Citation Nr: 0008938 Decision Date: 04/03/00 Archive Date: 04/11/00 DOCKET NO. 98-15 825 ) DATE ) ) On appeal from the Department of Veterans Affairs Regional Office in Phoenix, Arizona THE ISSUE Entitlement to service connection for residuals of cervical spine degenerative disc disease. REPRESENTATION Appellant represented by: Arizona Department of Veterans Services WITNESS AT HEARING ON APPEAL Appellant ATTORNEY FOR THE BOARD Neil T. Werner, Associate Counsel INTRODUCTION The veteran served on active duty from August 1948 to August 1949 and from December 1955 to November 1974. This matter comes before the Board of Veterans' Appeals (Board) following a July 1998 decision of the Phoenix, Arizona, Regional Office (RO) of the Department of Veterans Affairs (VA) which, among other things, denied service connection for post-operative residuals of cervical spine degenerative disc disease. FINDING OF FACT The veteran's has post-operative cervical spine degenerative disc disease with radiculopathy that is likely the result of injury that occurred coincident with military service. CONCLUSION OF LAW Post-operative cervical spine degenerative disc disease with radiculopathy is the result of disease or injury incurred during active military service. 38 U.S.C.A. §§ 1110, 1131, 5107 (West 1991); 38 C.F.R. § 3.303 (1999). REASONS AND BASES FOR FINDING AND CONCLUSION The veteran and his representative contend that the veteran's cervical disc disease was brought about by injuries sustained during his military service. Specifically, it is alleged that the cumulative effect of almost a hundred parachute jumps caused damage to the veteran's cervical spine and that this damage led to his current problems. Service connection is warranted where the evidence of record establishes that a particular injury or disease resulting in disability was incurred in the line of duty in the active military service or, if pre-existing such service, was aggravated thereby. 38 U.S.C.A. §§ 1110, 1131 (West 1991); 38 C.F.R. § 3.303(a) (1999). When disease is shown as chronic in service, or within a presumptive period so as to permit a finding of service connection, subsequent manifestations of the same chronic disease at any later date are service connected unless clearly attributable to intercurrent causes. 38 C.F.R. § 3.303(b) (1999). The Board finds that, with application of the benefit-of-the- doubt doctrine, a grant of service connection for post- operative cervical spine degenerative disc disease with radiculopathy is warranted. The veteran's service medical records show his complaints, diagnoses, and/or treatment for neck pain. See treatment records dated in May 1960, February 1963, March 1963, June 1963, February 1973, and May 1973. Additionally, service personnel records show that the veteran was awarded the parachute badge and master parachute badge. Moreover, the veteran filed with the RO a copy of his "jump log" which catalogued 75 jumps between October 1960 and September 1969. VA and private treatment records, dated from June 1975 to September 1998, were received by the RO. These records show the veteran's complaints and/or treatment for cervical spine/neck pain starting in December 1975. See VA orthopedic examination report dated in December 1975 (the veteran complained of some discomfort and minimal pain at C5-C6, but examination was normal). They also show the veteran's complaints, diagnoses, and/or treatment for left shoulder pain and weakness. The diagnoses and/or possible diagnoses included left shoulder impingement, carpal tunnel syndrome, herniated nucleus pulposus, and/or fibromyalgia. However, starting in November 1993, the diagnosis was cervical spine degenerative disc disease with left C6 radiculopathy. See VA treatment records dated in November 1992, November 1993, and January 1994; private treatment records dated in November 1993, January 1994, December 1995, February 1996, March 1996, October 1996, and November 1996; magnetic resonance imaging evaluation (MRI) dated in October 1996 (narrowed C5-C6 root canal); and nerve conduction study dated in November 1996 (C5 radiculopathy with C4-C5 nerve root cutoff). Thereafter, private treatment records, including physical therapy records, dated from November 1996 to November 1997, show the veteran's pre- and post-operative complaints and treatment related to a November 1996 left hemilaminectomy, C4-C5 and C5-C6, with foraminotomies and decompression of nerve roots due to cervical radiculopathy with left deltoid biceps paralysis. In a September 1998 note, David J. Knapp, M.D., reported that the veteran had been a paratrooper from 1960 to 1974, and that he started experiencing shoulder and neck pain in approximately 1963. It was opined that the veteran's pain and previous neck surgery were related to his years as a paratrooper. Similarly, in September 1998, Joseph C. Mirabile, M.D., noted that he