Citation Nr: 1322536	
Decision Date: 07/15/13    Archive Date: 07/24/13

DOCKET NO.  09-25 383	)	DATE
	)
	)

On appeal from the
Department of Veterans Affairs Regional Office in Houston, Texas


THE ISSUES

1. Entitlement to service connection for a low back disorder. 

2. Entitlement to service connection for a right hip disorder. 

3. Entitlement to service connection for a neck disorder.  

4. Entitlement to service connection for a gastrointestinal disorder, to include gastroesophageal reflux disease (GERD), claimed as secondary to service-connected disabilities, to include the medication prescribed therefore.


REPRESENTATION

Appellant represented by:	Texas Veterans Commission




WITNESS AT HEARING ON APPEAL

The Veteran


ATTORNEY FOR THE BOARD

T. M. Gillett, Counsel


INTRODUCTION

The Veteran served on active duty from December 1965 to December 1969. 

This matter comes before the Board of Veterans' Appeals (Board) on appeal of a September 2007 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO) in Houston, Texas. 

The Veteran testified at a Travel Board hearing which was chaired by the undersigned Veterans Law Judge (VLJ) at the RO in July 2012. A transcript of the hearing has been associated with the Veteran's VA claims folder.

The Veteran's claim for service connection for a gastrointestinal disorder previously was adjudicated as a claim for service connection for GERD. However, the record indicates that the Veteran had been diagnosed with other gastrointestinal disorders, to include stomach erosions consistent with gastritis, during the pendency of the appeal; therefore, the Board has reclassified the Veteran's claim as one of service connection for a gastrointestinal disorder. See Clemons v. Shinseki, 23 Vet. App. 1 (2009) (holding that the scope of a health disability claim includes any disability that may reasonably be encompassed by the claimant's description of the claim, reported symptoms, and the other information of record). 

In a November 2012 Remand, the Board, in pertinent part, remanded the issue of service connection for a gastrointestinal disorder to the Appeals Management Center (AMC) for development. As will be discussed in the Remand section below, the AMC did not fully comply with the Board's November 2012 Remand instructions regarding this claim and the Board must remand it again for further development. Stegall v. West, 11 Vet. App. 268 (1998). 

In the November 2012 Remand, the Board also remanded the Veteran's claim for a psychiatric disorder to the AMC for further development. In a May 2013 rating decision, the RO granted the Veteran's claim for service connection for a psychiatric disorder, specifically a depressive disorder not otherwise specified (NOS). As the May 2013 rating decision fully granted the Veteran's claim for service connection for a psychiatric disorder, that issue is no longer in appellate status and is not before the Board.  

In the November 2012 Remand, the Board also remanded the respective issues of service connection for a right hip disorder, a low back disorder, and a neck disorder to the AMC for additional development. Following the directed development, the AMC returned the case to the Board for further appellate action.

The issue of service connection for a gastrointestinal disorder is addressed in the REMAND portion of the decision below and is REMANDED to the RO via the AMC in Washington, DC.


FINDINGS OF FACT

1. The Veteran's diagnosed low back disorder did not manifest itself in service or within one year thereafter, and is not causally or etiologically related to service.

2. The Veteran's diagnosed neck disorder did not manifest itself in service or within one year thereafter, and is not causally or etiologically related to service.

3. The Veteran has not been shown to have a right hip disorder that manifested in service or within one year thereafter, or a current right hip disorder that is causally or etiologically related to service.


CONCLUSIONS OF LAW

1. The criteria for entitlement to service connection for a low back disorder have not been met. 38 U.S.C.A. §§ 1101, 1110, 1112, 1113, 5103, 5103A, 5107(b) (West 2002 & Supp. 2012); 38 C.F.R. §§ 3.102, 3.159, 3.303, 3.307, 3.309 (2012).

2. The criteria for entitlement to service connection for a right hip disorder have not been met. 38 U.S.C.A. §§ 1101, 1110, 1112, 1113, 5103, 5103A, 5107(b) (West 2002 & Supp. 2012); 38 C.F.R. §§ 3.102, 3.159, 3.303 (2012).

3. The criteria for entitlement to service connection for a neck disorder have not been met. 38 U.S.C.A. §§ 1101, 1110, 1112, 1113, 5103, 5103A, 5107(b) (West 2002 & Supp. 2012); 38 C.F.R. §§ 3.102, 3.159, 3.303, 3.307, 3.309 (2012).



REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

Introductory Matters

In this decision, the Board will discuss the relevant law which it is required to apply. This includes statutes enacted by Congress and published in Title 38, United States Code ("38 U.S.C.A."); regulations promulgated by VA under the law and published in the Title 38 of the Code of Federal Regulations ("38 C.F.R."), and the precedential rulings of the United States Court of Appeals for the Federal Circuit (Federal Circuit) (as noted by citations to "Fed. Cir.") and the United States Court of Appeals for Veterans Claims (Court) (as noted by citations to "Vet. App."). 

The Board is bound by statute to set forth specifically the issue under appellate consideration and its decision must also include separately stated findings of fact and conclusions of law on all material issues of fact and law presented on the record, and the reasons or bases for those findings and conclusions. 38 U.S.C.A. 
§ 7104(d) (West 2002 & Supp. 2012); see also 38 C.F.R. § 19.7 (2012) (implementing the cited statute); see also Vargas-Gonzalez v. West, 12 Vet. App. 321, 328 (1999); Gilbert v. Derwinski, 1 Vet. App. 49, 56-57 (1990) (the Board's statement of reasons and bases for its findings and conclusions on all material facts and law presented on the record must be sufficient to enable the claimant to understand the precise basis for the Board's decision, as well as to facilitate review of the decision by courts of competent appellate jurisdiction. The Board must also consider and discuss all applicable statutory and regulatory law, as well as the controlling decisions of the appellate courts). 

