Entitlement to service connection for a left shoulder disability, to include as secondary to a service-connected disability, is denied.

Citation Nr: 26001446 Decision Date: 01/30/26 Archive Date: 01/30/26 DOCKET NO. 19-22 447 DATE: January 30, 2026 ORDER Entitlement to service connection for a left shoulder disability, to include as secondary to a service-connected disability, is denied. Entitlement to service connection for a lumbar spine disability, to include as secondary to a service-connected disability, is denied. FINDINGS OF FACT 1. The evidence is against a finding that the Veteran's left shoulder disability had an onset in service, manifested to a compensable degree within a year of service, or is otherwise related to service or a service-connected disability. 2. The evidence is against a finding that the Veteran's lumbar spine disability had an onset in service, manifested to a compensable degree within a year of service, or is otherwise related to service or a service-connected disability. CONCLUSIONS OF LAW 1. The criteria for entitlement to service connection for a left shoulder disability have not been met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309, 3.310. 2. The criteria for entitlement to service connection for a lumbar spine disability have not been met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309, 3.310. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served in the United States Marine Corps Reserve. His service includes a DD Form 214 which reflects inactive duty for training from July 2006 to January 2007. A July 2019 rating decision granted service connection for tinnitus based on his noise exposure during that period of service. Therefore, his service from July 2006 to January 2007 is considered active duty. These matters are before the Board of Veterans' Appeals (Board) on appeal from an August 2017 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO). The matters were previously before the Board in May 2023 and September 2023 and were remanded for further development. A May 2024 Board decision denied claims of service connection for the Veteran's left shoulder disability and lumbar spine disability. The Veteran appealed to the United States Court of Appeals for Veterans Claims (Court). Subsequently, the Secretary of VA and the Veteran (the parties) submitted a Joint Motion for Remand (Joint Motion), and, in a January 2025 Court Order, the Court granted the Joint Motion, vacating the Board's May 2024 decision and remanding the matter for compliance with the Joint Motion. Most recently, the Board remanded this appeal in June 2025, to obtain addendum VA nexus opinions. Service Connection Service connection may be granted for a disability resulting from disease or injury incurred coincident with or aggravated by service. 38 U.S.C. § 1131; 38 C.F.R. § 3.303. Service connection generally requires evidence satisfying three criteria: (1) the existence of a present disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship ("nexus") between the present disability and the disease or injury incurred or aggravated during service. See Walker v. Shinseki, 708 F.3d 1331, 1333 (Fed. Cir. 2013); Hickson v. West, 12?Vet. App.?247, 253 (1999). Establishing service connection on a secondary basis requires evidence sufficient to show (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. 38 C.F.R. § 3.310(a),(b). Secondary causation exists when, but for the service-connected disability, the non-service-connected was caused by a service-connected disability either in a direct, etiological way or via multiple steps in a causal chain. Spicer v. McDonough, 61 F.4th 1360, 1365 (Fed. Cir. 2023) (citations omitted). Secondary aggravation exists when the non-service-connected disability not caused by a service-connected disability would be less severe were it not for a service-connected disability. Id. at 1364. For example, secondary aggravation may be established where the natural progression of the non-service-connected disability could have been arrested or improved but for the service-connected disability. 1. Entitlement to service connection for a left shoulder disability, to include as secondary to a service-connected disability, is denied. 2. Entitlement to service connection for a lumbar spine disability, to include as secondary to a service-connected disability, is denied. With regard to the lumbar spine disability, the Veteran contends that he has a lumbar spine disability that is due to service. Specifically, he asserts that he developed a disability from hiking while carrying heavy equipment, driving trucks with poor lumbar support, and a training incident when he was slammed to the ground. See July 2023 Correspondence. In a July 2023 statement, the Veteran reported that he was discharged without an exit medical examination and provided no information about available resources, not even about getting treatment at a VA hospital. Since service until 2017, when he was "informed otherwise," he continued to self-medicate as he was unable to afford treatment. See id. With regard to the left shoulder disability, the Veteran contends that it was incurred in service from the same activities as his back disability. Furthermore, he clarified in a July 2023 statement that although the STRs show complaints of pain in the right shoulder, it was incorrectly noted as the pain was in the left shoulder and has continued since. The Board further notes that the Veteran has attributed his lumbar spine disability to his service-connected left ankle disability and the claimed left shoulder disability. See July 2023 Correspondence. He has also attributed the left shoulder disability to his service-connected left ankle disability. See April 2025 Appellate Brief. Service treatment records (STRs) are silent for any complaints, injuries, or treatment for any lumbar spine disability and left shoulder disability. Post-service treatment records, to include treatment records from the Veteran's Reserve service following active duty, reflect a November 2007 STR document that the Veteran reported to the sick call complaining of ongoing left ankle pain and reported an injury date in August 2006. No other musculoskeletal injury or