An increased initial 20 percent rating for painful motion of the right arm is granted effective August 7, 2022.

Citation Nr: A26069993 Decision Date: 07/30/26 Archive Date: 07/30/26 DOCKET NO. 230412-338871 DATE: July 30, 2026 ORDER An increased initial 20 percent rating for painful motion of the right arm is granted effective August 7, 2022. An initial rating in excess of 20 percent for separation of the right shoulder acromioclavicular joint is denied. REMANDED Entitlement to an initial rating in excess of 20 percent for painful motion of the right arm is remanded. Entitlement to service connection for a left shoulder disability secondary to the service-connected right shoulder disability is remanded. FINDINGS OF FACT 1. The Veteran filed a new August 8, 2022 claim seeking service connection for painful motion of the right arm and for acromioclavicular joint separation of the right shoulder. 2. From August 7, 2022, the Veteran was entitled to separate 20 percent ratings for service connection of painful motion of the right arm under DC 5201 and for acromioclavicular joint separation of the right shoulder under DC 5203. 2. The Veteran is rated at the highest available schedular rating for acromioclavicular joint separation of the right shoulder under DC 5203. CONCLUSIONS OF LAW 1. The criteria for an initial 20 percent rating for painful motion of the right arm are met effective date of August 7, 2022. 38 U.S.C. § 5110; 38 C.F.R. §§ 4.7, 4.71(a), DC 5201. 2. The criteria for entitlement to an initial rating in excess of 20 percent for right arm acromioclavicular joint separation are not met. 38 U.S.C. § 1155; 38 C.F.R. §§ 4.7, 4.71(a), DC 5203. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from August 2018 to August 2022. The rating decision on appeal was issued in January 2023 and constitutes an initial decision; therefore, the modernized review system, also known as the Appeals Modernization Act (AMA), applies. In the April 2023 VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement), the Veteran elected the Direct Review docket. In January 2025, the Board issued a decision granting a 20 percent rating for right arm acromioclavicular joint separation. In January 2026 the United States Court of Veterans Appeal (CAVC) granted a joint motion for partial remand (JMPR) of the Board's decision. Therefore, the Board may only consider the evidence of record at the time of the January 2023 agency of original jurisdiction (AOJ) decision on appeal. 38 C.F.R. § 20.301. Any evidence submitted after the AOJ decision on appeal cannot be considered by the Board. 38 C.F.R. §§ 20.300, 20.301, 20.801. Increased Rating VA's percentage ratings are based on the average impairment of earning capacity as a result of service-connected disability. 38 U.S.C. § 1155; 38 C.F.R. § 4.1. If two disability evaluations are potentially applicable, the higher evaluation will be assigned if the disability picture more nearly approximates the criteria for that rating; otherwise, the lower rating will be assigned. 38 C.F.R. § 4.7. All reasonable doubt will be resolved in favor of the claimant. 38 C.F.R. § 4.3. This decision will focus on the evidence pertinent to the rating criteria and disability severity during the relevant period on appeal, but the Board has considered the entire record to have a full picture of the disability. See 38 C.F.R. §§ 4.1, 4.2, 4.41; Gonzales v. West, 218 F. 3d 1378 (Fed. Cir. 2000). In Jones v. Shinseki, the Court held that when assigning a disability evaluation, the Board may not consider the ameliorative effects of medication when those effects are not explicitly contemplated by the rating criteria. 26 Vet. App. 56, 61 (2012). Recently, in Ingram v. Collins, the Court reaffirmed its central holding in Jones and held that since the applicable Diagnostic Codes and special regulations pertaining to musculoskeletal disabilities do not explicitly contemplate medication use, the Board must discount the beneficial effects of medication when assigning an evaluation for a musculoskeletal disability. 38 Vet. App. 130 (2025). 1. Right arm painful motion The January 2026 JMPR directed the Board to consider whether the Veteran is entitled to a compensable rating under Diagnostic Code 5201, as separate and apart from the 20 percent rating the Board granted under Diagnostic Code 5203. If warranted, the Board was directed to assign the appropriate effective date. The Board notes that the Veteran is currently service connected for right arm limitation of motion pursuant to DC 5201 at a 20 percent rating effective October 30, 2024. The Board finds that when the Veteran filed a new August 8, 2022 claim for a right shoulder disability, he was entitled to separate ratings both under DC 5201 and under DC 5203. The Board sees no evidence of worsening of the right