had treated the veteran since the later part of 1996, that the veteran had been a paratrooper from 1960 to 1974, and that, during that time, the veteran sustained injuries to multiple areas of the body, including his back and neck. Dr. Mirabile reported as follows: . . . there is no question that that type of activity and those types of injuries would lead to an increased risk of degenerative changes of the spine, especially the cervical area, and would exacerbate any symptoms that were there. So, from a medical point of view, I would certainly think that some of these degenerative changes, although it is difficult to say to what degree, are due to the trauma sustained during those many years of jumping activities. Specifically, Dr. Mirabile reported that, in 1996, the veteran complained of increasing neck discomfort as well as pain and paralysis involving the left arm. The diagnoses at that time was C5 and C6 radiculopathy with significant cervical spondylosis which had caused significant atrophy and muscle wasting of the shoulder girdle on the left side, very severe weakness of the biceps, and almost total disappearance of deltoid function on the left side. Dr. Mirabile also opined that, following the November 1996 cervical hemilaminectomy at C4-C5 and C5-C6 with foraminotomies, the veteran had a good recovery with moderately good return of function involving the deltoid and biceps on the left side. However, he continued to have significant atrophy of both of those muscle groups. Three lay statements, dated from August 1998 to September 1998, were received by the RO from the veteran's wife and children. These individuals reported that the veteran, upon coming home after a parachute jump, frequently complained of neck and shoulder pain due to the impact when landing. It was noted that the veteran medicated himself for these injuries. The veteran also filed with the RO excerpts from medical texts related to cervical spine injuries and parachuting. The veteran testified at a personal hearing before the undersigned at the RO in February 2000. He reported that he started parachute jumping in 1960 when he was approximately 30 years old. He estimated that he jumped 90-plus times in all types of conditions between 1960 and 1974. During these jumps, he injured his neck on a number of occasions. Specifically, the veteran believed that he first injured his neck while in airborne training school in 1960. He also reported that the first complaint of neck pain that appears in his service medical records corresponds to the time he was in airborne training school, i.e., in approximately 1960. Following this first injury, his neck periodically bothered him throughout his military service. At those times, he either medicated himself or sought treatment from his unit's medic. (His unit's medic did not keep records.) However, he remembered one occasion, in approximately 1967, when he sought treatment for his neck pain from a physician. On the occasion of his separation examination, because of his other medical problems, he did not list his neck problem. This was so in part because his neck was not bothering him at that time. The Board observes that the veteran is competent to provide testimony regarding specific symptoms he experienced and the duration thereof during and since his military service, such as his problems with neck pain, as well as left shoulder and arm pain, numbness, and/or weakness. Similarly, the veteran's wife and children are competent to provide statements as to the veteran's complaints of neck and shoulder pain due to the impact of landing after his parachute jumps, and about how they observed the veteran medicating himself. Murphy v. Derwinski, 1 Vet. App. 78, 81 (1990). Medical evidence contained in the record on appeal also shows a current diagnosis of post-operative disc disease with radiculopathy. Additionally, Drs. Knapp and Mirabile provided VA with opinions directly linking the veteran's cervical spine degenerative disc disease to his military service. The record on appeal is devoid of any medical opinion to contradict these opinions as to the origins and etiology of the veteran's radiculopathy and degenerative disc disease. Accordingly, the Board finds that the evidence of a medical nexus to military service is at least in relative equipoise. Under such circumstances, the Board concludes that the evidence supports a grant of service connection for post-operative cervical spine degenerative disc disease with radiculopathy. Colette v. Brown, 82 F.2d 389 (Fed. Cir. 1996); Hensley v. Brown, 5 Vet. App. 155 (1993); 38 U.S.C.A. §§ 1110, 5107 (West 1991); 38 C.F.R. § 3.303 (1999). ORDER Service connection for post-operative cervical spine degenerative disc disease with radiculopathy is granted, subject to the laws and regulations governing the award of monetary benefits. MARK F. HALSEY Member, Board of Veterans' Appeals