complaint was documented. See December 2010 STR - Medical. In a June 2008 report of medical history for Reserve service, the Veteran denied a painful shoulder, recurrent back pain or any back problem, and numbness or tingling. The Veteran reported having trouble with his knees and feet. In the explanation section, the Veteran wrote that he played football with other Marines, when he landed on his shoulder, he was given muscle relaxants and that he got better in a few days. The Veteran also explained that he twisted his ankle in recruit training, which still bothered him, as well as injuring his knee during recruit training. See December 2010 STR - Medical. In a September 2008 report of medical history for enlistment to Reserve service, the Veteran denied a painful shoulder, recurrent back pain or any back problem, and numbness or tingling. The Veteran did answer yes on the question asking if he had swollen or painful joints, for which he specifically wrote "ankle trouble." See December 2010 STR - Medical. In a July 2009 report of medical history during Reserve service, the Veteran denied a painful shoulder, recurrent back pain or any back problem, and numbness or tingling. The Veteran reported having trouble with his knees and feet. The Veteran also elaborated that he has had left ankle problems and painful knee joints. See December 2010 STR - Medical. In a January 2009 Reserve Health Readiness Program Health Questionnaire, the Veteran reported that he had not seen a physician in the past year and that he did not have a joint or bone problem that would prevent him from doing physical activity. He also denied taking any medications. See December 2010 STR - Medical. A June 2009 STR documents the Veteran's complaint of right ankle pain at rest. No other musculoskeletal injury or complaint was documented. See December 2010 STR - Medical. In a December 2009 health history questionnaire, the Veteran denied recently having had any medical problems. He denied being diagnosed with any medical condition that required any special or continuous treatment. The Veteran marked that to the best of his knowledge, he had no other significant medical history occurring since his last exam, and the examiner documented that the Veteran denied any significant medical history. See December 2010 STR - Medical. In a February 2010 health history questionnaire, the Veteran denied recently having had any medical problems. The Veteran specifically only wrote left ankle on the question asking if he had any medical treatment since his last evaluation. The Veteran marked that that the best of his knowledge, he had no other significant medical history occur since his last exam, and the examiner documented that the Veteran denied any significant medical history. An April 2020 VA treatment record documents that the Veteran called complaining of pain in his back. See May 2020 Medical Treatment Record - Government Facility. In a June 2023 VA examination, the Veteran was diagnosed with degenerative arthritis of the lumbar spine, degenerative disc disease (DDD) other than intervertebral disc syndrome (IVDS), spinal stenosis, levoscoliosis of the thoracic spine, and lumbar radiculopathy. The examiner documented the Veteran's report that he injured his back during active military service, when he was slammed to the ground during martial arts training as part of active duty, and that it has progressively gotten worse since then. He reported treating it with Motrin. In September 2025, the RO obtained addendum opinions regarding the left shoulder and lumbar spine disabilities. See October 2025 C&P Exams. Regarding the left shoulder disability, the VA examiner opined that it was less likely than not that this condition was related to or caused by the Veteran's military service. She explained that the STRs did not reflect any treatment or diagnoses related to the left shoulder and that the record did not indicate any reports of shoulder pain until August 2024. The opinion also referenced the findings of a May 2023 VA examination report that indicated the Veteran did not have a left shoulder disability at that time. The examiner further noted that the current examination revealed findings of a left shoulder strain and tendinitis. However, she concluded that there was no evidence that the current conditions were incurred during or caused by service and that a post-service injury or event was the more likely etiology. The examiner further concluded that the left shoulder disability was less likely than not caused or aggravated by a service-connected disability. She explained that the current diagnoses of a strain and tendinitis were caused by overstretching or tearing of a muscle or tendon in the shoulder, often due to repetitive motion, overuse, sudden impact, or a fall. The examiner cited to medical literature, which did not support a causal relationship between the Veteran's service-connected left ankle and bilateral knee disability and the claimed left shoulder disability. Finally, the examiner opined that the left shoulder disability was not aggravated by a service-connected condition and explained that the natural progression of his condition included persistent pain and functional limitation that may fluctuate over time, resulting in incomplete recovery and ongoing symptoms. She cited to medical literature indicating that a chronic shoulder strain, typically resulting from repetitive overuse or microtrauma to the rotator cuff or periarticular musculature, may evolve into tendinopathy, subacromial impingement, or myofascial pain syndrome. Regarding the lumbar spine disability, the VA examiner opined that it was less likely than not that this condition was related to or caused by the Veteran's military service. She explained that the STRs did not reflect any treatment or diagnoses related to the left shoulder and that the record did not indicate any reports of lower back pain until May 2023. The examiner further noted that the current examination revealed findings of a lumbosacral strain, scoliosis, arthritis, degenerative disc disease, and stenosis. However, she concluded that there was no evidence that the current conditions were incurred during or caused by service and that a