Duty to Notify and Assist

The Veterans Claims Assistance Act of 2000 ("VCAA") describes VA's duty to notify and assist claimants in substantiating a claim for VA benefits. 38 U.S.C.A. 
§§ 5100, 5102, 5103, 5103A, 5107, 5126 (West 2002 & Supp. 2012); 38 C.F.R. 
§§ 3.102, 3.156(a), 3.159, 3.326(a) (2012).

Upon receipt of a complete or substantially complete application for benefits, VA is required to notify a veteran and his representative, if any, of any information and medical or lay evidence that is necessary to substantiate the claim, and to indicate which information and evidence VA will obtain and which information and evidence the claimant is expected to provide. 38 U.S.C.A. § 5103(a); 38 C.F.R. 
§ 3.159(b); Quartuccio v. Principi, 16 Vet. App. 183 (2002). The notice must be provided to the veteran prior to the initial adjudication of his or her claim. Pelegrini v. Principi, 18 Vet. App. 112 (2004). 

VCAA notice requirements apply to all five elements of a service connection claim: (1) veteran status; (2) existence of a disability; (3) a connection between the Veteran's service and the disability; (4) degree of disability; and (5) effective date of the disability. Dingess/Hartman v. Nicholson, 19 Vet. App. 473, 486 (2006). 

VA satisfied its duty to notify the Veteran by issuing a notice letter in March 2006. In this notice letter, VA informed the Veteran about the information and evidence not of record that was necessary to substantiate the claims; the information and evidence that VA would seek to provide; the information and evidence the Veteran was expected to provide; and the information regarding the assignment of ratings and effective dates required by Dingess.

The duty to assist provisions of the VCAA have been met. The claims file contains service treatment records, reports of post-service medical treatment, Social Security Administration (SSA) records, and the report of a VA medical examination provided in February 2013.  

In November 2012, the Board remanded the Veteran's claims to the AMC, requesting that the AMC take reasonable action to procure any outstanding treatment records and provide a VA medical examination reports containing adequate etiology opinions regarding the Veteran's claimed low back, neck, and right hip disorders. The record indicates that the AMC procured the Veteran's outstanding SSA administrative records, to include all treatment records utilized by SSA, and VA treatment records. In addition, in a December 2012 letter, the AMC asked that the Veteran sign and return enclosed authorization and release forms to allow the AMC to acquire records from the Calhoun Injury Rehabilitation Center. The Veteran did not return the authorization and release form as requested by the AMC. Instead, the Veteran returned an authorization and release form, allowing the AMC to procure treatment records from the University Health System in San Antonio (Health System). The record indicates that the AMC attempted to procure the records from the Health System, as authorized by the Veteran. Specifically, in March 2013, the AMC issued two separate letters to the University Health System, requesting copies of the Veteran's private treatment records from that facility. In a March 2013 response to the AMC's first letter, the Health System indicated that they not identify the Veteran. In an April 2013 response to the AMC's second letter, the Health System wrote that it did not have any record indicating that they had treated the Veteran at their facility. 

As noted above, the Veteran did not return a release and authorization form that would have allowed the AMC to acquire the Veteran's records from the Calhoun Injury Rehabilitation Center, despite being requested specifically to take such action. The duty to assist in the development and the adjudication of claims is not a one-way street. If a veteran wishes help, he or she cannot passively wait for it in those circumstances where he or she may or should have information that is essential in obtaining the evidence. Wood v. Derwinski, 1 Vet. App. 190 (1991). As the AMC sent a proper authorization and release form to the Veteran along with a letter explaining its purpose, the AMC's inability to acquire the Calhoun Injury Rehabilitation Center records resulted from the Veteran's failure to return the properly issued authorization and release form as requested. As for the Health System's records, the record indicates that the AMC attempted twice to procure the Veteran's private treatment records from that facility and, each time, the Health System indicated that they did not have any records for the Veteran at that facility. As the AMC took all reasonable steps to procure records from both the Calhoun Injury Rehabilitation Center and the Health System, the Board finds that an additional remand to seek procurement of those records would serve no useful purpose and would result in unnecessarily imposing additional burdens on VA with no benefit flowing to the veteran. See Soyini v. Derwinski, 1 Vet. App. 540, 546 (1991); Sabonis v. Brown, 6 Vet. App. 426, 430 (1994).

In February 2013, the AMC provided a VA medical examination, performed by a qualified VA examiner. After a review of all evidence and a physical examination, the VA examiner provided opinions regarding the respective natures and etiologies of the Veteran's claimed low back, neck, and right hip disorders, based on the evidence of record, with references to the evidence reviewed. Therefore, the Board finds that the February 2013 VA medical examination report has probative value in this matter. See Prejean v. West, 13 Vet. App. 444, 448 (2000) (indicating that the Board may determine the probative value of medical opinions based on their detail, the persuasiveness of their opinions, and the physicians' access to a veteran's medical records). VA has fulfilled its duty to assist the Veteran by providing the Veteran with a factually informed and medically supported VA medical examination. Therefore, the Board finds that the AMC complied with the Board's Remand directives. See Stegall, 11 Vet. App. at 268; Dyment v. West, 13 Vet. App. 141, 146-47 (1999).

Regarding the July 2012 Travel Board hearing, in Bryant v. Shinseki, 23 Vet. App. 488 (2010), the Court held that 38 C.F.R. § 3.103(c)(2) (2012) requires that the VLJ who conducts a hearing fulfill two duties to comply with the above regulation. These duties consist of (1) the duty to fully explain the issues and (2) the duty to suggest the submission of evidence that may have been overlooked. Here, during the July 2012 Travel Board hearing, the VLJ specifically noted the issues on appeal. Then, having heard the Veteran's evidence, the VLJ sought to identify any pertinent evidence not currently associated with the claims folder that might have been overlooked or was outstanding that might substantiate the claims. Both the VLJ and the Veteran's representative specifically queried the Veteran regarding any evidence the Veteran might have that indicated that the low back, neck, and right hip disorders were related to any incident in service. Partially as a result of these inquiries, the VLJ determined that a VA medical examination was necessary to assist in determining the respective etiologies of the Veteran's claimed disorders. The Board subsequently remanded the claim. In this case, the VLJ substantially complied with the requirements of Bryant.

