BVA9505780 DOCKET NO. 93-08 766 ) DATE ) ) On appeal from the decision of the Department of Veterans Affairs Regional Office in Chicago, Illinois THE ISSUE Entitlement to service connection for a right shoulder condition. WITNESS AT HEARING ON APPEAL Appellant ATTORNEY FOR THE BOARD Rebecca A. Kelly, Associate Counsel INTRODUCTION The appellant served on active duty for training from October 1 to December 12, 1991. This appeal arises from a December 1991 rating decision of the Chicago, Illinois, Department of Veterans Affairs (VA), Regional Office (RO), which denied entitlement to service-connection for a right shoulder condition. The appellant testified at a personal hearing in September 1992. By a decision dated September 1992, a VA Hearing Officer confirmed and continued the prior denial. CONTENTIONS OF APPELLANT ON APPEAL The appellant that service-connection is warranted for her right shoulder condition because she had never had any right shoulder problems prior to entering active duty for training. She asserts that she has had constant pain in her right shoulder ever since her separation and that the intensity of the pain varies with different movements. 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 appellant'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 evidence supports the appellant's claim of service connection for bursitis with impingement syndrome in the right shoulder. FINDING OF FACT The appellant's diagnosis of impingement syndrome, subacromial bursitis of the right shoulder had its onset during active duty for training. CONCLUSION OF LAW Right shoulder joint bursitis with impingement syndrome was incurred during active duty for training. 38 U.S.C.A. §§ 101 (2) (16) (22), (24), 1131, 1132 (West 1992). REASONS AND BASES FOR FINDINGS AND CONCLUSION Factual Background The service medical records include an induction examination conducted in May 1991. The appellant did not report any pertinent complaints or medical history concerning a prior right shoulder disorder. The examination showed that both shoulders were normal. During active duty for training, the appellant's first complaint about her right shoulder occurred on October 29, 1991 when she claimed she was unable to perform the requisite number of push-ups and that she had occasional pain in her right shoulder. The objective examination results included normal range of motion in the upper extremities; the neurology evaluation and motor skills were normal. The recommended treatment was Motrin. The assessment was inability to do push- ups. By early November 1991, the appellant's complaints included increased right shoulder pain consistent with trauma. She denied having had any right shoulder problems prior to service. Although the examination showed that her right shoulder was stable with full range of motion, there was pain on extreme ranges of motion and a diagnosis of impingement in the right shoulder was made. Her motor and neurological findings were normal. Tenderness over the anterior-superior right shoulder was noted. The treatment plan included ultrasound, ice massages three times per week and Motrin. The assessment was rule out impingement syndrome. Several days later, there was no change in the appellant's condition; the treatment was continued and the push-up profile was continued for one week. By mid- November 1991, an orthopedic consultation was performed because there had been no improvement after three weeks of treatment; her right shoulder pain persisted and she was unable to do push-ups secondary to pain and weakness. The objective examination showed negative drop arm with full active range of motion for the shoulder. She had bilateral 5/5 muscle strength in the upper extremities. Acromioclavicular joint tenderness and slight inferior laxity were noted. There were signs of impingement on external rotation and internal rotation, although there was no rotator cuff weakness. The examiner noted that the right shoulder x-ray showed possible small spur in the acromioclavicular joint. The assessment was impingement syndrome, subacromial bursitis of the right shoulder. No separation examination is of record. In March 1992, on VA examination appellant provided the history that her initial right shoulder injury occurred in basic training while doing a high and low crawl; her pain occurred when lifting and on movement. The examination showed atrophy of the muscles, although her right hand grip was strong and normal. The right shoulder joint showed pain on maneuvers with forward elevation from zero to 170 degrees with pain mostly in the right anterior shoulder area. The shoulder abduction ranges from zero to 170 degrees with pain in the anterior area. The external rotation was zero to 80 degrees and internal rotation of the right shoulder was zero to 80 degrees. Pain was noted in the anterior joint area. There was no swelling of the shoulder joints and no crepitation in the right shoulder area. The right shoulder x-ray was unremarkable. The diagnosis was right shoulder joint bursitis with impingement syndrome, to include mild limitation in range of motion of abduction and elevation and subjective pain in the right anterior shoulder joint area with movement and palpation. In September 1992, the appellant testified that prior to active duty for training she never had any problems or injuries to her right shoulder; she first experienced pain in her right shoulder when she was ordered to repeat a high crawl, low crawl maneuver in basic training. She testified that the pain in her right shoulder made it difficult for her to do the straight-legged type push-ups. She stated that she was right-handed. She had elected not to undergo a separation examination prior to discharge. After her discharge, she resumed teaching. Her current symptoms included numbing and achy pain in her right shoulder. Analysis Initially, the Board finds that the appellant has submitted evidence which is sufficient to justify a belief that her claim is well grounded. 38 U.S.C.A. § 5107(a)(West 1991) and Murphy v. Derwinski, 1 Vet.App. 78 (1990). That is, we find that she has presented a claim which is plausible. We are also satisfied that all relevant evidence has been obtained. There is no indication in the record that there are other records available that should be obtained. Therefore, no further development is necessary in order to comply with the duty to assist mandated by 38 U.S.C.A. § 5107(a). The term "active duty for training" means service as a full-time reservist for training purposes in either the Armed Forces, Reserve Corps of the Public Health Service, Army National Guard or Air National Guard of any State or as a member of a Senior Reserve Officers' Training Corps program for the duration of the training and while traveling to or from such duty. 38 U.S.C.A. §§ 101 (22) (West 1992). Moreover, "active military, naval or air service" includes active duty or active duty for training where a disability resulting from disease or injury was incurred in or aggravated in the line of duty. 38 U.S.C.A. §§ 101 (24) (West 1992). A "veteran" is a person who served in the active military, naval, or air service, and who was discharged or released therefrom under conditions other than dishonorable. 38 U.S.C.A.§§ 101 (2) (West 1992). Therefore, service connection may be granted for a disability resulting from disease or injury incurred in or aggravated while on active duty for training. 38 U.S.C.A.§§ 101 (16)(24), 1131,1132 (West 1992). In this case, the Board recognizes that the appellant's injury, diagnosed as impingement syndrome-subacromial bursitis of the right shoulder, was incurred during her initial period of active duty for training. Although the appellant testified that she had elected not to undergo a separation examination, the objective evidence on the March 1992 VA examination confirms that the appellant's residuals from her right shoulder injury included pain on movement or palpation, muscle atrophy, and mild limitation of range of motion on both abduction and elevation and that her residuals continued to persist after discharge. Therefore, it is the opinion of the undersigned, that the evidence of record supports a finding of entitlement to service connection for right shoulder joint bursitis with impingement syndrome. ORDER Service connection for right shoulder bursitis with impingement syndrome is granted. KENNETH R. ANDREWS, JR. 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.