post-service injury or event was the more likely etiology. The examiner further concluded that the lumbar spine disability was less likely than not caused or aggravated by a service-connected disability. She explained that the current diagnoses were caused by natural wear and tear of the spine's joints and discs over time, which could lead to pain, inflammation, and potential joint damage. She further noted that, while aging is a major factor, other causes and risk factors included injuries, repetitive stress, genetics, and certain diseases. The examiner cited to medical literature, which did not support a causal relationship between the Veteran's service-connected disabilities and the claimed lumbar spine disability. Finally, the examiner opined that the lumbar spine disability was not aggravated by a service-connected condition and explained that the natural progression of his condition included a gradual biochemical and structural deterioration of the disc, often beginning with matrix breakdown and progressing to disc height loss, annular tears, endplate changes, osteophyte formation and increase in symptom severity, as documented by medical literature. In the present case, there is sufficient evidence that the Veteran meets the threshold criterion for service connection of a current disability for each of his lumbar spine disability and left shoulder disability. Boyer v. West, 210 F.3d 1351 (Fed. Cir. 2000). Accordingly, the only question that remains is whether the Veteran's lumbar spine disability and left shoulder disability are related to his service. In this regard, the Board finds the September 2025 VA examination opinions to be the most probative evidence of record. The examiner opined that it was less likely than not that the Veteran's left shoulder lumbar spine disabilities were caused by or were otherwise etiologically related to his active duty service or a service-connected disability. The Board finds that the VA examiner's opinions are probative as they are factually supported, consistent with the other evidence of record, and included review of the claims file and relevant medical literature. Barr v. Nicholson, 21 Vet. App. 303 (2007); Stefl v. Nicholson, 21 Vet. App. 120 (2007); Nieves-Rodriguez v. Peake, 22 Vet. App. 295 (2008). Lastly, the Board has considered the Veteran's statements that his claimed lumbar spine disability and left shoulder disability were caused by hiking while carrying heavy equipment, driving trucks with poor lumbar support, and a football injury. The Board also acknowledges his general contentions that the claimed conditions are the result of his service-connected left ankle disability. However, the question of whether such a relationship exists is a complex medical issue that is far beyond the purview of a lay person. As the Veteran has not been shown to have any medical training sufficient to offer such an opinion, his opinion is afforded little probative value. The Board also notes that while the Veteran has reported that he experienced continued back and shoulder pain since service, the medical evidence of reflects that he did not seek treatment for his low back pain and shoulder pain until many years after service. See Maxson v. West, 12 Vet. App. 453, 459 (1999), aff'd sub nom., Maxson v. Gober, 230 F.3d 1330, 1333 (Fed. Cir. 2000) (holding that the Board may take into consideration the passage of a lengthy period of time in which the Veteran did not complain of the disorder at issue). To this end, the Board notes that the treatment records from his Reserve service reflect that the Veteran was provided multiple reports of medical history, and while he continued to document his left ankle pain, he repeatedly denied any left shoulder and lumbar spine pain or symptoms. The Veteran did report in a June 2008 report of medical history that he sought treatment for his shoulder while playing football, but he also reported that he was given muscle relaxants and got better in a few days. The Veteran did not report any history of shoulder problems in the subsequent reports of medical history or other medical records during Reserve service in September 2008, July 2009, January 2009, June 2009, December 2009, and February 2010. While the Veteran has asserted that his left shoulder and lumbar spine disabilities began in service and that he experienced symptoms of shoulder pain and back pain during service, the more probative contemporaneous evidence of record does not support this contention. As reflected above, he continued to deny left shoulder and lumbar spine pain and symptoms during his many treatment records as part of the Reserve service following active duty. This is significant as he did report other conditions during his Reserve service. The Board observes the Veteran's contention that he did not report his left shoulder and lumbar spine pain until he established VA care in 2017 because he was not aware of the VA and had to self-medicate as he could not afford private treatment. However, this assertion is contradicted by his reporting of other complaints, such as his repeated complaints of left ankle pain, during Reserve service. It seems logical that if he had experienced consistent left shoulder and lumbar spine pain during and following service, he would have reported it on the many medical treatment records during his Reserve service, as he reported other ailments. Based on the forgoing, the Board is not able to credit the Veteran's allegations of left shoulder and back pain during and since service and does not find such assertions persuasive. (Continued on the next page) ? The Board finds that the evidence is persuasively against the conclusion that the Veteran's left shoulder disability and lumbar spine disability either began during or are otherwise related to his active service, and they did not manifest to a compensable degree within the one year presumptive period. Furthermore, the evidence does not reflect that the claimed conditions are secondary to a service-connected disability, to include the left ankle disability. Thus, the claims are denied. S. HENEKS Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Erin J. Trojanowski, 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.