The Veteran has been given ample opportunity to present evidence and argument in support of his claims. The Veteran has not provided VA with information regarding any additional evidence or authorization and consent forms that would allow for the procurement of any additional evidence not already on file. See Wood, 1 Vet. App. at 193. Therefore, pursuant to 38 C.F.R. § 3.655 (2012), all relevant evidence necessary for an equitable disposition of the Veteran's appeal of these issues has been obtained and the case is ready for appellate review. General due process considerations have been complied with by VA. See 38 C.F.R. § 3.103. 

Service Connection Rules and Regulations

Service connection may be granted for a disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C.A. § 1110; 38 C.F.R. § 3.303. That an injury or disease occurred in service is not enough; there must be chronic disability resulting from that injury or disease. If there is no showing of a resulting chronic condition during service, then a showing of continuity of symptomatology after service is required to support a finding of chronicity. 38 C.F.R. § 3.303(b). Service connection may also be granted for any disease diagnosed after discharge, when all the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303(d).

In order to establish service connection for the claimed disorder, there must be 
(1) medical evidence of a current disability; (2) medical, or in certain circumstances, lay evidence of in-service incurrence or aggravation of a disease or injury; and (3) medical, or in certain circumstances, lay evidence of a nexus between the claimed in-service disease or injury and the current disability. See 
38 C.F.R. § 3.303; see also Hickson v. West, 12 Vet. App. 247, 253 (1999); Davidson v. Shinseki, 581 F.3d 1313 (Fed. Cir. 2009). 

Under 38 C.F.R. § 3.303(b), claims for certain chronic diseases - namely those listed in 38 C.F.R. § 3.309(a) - benefit from a somewhat more relaxed evidentiary standard. See Walker v. Shinseki, 708 F.3d. 1331, 1339 (Fed. Cir. 2013) (holding that "[t]he clear purpose of the regulation is to relax the requirements of § 3.303(a) for establishing service connection for certain chronic diseases."). When a chronic disease is established during active service, then subsequent manifestations of the same chronic disease at any later date, however remote, will be entitled to service connection, unless clearly attributable to causes unrelated to service ("intercurrent causes"). 38 C.F.R. § 3.303(b). In order to establish the existence of a chronic disease in service, the evidence must show a combination of manifestations sufficient to identify the disease entity, and sufficient observation to establish chronicity at the time, as distinguished from merely isolated findings or a diagnosis including the word "chronic." Id. Thus, the mere manifestation during service of potentially relevant symptoms (such as joint pain or abnormal heart action in claims for arthritis or heart disease, for example) does not establish a chronic disease at that time unless the identity of the disease is established and its chronicity may not be legitimately questioned. Id. If chronicity in service is not established, then a showing of continuity of symptoms after discharge is required to support the claim. Id.  

The Federal Circuit noted that the requirement of showing a continuity of symptomatology after service is a "second route by which a veteran can establish service connection for a chronic disease" under subsection 3.303(b). Walker, 
708 F3d. at 1336. Showing a continuity of symptoms after service itself "establishes the link, or nexus" to service and also "confirm[s] the existence of the chronic disease while in service or [during the] presumptive period." Id. (holding that section 3.303(b) provides an "alternative path to satisfaction of the standard three-element test for entitlement to disability compensation"). Significantly, the Federal Circuit indicated that showing a continuity of symptomatology after service is a lesser evidentiary burden than the nexus requirement of the three-part test discussed above: "The primary difference between a chronic disease that qualifies for 
§ 3.303(b) analysis, and one that must be tested under § 3.303(a), is that the latter must satisfy the 'nexus' requirement of the three-element test, whereas the former benefits from presumptive service connection . . . or service connection via continuity of symptomatology" (emphasis added). Id. at 1339. 

Not all diseases that may be considered "chronic" from a medical standpoint qualify for the relaxed evidentiary standard under section 3.303(b). Rather, the Federal Circuit held that this subsection only applies to the specific chronic diseases listed in 38 C.F.R. § 3.309(a). Id. at 1338-40. Thus, if the claimant does not have one of the chronic diseases enumerated in section 3.309(a), then the more relaxed continuity-of-symptomatology standard does not apply, and "medical nexus of a relationship [sic] between the condition in service and the present condition is required." Id. at 1338; see also id. at 1336, 1340 (holding that the claimant's allegation of a continuity of hearing loss ever since active service was not sufficient to support the claim under subsection 3.303(b), as hearing loss was not among the chronic diseases listed in section 3.309(a)). 

Because the Veteran has been diagnosed with arthritis of the lumbar spine and cervical spine, the provisions of subsection 3.303(b) for chronic disabilities apply, and the Veteran's claims for service connection for low back and neck disorders may be supported by evidence of a continuity of symptomatology after service. Because the Veteran's right hip disorder has been found to be merely a manifestation of the Veteran's lumbar spine disorder, the Board will find that it is not a separate disability; however, the Board will discuss possible manifestations of lumbar spine disorder in the right hip when discussing continuity of symptomatology of the lumbar spine. 

Service connection may be granted for the listed chronic diseases, to include arthritis of the lumbar and cervical spines, when they are manifested to a compensable degree within one year of separation from service. 38 U.S.C.A. 
§§ 1101, 1112, 1113; 38 C.F.R. §§ 3.307, 3.309.

In all cases, the Board must determine the value of all evidence submitted, including lay and medical evidence. Buchanan v. Nicholson, 451 F.3d 1331 (Fed. Cir. 2006). The evaluation of evidence generally involves a three-step inquiry. First, the Board must determine whether the evidence comes from a "competent" source. The Board must then determine if the evidence is credible, or worthy of belief. Barr v. Nicholson, 21 Vet. App. 303, 308 (2007) (observing that once evidence is determined to be competent, the Board must determine whether such evidence is also credible). The third step of this inquiry requires the Board to weigh the probative value of the proffered evidence in light of the entirety of the record. 

