosis of a condition when: (1) a layperson is competent to identify the medical condition, (e.g., a broken leg, separated shoulder, pes planus (flat feet), varicose veins, tinnitus (ringing in the ears), etc.), (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. See Jandreau v. Nicholson, 492 F.3d 1372, 1377 (Fed. Cir. 2007).

In essence, lay testimony is competent when it pertains to the readily observable features or symptoms of injury or illness and "may provide sufficient support for a claim of service connection." Layno v. Brown, 6 Vet. App. 465, 469 (1994); see also 38 C.F.R. § 3.159(a)(2). A determination as to whether medical evidence is needed to demonstrate that a Veteran presently has the same condition he or she had in service or during a presumptive period, or whether lay evidence will suffice, depends on the nature of the Veteran's present condition (e.g., whether the Veteran's present condition is of a type that requires medical expertise to identify it as the same condition as that in service or during a presumption period, or whether it can be so identified by lay observation). See Barr v. Nicholson, 21 Vet. App. 303, 310 (2007).

Thus, medical evidence is not always or categorically required when the determinative issue involves either medical diagnosis or etiology, but rather such issue may, depending on the facts of the particular case, be established by competent and credible lay evidence under 38 U.S.C. § 1154(a). See Davidson, supra.

When there is an approximate balance of positive and negative evidence regarding the merits of an issue, the benefit of the doubt shall be given to the veteran. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102. If the evidence is not in approximate balance or nearly equal, the claim is to be denied. See Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021).

The Board finds that service connection is not warranted for a right shoulder disability.

Initially, the Board notes that in February 2026, the AOJ found that the Veteran had a current diagnosis of right shoulder impairment and that his service treatment records (STRs) reflect complaints of shoulder pain. The Board is bound by these favorable findings, and the first two requirements of service connection are met. 38 C.F.R. §§ 3.104(c), 3.303.

Turning next to evidence of a causal relationship between the Veteran's service and the current disability, the Board finds the weight of the competent evidence does not support a nexus.

In September 2025, after a review of the Veteran's records, a VA examiner provided a negative opinion. The examiner found that although the Veteran was seen and treated several times for his right shoulder during military service (noted as chronic recurrent tendonitis in 1988 and 1989), several health changes had taken place since the Veteran's military service ended in 1990. The examiner noted documentation of a physical therapy note that the Veteran had a CVA (cerebrovascular accident) in 2016 with right hemiparesis. In April 2019, a note with primary care documented that the Veteran was diagnosed with Parkinson's Disease approximately six years prior and he'd had three falls in the last month. In addition, Veteran was seen in July 2025 for right shoulder pain with a note that he had only fallen once in the past 12 months. The note further elaborated that the Veteran fell against a wall with right shoulder four weeks ago, with the fall causing an injury, resulting in a change of functionality with pain and loss of mobility. At that time, the Veteran was given a diagnosis of right shoulder impairment. The examiner found that it was not plausible to state that the current diagnosis of right shoulder impairment was as a result of military service but was rather due to falls since leaving military service.

Based on the foregoing, the Board finds that the evidence is not in approximate balance or nearly equal and is against the Veteran's claim of service connection for a right shoulder disability. While the evidence of record shows that the Veteran is diagnosed with a right shoulder disability, the most persuasive evidence demonstrates it is not related to his service. In this regard, the Board places greater probative weight on the VA examiner's opinion as the examiner sets out clear conclusions and supporting data, as well as a reasoned medical explanation connecting the two. See Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 301 (2008).

The Board has considered the Veteran's contentions that his symptoms and diagnosis are related to service. Lay witnesses are competent to provide testimony or
in approximate balance or nearly equal and is against the Veteran's claim of service connection for a right shoulder disability. While the evidence of record shows that the Veteran is diagnosed with a right shoulder disability, the most persuasive evidence demonstrates it is not related to his service. In this regard, the Board places greater probative weight on the VA examiner's opinion as the examiner sets out clear conclusions and supporting data, as well as a reasoned medical explanation connecting the two. See Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 301 (2008).

The Board has considered the Veteran's contentions that his symptoms and diagnosis are related to service. Lay witnesses are competent to provide testimony or statements relating to symptoms or facts that they have observed and are within the realm of their personal knowledge but are not competent to establish that which would require specialized knowledge or training, such as medical expertise. See Layno v. Brown, 6 Vet. App. 465, 469-70 (1994).

In the instant case, the Board finds that questions regarding the potential relationship between the Veteran's service to be complex in nature. See Woehlaert v. Nicholson, 21 Vet. App. 456 (2007) (although the claimant is competent in certain situations to provide a diagnosis of a simple condition such as a broken leg or varicose veins, the claimant is not competent to provide evidence as to more complex medical questions). Thus, while the Veteran is competent to describe the manifestations of his right shoulder disability, the Board must accord his lay statements regarding the etiology of his disability little probative value.

Based on the foregoing, the Board finds that the Veteran's right shoulder disability was not shown to be due to the Veteran's service. In reaching this decision, the Board has considered the applicability of the benefit of the doubt doctrine. However, there is not an approximate balance of positive and negative evidence regarding the merits of the issue, and the benefit of the doubt shall not be given to the Veteran. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102. When the evidence is not in approximate balance or nearly equal, the claim is to be denied. See Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021).

REASONS FOR REMAND

Service connection for heart disability is remanded.

The Board finds that a remand is warranted to correct a pre-decisional duty to assist error.

In October 2025, a VA examiner found that the Veteran's heart disability was not related to his inservice toxic exposure risk activity. A review of the Veteran's file reflects that no opinion has been obtained as to whether the Veteran's heart disability is directly related to his service. In this regard, the Board notes that the Veteran's STRs reflect that he frequently complained of chest pain or pressure during service and that he indicated that he had pain or pressure in his chest at the time of his retirement report of medical history. As such, the Board finds that an additional opinion is warranted to determine if the Veteran's heart disability began in service or was due to service.

The matter is REMANDED for the following action:

1. Ask an examiner of appropriate expertise to review the Veteran's file. The necessity of an in-person examination is left to the discretion of the examiner. Based on review of the record and conducting an examination (if deemed necessary) of the Veteran, the examiner should respond to the following:

a) The examiner should state whether it is at least as likely as not (likelihood is at least approximately balanced or nearly equal, if not higher) that the Veteran's heart disability began in service, was caused by active service, or is otherwise related to active service to include the report of pain or pressure in his chest at the time of his retirement report of medical history.

The examiner is advised that the Veteran is competent to report symptoms, treatment, and injuries, and that his reports must be taken into account in formulating the requested opinions.

The examiner is also reminded that the absence of documented treatment in service or thereafter is not fatal to a service connection claim, and the absence of evidence in the service treatment records is an insufficient basis, by itself, for a negative opinion. See Ledford v. Derwinski, 3 Vet. App. 87, 89 (1992). Thus, the examiner is to consider the totality of the record, and not just the absence of clinical treatment, in weighing the Veteran's statements asserting symptomatology.

The examiner must provide the rationale for all proffered opinions. If the examiner is unable to provide any required opinion, he or she should explain why. If the examiner cannot provide an opinion without resorting to mere speculation, he or she shall provide a complete explanation as to why this is so. If the inability to provide a more definitive opinion is the result of a need for additional information, the examiner should identify the additional information that is needed.

Christopher Seppanen

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board Gandhi, Rahil

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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