BVA9503235 DOCKET NO. 93-09 740 ) DATE ) ) On appeal from the decision of the Department of Veterans Affairs Regional Office in Los Angeles, California THE ISSUE Entitlement to service connection for bilateral fractures of the shoulder blades. REPRESENTATION Appellant represented by: California Department of Veterans Affairs WITNESS AT HEARING ON APPEAL Appellant ATTORNEY FOR THE BOARD Jeffrey J. Schueler, Associate Counsel INTRODUCTION The veteran served on active duty from September 1951 to July 1954. The veteran appealed the July 1991 rating action of the regional office (RO) denying service connection for bilateral fracture of shoulder blades and a permanent and total disability rating for nonservice-connected pension purposes. The case was remanded to the RO in August 1993, and the RO subsequently, in a February 1994 rating decision, granted the claim of entitlement to a permanent and total disability rating for nonservice-connected pension purposes. The only issue for appellate review, therefore, is as cited on the title page of this decision. In the August 1993 remand, the Board of Veterans' Appeals (Board) directed that the veteran be scheduled for a Department of Veterans Affairs (VA) examination to determine the nature and severity of his headaches and that a claim of entitlement to service connection for headaches as a residual of food poisoning in service should be developed for appellate review. It does not appear from a review of the claims folder that an examination was conducted or that the claim was adjudicated. This issue is referred to the RO for appropriate actions not inconsistent with the mandated actions contained in the August 1993 remand. CONTENTIONS OF APPELLANT ON APPEAL The veteran contends that he incurred fracture his shoulders during active service. He maintains that while at sea he fell fracturing both shoulder blades, that he was placed in a body cast and was transferred to a naval hospital in San Francisco, California. He asserts that he cannot lift weight over 15 pounds with his left shoulder and that he has "a little more strength" and pain in his right shoulder. DECISION OF THE BOARD The Board, in accordance with the provisions of 38 U.S.C.A. § 7104 (West 1991), has reviewed and considered all of the evidence and material of record in the veteran's claims file. Based on its review of the relevant evidence in this matter, and for the following reasons and bases, it is the decision of the Board that the veteran has not submitted evidence of a well- grounded claim of entitlement to service connection for bilateral fractures of the shoulder blades. FINDING OF FACT Competent medical evidence has not been submitted establishing an etiologic relationship between the veteran's post-service bilateral fractures of the shoulder blades and active service. CONCLUSION OF LAW The veteran's claim of entitlement to service connection for bilateral fractures of the shoulder blades is not well-grounded. 38 U.S.C.A. § 5107 (West 1991). REASONS AND BASES FOR FINDING AND CONCLUSION Service connection may be granted for disability resulting from disease or injury incurred in or aggravated by wartime service. 38 U.S.C.A. § 1110 (West 1991). For the showing of a chronic disease in service there is required a combination of manifestations sufficient to identify the disease entity, and sufficient observation to establish chronicity, as distinguished from merely isolated findings or a diagnosis including the word "Chronic." Continuity of symptomatology is required where the condition noted during service is not, in fact, chronic or where the diagnosis of chronicity may be legitimately questioned. When the fact of chronicity in service is not adequately supported, then a showing of continuity after discharge is required to support the claim. 38 C.F.R. § 3.303(b) (1994). The threshold question to be addressed is whether the veteran has presented a well-grounded claim for service connection. If he has not presented a well-grounded claim, the appeal must fail and the VA is under no duty to assist him further in the development of his claim. 