Competent lay evidence means any evidence not requiring that the proponent have specialized education, training, or experience. Lay evidence is competent if it is provided by a person who has knowledge of facts or circumstances and conveys matters that can be observed and described by a lay person. Layno v. Brown, 6 Vet. App. 465 (1994). Lay evidence may be competent and sufficient to establish a diagnosis of a condition when: (1) a layperson is competent to identify the medical condition (i.e., when the layperson will be competent to identify the condition where the condition is simple, for example a broken leg, and sometimes not, for example, a form of cancer); (2) the layperson is reporting a contemporaneous medical diagnosis, or; (3) lay testimony describing symptoms at the time supports a later diagnosis by a medical professional. Jandreau v. Nicholson, 492 F. 3d 1372 (Fed. Cir. 2007); see also Davidson v. Shinseki, 581 F.3d 1313, 1316 (Fed. Cir. 2009) (where widow seeking service connection for cause of death of her husband, the veteran, the Court holding that medical opinion not required to prove nexus between service-connected mental disorder and drowning which caused veteran's death).  

Competent medical evidence is evidence provided by a person who is qualified through education, training, or experience to offer medical diagnoses, statements, or opinions. Competent medical evidence may also include statements conveying sound medical principles found in medical treatises. It also includes statements contained in authoritative writings, such as medical and scientific articles and research reports or analyses. 38 C.F.R. § 3.159(a)(1).

After determining the competency and credibility of evidence, the Board must then weigh its probative value. In this function, the Board may properly consider internal inconsistency, facial plausibility, and consistency with other evidence submitted on behalf of the claimant. Caluza v. Brown, 7 Vet. App. 498, 511-12 (1995), aff'd, 78 F.3d 604 (Fed. Cir. 1996) (per curiam) (table); see Madden v. Gober, 125 F.3d 1477, 1481 (Fed Cir. 1997) (holding that the Board has the "authority to discount the weight and probative value of evidence in light of its inherent characteristics in its relationship to other items of evidence").

The standard of proof to be applied in decisions on claims for veterans' benefits is set forth in 38 U.S.C.A. § 5107. A claimant is entitled to the benefit of the doubt when there is an approximate balance of positive and negative evidence. See 38 C.F.R. § 3.102. When a claimant seeks benefits and the evidence is in relative equipoise, the claimant prevails. See Gilbert, 1 Vet. App. at 49. The preponderance of the evidence must be against the claim for benefits to be denied. See Alemany v. Brown, 9 Vet. App. 518 (1996).

The Board has considered all evidence of record as it bears on the question of service connection. See 38 U.S.C.A. § 7104(a) (West 2002 & Supp. 2011) ("Decisions of the Board shall be based on the entire record in the proceeding and upon consideration of all evidence and material of record"); 38 U.S.C.A. § 5107(b) ("Secretary shall consider all information and lay and medical evidence of record in a case"). Although the Board has an obligation to provide reasons and bases supporting this decision, there is no need to discuss, in detail, the extensive evidence of record. The U.S. Court of Appeals for the Federal Circuit has held that the Board must review the entire record, but does not have to discuss each piece of evidence. Gonzales v. West, 218 F.3d 1378, 1380-81 (Fed. Cir. 2000). Therefore, the Board will summarize the relevant evidence where appropriate, and the Board's analysis below will focus specifically on what the evidence shows, or fails to show, as to the Veteran's appeal.

Service Connection for Low Back Disorder and
Right Hip Disorder

The Veteran essentially contends that he developed lumbar spine and right hip disorders due to an injury incurred during service. After a review of the evidence, both lay and medical, the Board finds that the weight of the evidence weighs against the Veteran's claim for service connection for both disorders.

Briefly reviewing the evidence of record, in a November 1967 service treatment record, the Veteran reported having been pinned under an aircraft in a sitting position with part of the craft over the upper thighs and his left hand "caught up in the nose wheel." At the time, the Veteran reported experiencing moderate pain solely in the right thigh and left hand. Upon physical examination, the service examiner noted that the Veteran was able to walk with difficulty and experienced pain upon making a fist.  

Subsequent service treatment records contain notations indicating treatment for a left hand/arm disorder, treated with a cast and splint. The service treatment records contain no notation indicating treatment for lumbar spine or right hip disorder symptomatology. In a December 1969 service discharge medical examination report, a service examiner noted that the Veteran's spine and other musculoskeletal systems, and lower extremities were normal. In the December 1969 service discharge medical examination report, the examiner provided a "PULHES" medical profile. The PULHES medical profile system is designed to reflect the overall physical and psychiatric condition of an individual on a scale of one (high level of fitness) to four (medical condition or physical defect that is below the level of medical fitness required for retention in the military service). The "P" stands for "physical capacity or stamina," the "U" indicates "upper extremities" (to include the cervical spine), the "L" is indicative of "lower extremities" (to include the lumbar spine and hips), the "H" reflects the condition of the "hearing and ears," the "E" is indicative of the "eyes," and the "S" stands for "psychiatric condition." See Odiorne v. Principi, 3 Vet. App. 456, 457 (1992). At the time of discharge, the service examiner noted that the Veteran's PULHES profile was all "ones," meaning that the Veteran had a high level of fitness in all areas.

Reviewing the post-service evidence of record, the Board notes that the post-service treatment records do not contain a diagnosis for a specific right hip disorder. In fact, most such records only note the Veteran's reports of pain radiating from the low back into the right hip.

In a December 2005 VA treatment record, the Veteran reported experiencing low back pain for the previous two months. The Veteran indicated that the pain would radiate, affecting his rib cage. After examination, the VA examiner diagnosed low back pain and osteoarthritis.  

In a March 2006 VA X-ray report, a VA examiner diagnosed degenerative joint disease of the lumbar spine.  

In a June 2006 VA physical rehabilitation consultation report, the Veteran stated that he had experienced a 37-year history of low back pain and a three year history of neck pain. The Veteran also indicated experiencing intermittent numbness radiating from his thoracic spine to his right buttock.  

