Shoulder conditions: what the Board looked for
Real appeals on rotator cuff tears, shoulder arthritis, and impingement where a private medical opinion carried the weight.
A nexus letter is a signed medical opinion that links a current condition to your service.
If the VA just denied your shoulder claim: your decision letter lists the reasons. We read those reasons next to your records, page by page.
If you haven’t filed yet: the points below are what the Board weighed in these appeals. A letter can cover them from the start.
Why shoulder claims get denied
- The VA exam says your service records show no shoulder problem, and misses the one entry that does.
- The VA exam points to a normal X-ray and stops there.
- When one shoulder is claimed as caused by the other, the VA exam gives a general reason that doesn’t fit your case.
- Private letters fall short when they skip a shoulder injury after service, assume an in-service injury the records don’t show, or give little reasoning.
What the Board looked for
“Probative” is the Board’s word for convincing.
A normal X-ray didn’t rule out impingement.Granted · 2024
“In reaching his conclusions and diagnosis, the private examiner thoroughly took into consideration the circumstances of the Veteran’s military service, her reported symptoms, and the totality of the claims record.”
The VA exam said no, citing a normal X-ray of one shoulder joint. The private orthopedic surgeon explained that impingement happens in a different spot, so that X-ray didn’t rule it out. The Board said the VA exam didn’t fully weigh the demands of service.
Read decision A24041439 on VA.gov (opens in a new tab)The VA exam missed a strain in the service records.Granted · 2026
“However, the Board finds the January 2023 private medical opinion related to the Veteran’s bilateral shoulder disability is probative as to the issues at hand, as it is based on the record, the Veteran’s lay statements, and provides an explanation that contains clear conclusions.”
The VA examiner said no service record showed the shoulder trouble began in service. A muscle strain was on record, and the VA opinion never considered it. The private opinion used the records, the veteran’s account, and studies. It explained that arthritis changes take time to develop.
Read decision A26069829 on VA.gov (opens in a new tab)One shoulder overworked the other.Granted · 2025
“However, the Board affords the private physician’s more probative weight because he considered and discussed the Veteran’s report that she overused her right shoulder due to the pain in her service-connected left shoulder.”
The left shoulder was already service-connected. The VA examiner said pain in one arm rarely leads to pain in the other. The Board said that reason wasn’t tailored to this case. The private physician dealt with how the veteran leaned on the right shoulder.
Read decision A25051308 on VA.gov (opens in a new tab)A private letter the Board turned down.Denied · 2025
“The private physician did not reconcile this opinion with the lack of in-service treatment records indicative of such an injury and, indeed, it is not clear the private physician was aware that such injury was not specifically noted in his records.”
The letter said the shoulder was first hurt in service. The service records showed no shoulder injury. Later records described a shoulder injury years after service. The letter dealt with neither and gave little reasoning.
Read decision A25051357 on VA.gov (opens in a new tab)
What a strong nexus letter for a shoulder condition does
From the opinions the Board found convincing:
- Points to the exact service records: a strain, a sick call visit, a shoulder complaint.
- Describes the real demands of your service, like hard training, full gear, or daily tasks that strained the shoulder.
- Takes on the VA exam’s reasoning head on. One letter explained why a normal X-ray didn’t rule out impingement.
- Explains how the shoulder got from then to now, such as arthritis changes that take time to develop.
- If one shoulder overworked the other, explains how you leaned on it and why.
- Deals with any shoulder injury after service, and with what your service records leave out.
- Shows it reviewed your claims file and considered your own account.
- Uses the VA’s standard, “at least as likely as not.”
See what your records support
Our Nexus Check reads every page you send and cites the page for each finding, including pages that work against the claim. It’s free. If you request a letter, we draft it, and a licensed clinician reviews it, edits it and signs only what they support.
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If we don’t respond the same day during business hours, you get 15% off your nexus letter.
A call, voicemail or text from us counts as our reply. Business hours: Mon to Fri 8 to 5, Sat and Sun 8 to 2 Pacific. Terms
We don’t file claims or contact the VA for you. You or your accredited representative decide how to submit your evidence.
Public Board of Veterans’ Appeals decisions. These veterans weren’t Anchorpoint clients. Every claim is decided on its own evidence.