arm motion effective October 30, 2024, and thus assigns a 20 percent rating as of that date. 2. Acromioclavicular joint separation of the right shoulder The Veteran is currently rated at 20 percent for right arm acromioclavicular joint separation under 38 C.F.R. § 4.17(a), DC 5203. This is the highest available schedular rating available under DC 5203. Neither the Veteran nor his representative have presented any argument as to why the 20 percent rating currently assigned under DC 5203 is not sufficient. Therefore, a rating in excess of 20 percent for acromioclavicular joint separation of the right shoulder under DC 5203 is denied. REASONS FOR REMAND 1. Entitlement to an initial rating in excess of 20 percent for painful motion of the right arm Per the January 2026 JMPR, a January 2023 VA examination report, on which the Board relied to determine the appropriate rating of the Veteran's painful motion of the right arm, is inadequate for adjudicative purposes. As such, a new VA examination is required in order to establish whether an initial rating in excess of 20 percent for painful motion of the right arm is warranted. 2. Entitlement to service connection for a left shoulder disability The January 2026 JMPR directed the Board to consider whether the evidence of record gave rise to the possibility of secondary service connection of the left shoulder. The January 2023 report of VA examination reflects the Veteran reported that "[t]he left started hurting 7 months after the injury, he thinks because he has had to use the left shoulder more. Both shoulders hurt now." Accordingly, the Board finds that the record did, in fact, give rise to that theory of service connection. In the January 2023 rating decision, the AOJ denied the claim without seeking an addendum opinion as to secondary service connection for the left arm. As secondary service connection for the left shoulder disability was within the scope of the increased initial rating claim, this was a duty to assist error. A remand is necessary to correct the deficiency. The matters are REMANDED for the following action: 1. Schedule the Veteran for a new examination with an appropriate clinician if possible. If not, seek an addendum opinion from an appropriate clinician. The clinician must conduct all required testing, if possible, and provide all required estimates, to include the Veteran's pain level during flare-ups. If the examination is not conducted in person, then the clinician is directed to the missing and contradictory sections of the January 2023 VA Examination Report and provide an opinion to complete and correct the record. In doing so, the clinician must at least consider the Veteran's report of increased difficulty using the affected arm at work and slower motions at work during flare-ups. The clinician must consider and report the effect of any ameliorative medication that the Veteran uses. 2. The VA should also seek an addendum opinion from an appropriate clinician as to whether it is at least as likely as not (the favorable and unfavorable evidence is in approximate balance or is nearly equal) that the Veteran's painful left shoulder and/or left arm is worsened due to the service connected right shoulder and arm disabilities. The claims file, including a copy of this Remand, must be made available to and be reviewed by the clinician in conjunction with the examination. The clinician is asked to explain the reasons behind all opinions expressed and conclusions reached. Note that the lack of documented treatment in service, or a long period after, while probative, cannot serve as the sole basis for a negative finding. The Veteran's lay contentions must be considered and weighed in making the determination. The medical opinion must support the conclusions reached with an analysis that is adequate to consider and weigh against other evidence of record; medical opinions must contain not only clear conclusions with supporting data, but also a reasoned medical explanation connecting the two. If an opinion cannot be expressed without resort to speculation, ensure that the clinician so indicates and discusses why an opinion is not possible, to include whether there is additional evidence that could enable an opinion to be provided, or whether the inability to provide the opinion is based on the limits of medical knowledge. In ordering?a?remand in the instant case, the Board is not making a preliminary formal finding as to the credibility of the Veteran's lay reports.?Rather, the Board is merely requesting that the?examiner?on remand consider the Veteran's own descriptions of the history of his disabilities.?See Smith v. Wilkie, 32 Vet. App. 332, 338-39 (2020). S. C. Krembs Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Jackson, Atossa K. 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.