In an August 2006 lay statement, a fellow service member wrote that he had served with the Veteran at the time of the incident involving the aircraft. The author indicated that he had worked the day shift, performing the same duties as the Veteran, while the Veteran worked on the night crew. The author wrote that the Veteran told him about an incident during which the Veteran was working on a plane when the hydraulic jack and landing gear slipped, catching the Veteran's left arm in the landing gear doors, breaking the Veteran's right wrist. The author wrote that the Veteran had to seek medical care at the dispensary, and was required to wear a cast on his arm and wrist for a while. The author reported that the Veteran incurred this injury in the service of his country.  

In a December 2006 lay statement, the Veteran recalled the in-service incident during which he contended that he was pinned underneath the aircraft after a jack holding the aircraft up during repairs failed. In recounting the incident, the Veteran stated that the aircraft "came down on my head and neck area." The Veteran indicated that the aircraft's "nose tires were between my legs and my left hand and arm were stuck up in the wheel well." The Veteran indicated that he had all of the weight of the aircraft on him at that time. The Veteran stated that he did not know how long he was trapped, but that he remembered hearing his fellow service members screaming. The Veteran stated that, at the time, the only parts of his body he could move were his eyes and right arm. The Veteran indicated that his fellow service members were able to get the plane off of him at which time he "popped out like a cork," landing on his back on the hangar floor. The Veteran wrote that a sergeant cleaned his left arm and hand, both of which were bleeding, and placed bandages on them. The Veteran stated that he could not go to a hospital that night so he had to take a bus to the field hospital located 30 miles away the next morning. The Veteran indicated that, although his entire body, to include his neck and back, was in pain, he was unable to see a doctor at the hospital the day after the incident. The Veteran wrote that he was able to see a doctor at the field hospital the following day. The Veteran stated that he told the doctor what had happened and specifically mentioned the pain he was experiencing in his left arm, left hand, back, and neck. The Veteran reported that the doctor merely replaced his arm bandages with a sling and told him to stay in bed for three days. The Veteran indicated that the doctor did not ask him anything about his back. The Veteran wrote that he was given an arm cast three days later and returned to regular duties. The Veteran stated that he had lived with back pain since the in-service incident. The Veteran wrote that he had learned to live with the pain, but that it had reached the point where he could no longer function in everyday life. The Veteran indicated that the low back pain had traveled to his lower right hip.  

In a March 2007 VA treatment record, the Veteran reported experiencing chronic back pain radiating down to his right hip from his neck. The Veteran indicated that the pain was related to an injury from a fallen aircraft in 1967.  

In a September 2007 work history report, provided for the SSA, the Veteran reported working as a store manager for a drilling fluids operation from 1984 to 1992. In describing his duties in this position, the Veteran stated that he ran all aspects of the store, including inventory, sales, labor, budgets, and billing. The Veteran indicated that he supervised 14 people while holding that position.  The Veteran wrote that, as part of his duties, he carried 50-pound sacks of drilling fluid chemicals onto boats, trucks, and helicopters. The Veteran wrote that he had to carry these sacks from 50 to 100 feet twice daily. The Veteran indicated that he also had to frequently lift 25-pound objects for one-third to two-thirds of each workday.  

In the same work history report, the Veteran reported working as an offshore base dispatcher for a drilling rig dispatcher operation from 1996 to 1999.  In describing his duties in this position, the Veteran stated that he took care of all incoming and outgoing tools, equipment, and workers for the drilling rig.  The Veteran also indicated that he supervised the loading and unloading of boats and trucks with rig equipment.  The Veteran indicated that he supervised 10 people while holding that position.  The Veteran wrote that, as part of his duties, he carried 20-pound sacks of drilling fluid chemicals onto boats, trucks, and helicopters.  The Veteran wrote that he had to carry these sacks from 50 to 100 feet four to five times daily.  The Veteran indicated that he also had to frequently lift 10-pound objects for one-third to two-thirds of each workday.  

In the same work history report, the Veteran reported working as a wastewater operator for a shipping port operation from 2000 to 2001. In describing his duties in this position, the Veteran stated that he managed and operated a wastewater and sewer system for a large county-owned shipping port. The Veteran wrote that, as part of his duties, he carried sewer plant chemicals and water sample bottles. The Veteran wrote that the heaviest weight he lifted in this job was 10 pounds. The Veteran indicated that he also had to frequently lift 10-pound objects for one-third to two-thirds of each workday.  

In a separate undated work history report, also provided to SSA, the Veteran indicated that he worked from April 1974 to October 1991 as a store manager. The Veteran indicated that, as part of this job, he serviced offshore oilrigs, and operated a facility that loaded all supplies and personnel onto boats and helicopters. As part of his duties, the Veteran stated that he had to lift and carry drill bits up to 15 feet six to seven times per week. The Veteran reported that the heaviest weight he lifted in this job was 90 pounds. The Veteran indicated that he also had to frequently lift 25-pound objects for one-third to two-thirds of each workday.  

In the same report, the Veteran indicated that he worked in 1992 as a restaurant owner. The Veteran indicated that, as part of this job, he cooked, prepped, served, purchased items, and washed dishes. As part of his duties, the Veteran stated that he had to lift and carry boxes of produce, water, meats, and seafood up to 10 feet every day. The Veteran reported that the heaviest weight he lifted in this job was 50 pounds. The Veteran indicated that he also had to frequently lift 10-pound objects for one-third to two-thirds of each workday.  

In the same report, the Veteran indicated that he worked from 1996 to 1999 as an offshore dispatcher. The Veteran indicated that, as part of this job, he loaded and unloaded equipment, materials, and groceries; inventoried items; made shipping orders; and insured that shipping stands were in place. As part of his duties, the Veteran stated that he had to lift and carry drilling equipment, test plugs, food, and water up to 20 feet daily. The Veteran reported that the heaviest weight he lifted in this job was 75 pounds. The Veteran indicated that he also had to frequently lift 75-pound objects for one-third to two-thirds of each workday.  