38 U.S.C.A. § 5107(a) (West 1991); 38 C.F.R. § 3.159 (1994). See Murphy v. Derwinski, 1 Vet.App. 78, 81 (1992). Although a claim need not be conclusive to be well- grounded, it must be accompanied by supporting evidence that justifies a belief by a fair and impartial individual that the claim is plausible. Tirpak v. Derwinski, 2 Vet.App. 609, 611 (1992); Dixon v. Derwinski, 3 Vet.App. 261, 262 (1992). A review of the service medical records fails to reveal complaints, findings, or treatment for a bilateral shoulder disorder during active service. Medical evidence associated with the veteran's reserve component service after separation from active service through July 1968 also failed to reveal complaints, findings, or treatment for a bilateral shoulder disorder during that period of time. The examiner at an October 1990 VA examination noted an impression of history of bilateral scapular fractures with pain and limitation of motion of both shoulder joints, and the examiner at an April 1991 VA examination noted that x-rays of the scapula showed ill-defined horizontal structure involving the neck of the left scapula. Records received at the March 1993 personal hearing, including Social Security Administration forms and treatment records prepared at the orthopedic clinical of the Los Angeles County and University of Southern California Medical Center, show that the veteran was treated in 1991 to 1992 for a left shoulder disorder. Evidence subsequently received in from the Los Angeles County and University of Southern California Medical Center show treatment from 1991 to 1993 for a left shoulder disorder, including a arthroscopy of the left shoulder in November 1992. A treatment record in November 1992 shows an examiner's notation to the effect that, as history, the veteran fell two stories onto a steel deck injuring his back and left shoulder. A VA examination in September 1993 revealed arthritis of the left lower shoulder. At his personal hearing in May 1993, the veteran testified that during active service he was treated at a San Francisco area naval hospital after falling and breaking his shoulder blades. He stated that he cannot lift over 15 pounds with his left shoulder, and that his right shoulder had "a little more strength," and that both shoulder have pain. While the veteran has related his belief that his current bilateral shoulder disorder resulted from a fall during active service, he is not medically qualified to render a medical opinion. Espiritu v. Derwinski, 2 Vet.App. 492, 494-95 (1992). Moreover, the service medical records fail to show treatment for a shoulder disorder during active service, and clinical evidence subsequent to active service does not show complaints, findings, or treatment for a shoulder disorder until the 1990's. As such, there has been no medical evidence submitted relating a shoulder disorder to the veteran's active service. In accordance with Grottveit v. Brown, 5 Vet.App. 91 (1993), lay assertions of medical causation cannot constitute evidence to render a claim well-grounded under 38 U.S.C.A. § 5107(a) (West 1991); if no cognizable evidence is submitted to support a claim, the claim cannot be well-grounded. Furthermore, the notation in a November 1992 private clinical record that the veteran had a history of left shoulder injury during active service was based on the veteran's account of his medical history and service background and without a review of the service medical records. The recitation of history in a clinical record prepared nearly 40 years after service separation is not probative. Reonal v. Brown, 5 Vet.App. 458, 460-461 (1993). If a claim is not well-grounded, the Board does not have jurisdiction to adjudicate the claim. Boeck v. Brown, 6 Vet.App. 14, 17 (1994). As such, the matter must be dismissed. ORDER The veteran's claim of entitlement to service connection for bilateral fractures of the shoulder blades is dismissed. J. U. JOHNSON Member, Board of Veterans' Appeals The Board of Veterans' Appeals Administrative Procedures Improvement Act, Pub. L. No. 103-271, § 6, 108 Stat. 740, ___ (1994), permits a proceeding instituted before the Board to be assigned to an individual member of the Board for a determination. This proceeding has been assigned to an individual member of the Board. NOTICE OF APPELLATE RIGHTS: Under 38 U.S.C.A. § 7266 (West 1991), a decision of the Board of Veterans' Appeals granting less than the complete benefit, or benefits, sought on appeal is appealable to the United States Court of Veterans Appeals within 120 days from the date of mailing of notice of the decision, provided that a Notice of Disagreement concerning an issue which was before the Board was filed with the agency of original jurisdiction on or after November 18, 1988. Veterans' Judicial Review Act, Pub. L. No. 100-687, § 402 (1988). The date which appears on the face of this decision constitutes the date of mailing and the copy of this decision which you have received is your notice of the action taken on your appeal by the Board of Veterans' Appeals.