In the same report, the Veteran stated that his low back disorder began to affect his employment in June 2003. 

In an October 2007 service treatment record, the Veteran indicated that he had been working on the control panel under the nose of an F-10 aircraft during service when the nose wheel collapsed while his hand was in the side of the plane. The Veteran stated that the weight of the aircraft's nose fell on him. The Veteran indicated that he believed that he heard men shouting before he passed out during the incident.  The Veteran reported being treated afterwards for injuries to his left hand, but not for his neck and back.  

In a December 2007 VA psychiatric note, the Veteran indicated that he had nightmares about the incident involving the plane. The Veteran indicated that he was trapped under the plane for what witnesses told him was a period of five minutes. The Veteran stated that he did not believe that he was knocked unconscious at the time of the incident, but reported being able to remember nothing about the incident besides the aircraft coming down on top of him.  

In a March 2008 lay statement, the Veteran reported experiencing degenerative joint disease of the lumbar spine and a lower right hip disorder. The Veteran indicated that, during service, a jet aircraft fell on himself and a fellow service member. The Veteran stated that he would have been killed during that accident if it were not for the service members who rescued him. The Veteran reported experiencing body pains for the previous 40 years due to that incident.

In a June 2008 lay statement, a fellow service member who served with the Veteran indicated that he recalled that the Veteran and an additional service member were injured when a plane collapsed upon them. The author of the letter indicated that he could not recall the date of the incident, as it had occurred 40 years prior to the writing of the letter. The author wrote that he distinctly remembered seeing the Veteran wearing an arm-sling and a bandage around his hand after the incident. The author indicated that he believed that the other service member who was injured in the incident was medically evacuated. The author stated that the plane itself was dangerous aircraft upon which to work. The author wrote that he could remember at least three different incidents in which the plane's nose wheel would collapse before locks were installed to prevent this. Moreover, the author indicated that the belly of the plane was only 18 to 20 inches off the ground, and the nose was extremely large and bulky. 

In an August 2008 VA treatment record, specifically a psychiatric examination report, the Veteran stated that, during service, he was working on an aircraft that was on jacks which fell of the jacks, pinning him to the ground, and injuring his hand.  The Veteran indicated that, during the summers prior to entry into service, he worked on shrimp boats during the summer months for his two uncles. In describing his post-service work history, the Veteran reported working in the oil fields for 17 years after his December 1969 discharge from service. The Veteran stated that he also owned and operated two fishing boats with family members. The Veteran indicated that he also built and ran a restaurant with his wife for a couple of years, went into business with a friend as an offshore dispatcher for three years, and went to work of the county navigation district for two years. The Veteran reported doing some remodeling work in 2002 and then running a convenience store with his wife. The Veteran stated that in 2006, after the death of his son, he and his wife moved to another town and he retired due to his chronic pain.  

In an October 2008 lay statement, the Veteran wrote that he had experienced chronic pain in his later years due to the in-service incident in which he was pinned under an aircraft. The Veteran stated that he was going to undergo back surgery on account of the accident.

In a July 2009 lay statement, the Veteran reported that, when the plane fell, he was trapped in the nose landing gear wheel wall. The Veteran indicated that the nose wheel was between his legs and his left arm was stuck in the left side of the wheel wall. The Veteran stated that all of the weight of the aircraft came down on his back area, from his head to his hip area. The Veteran wrote that he was rushed after the incident to the field hospital in Da Nang, at which time doctors worked only on his cuts and bones of the left hand and arm. The Veteran indicated that he specifically told the doctors about his back and neck pain, but they never performed an X-ray examination. The Veteran stated that he never reported his pain during service as he was young and strong. The Veteran reported experiencing greater pain as he began to age and starting to take medications when he turned 50 to calm the pain. The Veteran stated that he started to get treatment at VA in 2003.  

In a July 2012 statement, a private chiropractor wrote that he had treated the Veteran for back pain for a number of years through the provision of adjustments every few months. The chiropractor stated that he had treated the Veteran during the years 1970 through 2006. Of note, in a March 2007 response to an authorized request for documents, the same chiropractor had advised VA that he had closed his offices and had no records to provide. 

In a July 2012 statement, the Veteran's spouse wrote that that the Veteran had experienced chronic back and hip pain since the beginning of their marriage in 1972. The Veteran's spouse indicated that the private chiropractor who wrote the July 2012 statement had treated the Veteran every three months since the start of their marriage, utilizing a number of treatment techniques, until the chiropractor retired in 2006. The Veteran's spouse stated that, during the time that the Veteran saw the chiropractor, she started noticing that the Veteran did not have the same energy level that he had shown previously. The Veteran's spouse indicated that the Veteran was tired all the time, could not drive long distances, and could not sit or stand longer than 30 minutes without having to lie down several times per day. The Veteran's spouse indicated that the chronic back and hip pain had kept the Veteran from working for the previous seven years.  

At the July 2012 Travel Board hearing, the Veteran indicated that, during the incident involving the airplane, he was standing on the top of a tire in the nose wheel well when the jack holding up the nose fell. The Veteran reported that the jacks holding the wings remained intact at the time. The Veteran stated that, after the nose jack fell, he found himself straddling the tire with his left hand stuck up in the wheel well. The Veteran remembered that he felt blood running down his arm and then he blacked out. The Veteran indicated that, after hearing some fellow service members screaming about getting on the tail section of the aircraft, he woke up on the ground to find a corpsman stopping the bleeding. The Veteran indicated that, during the incident, he was stuck, but not flattened by the aircraft. The Veteran stated that he went to the hospital the next morning and told the doctors that he was experiencing back, neck, and hip pain; however, the Veteran indicated that the doctors only treated him for a hand disorder, to include X-ray examinations of the hand. When discussing his neck and back disorder, the Veteran indicated that things, such as pain, did not bother him at the time due to his age. The Veteran testified that he played football at his base after his return from Vietnam. The Veteran stated that he did not handle any heavy objects during the years immediately after service, as he worked in an oilfield in management.  

In a February 2013 VA medical examination report, the Veteran reported being trapped in the wheel well of a plane for about five to 10 minutes when the jack holding up the nose of the plane failed. The Veteran indicated that he was treated at a field hospital primarily for a left arm injury, reported complaining to the service examiners of back pain at the time. The Veteran stated that his arm was treated by use of a cast for about six weeks and that he continued to work as an aircraft mechanic during those six weeks.  The Veteran indicated that he was not provided with any further evaluations of hip or back pain during service. The Veteran reported experiencing intermittent low back pain following service discharge.  The Veteran stated that he had seen a chiropractor for back adjustments from 1976 until 1991. The Veteran indicated that, when the pain in his lower back worsened, he sought medical treatment from VA in the mid-2000s. The Veteran stated that he worked as an oil field manager until 2007 when he retired due to low back pain. Regarding his current symptomatology, the Veteran reported experiencing constant and severe pain, measuring a seven on a scale of 10, in the right side of the lower back, helped by injections. The Veteran also indicated that he experienced right "hip" pain with onset in 2012, approximately one year prior to the examination. The VA examiner noted that the pain, as reported by the Veteran, was actually located two to three inches below the right sacroiliac joint. The VA examiner indicated that this location was actually considered part of the back, not the right hip.

Upon examination of the lumbar spine, the VA examiner reported finding limitation of motion of the lumbar spine, incoordination, pain on movement, and disturbance of locomotion. In examining the Veteran's right hip, the VA examiner noted that the examination indicated pain that the Veteran experienced pain to palpation in the right lower back, near the sacroiliac joint. Upon testing of the right hip, the VA examiner found no objective evidence of painful motion of the right hip. The VA examiner reported that the Veteran's right hip abduction was limited such that the Veteran could not cross his legs. After a thorough examination of the lumbar spine, the VA examiner diagnosed lumbar spondylosis and stenosis. As for the claimed right hip disorder, the VA examiner stated that the Veteran's hip pain symptomatology was actually located in the lower back, near the sacroiliac joint, and not the hip joint. 

After reviewing the claims file, interviewing the Veteran, and performing a thorough VA medical examination, the VA examiner opined that the Veteran's claimed lumbar spine disorder was less likely than not incurred in or caused by an in-service injury, event, or illness, to include the accident involving the aircraft. In explaining this opinion, the VA examiner noted that the accident in question occurred on November 20, 1967. The evidence, lay and medical, indicated that the Veteran was able to return to work as aircraft mechanic right after the accident and that the Veteran worked with a cast on his left arm for a period of six weeks following the accident. The VA examiner further noted the record contained no indication that the Veteran sought treatment for any back or hip disorder during the remainder of service. The VA examiner indicated that he had read statements from the Veteran and his family concerning his history of back pain. The VA examiner wrote that, although the Veteran reported seeing a chiropractor from 1976 to 1991, there were no contemporaneous medical reports documenting any back or hip problems during that period. The VA examiner noted that the Veteran worked as a shrimper for several years after he left service and then worked as a manager of an oil field until 2007. 

Regarding the Veteran's claimed right hip disorder, the VA examiner wrote that the Veteran did not have a diagnosed right hip disorder. The VA examiner wrote that the Veteran had a low back disorder with right-sided pain, not originating from the hip. 

Having reviewed the evidence of record, both lay and medical, the Board finds that the preponderance of the evidence weighs against the Veteran's claim for service connection for a low back disorder.  

Initially, the Board finds that the Veteran did not experience chronic low back disorder symptomatology during service. As noted above, the Veteran essentially contends that he experienced onset of low back disorder symptomatology at the time of the in-service accident involving an aircraft which partially fell on him while he was inside the wheel well. The Veteran has contended that the aircraft pinned him from his lumbar spine to his neck, rendering him unable to move. The Veteran has indicated that he experienced immediate back pain after the incident and chronic back pain during the remainder of his service. 

However, the Board finds that the preponderance of the evidence weighs against a finding of in-service low back disorder or right hip disorder symptomatology.

The Board notes that the Veteran is considered to have engaged in combat with the enemy, as indicated by the Navy Commendation Medal with a "V" denoting combat listed on his VA Form DD-214. If a veteran is a combat veteran, satisfactory lay or other evidence that an injury or disease was incurred in combat will be accepted as sufficient proof of service incurrence if the evidence is consistent with the circumstances, conditions, or hardships of such service, even though there is no official record of such incurrence or aggravation. 38 U.S.C.A. 
§ 1154(b) (West 2002); 38 C.F.R. § 3.304(d) (2012). 

Yet, in this instance, the provisions of 38 U.S.C.A. § 1154(b) and 38 C.F.R. 
§ 3.304(d) are not applicable as the injuries in question are completely unrelated to combat. The Veteran's military occupational specialty (MOS) was that of a hydraulics mechanic. The claims file contains an official record, citing the Veteran's actions that led to the awarding of the Navy Commendation Medal with a "V" device. In this record, a lieutenant general noted that the Veteran and two companions towed an aircraft to a safe position during a rocket attack on their base.  The Board notes that this incident is completely separate from the incident during which the Veteran claims to have been injured. In the case of the incident which the Veteran claims caused his low back and right hip disorders, specifically the accident involving the collapse of an aircraft, the incident in question did not involve combat nor does the Veteran claim that it did. The record indicates that the nose of the plane collapsed due to the failure of a jack and that failure was unrelated to any enemy action. Therefore, as the accident involving the aircraft collapse was unrelated completely to combat, the provisions of 38 U.S.C.A. § 1154(b) and 38 C.F.R. § 3.304(d) are not applicable. Therefore, the Veteran's lay evidence, by itself, might not be sufficient to prove in-service incurrence of low back and right hip disorders. Therefore, the Board must determine whether the Veteran's low back and right hip disorders were incurred during service by examining the entirety of the evidence of record.  

As noted above, in a July 2009 lay statement, the Veteran reported that the nose section of an aircraft fell on him during service, forcing all the weight of the aircraft onto his back area, from his head to his hip area. In this and other statements, the Veteran indicated that he experienced low back and right hip pain immediately after the incident. The Veteran also indicated that, upon seeking treatment after the accident, he told service medical personnel about his back pain, but was only treated for a hand disorder.  

The Board may properly consider internal inconsistency, facial plausibility, and consistency with other evidence submitted on behalf of the claimant. Caluza, 7 Vet. App. 498 at 511-12; see Madden, 125 F.3d at 1481. In this instance, the Board finds that the Veteran's reports of an in-service low back injury followed by chronic low back pain during service are not credible as they are inconsistent with the other evidence of record, to include the Veteran's own statements.

Initially, the Board notes that the Veteran has reported that, after the aircraft's nose collapsed, the entire weight of the aircraft was placed on his back. Specifically, in a July 2009 statement, the Veteran wrote that, after the failure of the jack, the aircraft came down on his back, from his head to his hips. However, in the November 1967 service treatment record, written within days of the accident, the Veteran reported having been pinned under an aircraft in a sitting position with part of the craft over his upper thighs and his left hand "caught up in the nose wheel." Although the Veteran has recently reported that he told the November 1967 service members about back pain, the service examiners made no notation in the service treatment records indicating that the Veteran reported experiencing any back pain at the time. Moreover, in "buddy" statements submitted by the Veteran in support of his claim, fellow service members who were stationed with the Veteran at the time of the accident mentioned that the Veteran experienced arm and hand injuries due to the incident. The Veteran's fellow service members made no notation in their statements indicating that the Veteran reported experiencing any low back disorder symptomatology after the accident. Therefore, the Veteran's statements, indicating chronic lumbar spine disorder symptomatology immediately following the November 1967 accident are not credible as they are inconsistent with both the contemporaneous treatment evidence of record and the recent statements from the Veteran's fellow service members. See id. 

Furthermore, the Board notes that the Veteran's statements regarding the accident itself are so inconsistent with each other as to cast doubt on the credibility of any particular statement. Although the Veteran contended that he experienced a lumbar spine injury during the incident involving the plane, in a December 2006 lay statement, the Veteran reported that, after the failure of the nose jack, the aircraft fell on his head and neck only. Moreover, in other statements, the Veteran reported experiencing a hand injury, but did not indicate experiencing any specific back or hip injury during the incident. Of particular note, in many statements, the Veteran indicated that he had difficulty remembering much of the incident as he blacked out during it. In a December 2007 VA psychiatric note, the Veteran stated that he could not remember anything of the incident besides the aircraft coming down on top of him. At the July 2012 Travel Board hearing, the Veteran stated that he remembered passing out after the plane had fallen on him as he felt blood rushing down his arm. In fact, the most consistent aspect of the Veteran's accounts of the incident involving the falling aircraft that the Veteran passed out or blacked out almost immediately after its onset, and was not conscious during the remainder. Therefore, the Veteran's accounts of the specific details of the incident lack credibility due to their inconsistencies with one another and the Veteran's admitted absence of consciousness during the incident in question. See id. 

Finally, the Veteran's statements involving treatment received after the incident cast doubt on his credibility as a lay witness to these events. In the December 2006 lay statement, the Veteran reported being treated at the scene of the incident with the application of bandages to his hand. The Veteran then indicated that he had to wait until the next morning to go to the hospital and then had to wait another day to see a service examiner. Subsequently, at the July 2012 Travel Board hearing, the Veteran testified that he was not provided with medical care at a hospital until the day after the accident. Yet, in a July 2009 lay statement, the Veteran indicated that he was "rushed" to the field hospital after the incident. The Board notes that the Veteran's July 2009 lay statement, in which he reported being rushed to the hospital after the incident, lacks credibility as it is inconsistent with the other statements of record. See id. 

The Board notes that the lack of urgency the Veteran's superiors showed in sending him to the field hospital for treatment, as described in the December 2006 lay statement, would appear appropriate for a person who had incurred a non-emergency hand/arm injury, as described in the November 1967 service treatment record. Moreover, the record, to include the Veteran's statements, shows that the Veteran was never taken off duty for any period greater than three days after the incident. The Veteran indicates that he still had to perform his regular duties even after service examiners provided him with a cast. The Board also notes that, in lay statements, both the Veteran and a fellow service member indicated that a second service member was injured during this incident. Although the Veteran never talked about what happened to the other individual, in a June 2008 lay statement, the Veteran's fellow service member wrote that the other individual hurt in the incident had to be medically evacuated from the base due to his injuries. The Board notes that this notation, indicating medical evacuation from the Veteran's location, indicates that such actions were possible for individuals who suffered severe injuries at the Veteran's location. Although the Veteran claims to have experienced injuries to his back and hip due to what could be defined as a crush accident, the admittedly slow manner in which sought hospital treatment, the restriction of in-service treatment solely to the Veteran's hand and arm after the accident, and the Veteran's continued performance of his duties after hospital treatment all cast doubt on the credibility of the Veteran's statements, indicating the incurrence of multiple disorders at the time of the incident involving the aircraft. 

As noted above, the Veteran claims to have experienced low back and right hip disorder symptomatology during service. However, the service treatment records contain no notation indicating treatment or diagnosis for any low back or right hip disorder symptomatology. In the December 1969 service discharge medical examination report, a service examiner noted that the Veteran's spine and other musculoskeletal systems, and lower extremities were normal. As the Veteran's reports of low back and right hip disorder symptomatology are inconsistent with the other evidence of record, to include the Veteran's own statements, the Board finds that they lack credibility. See id. Therefore, the Board finds that the Veteran did not experience chronic low back or right hip disorder symptomatology during service.

The Board also finds that the Veteran did not experience continuous low back or right hip disorder symptomatology after service or low back disorder symptomatology, specifically arthritis of the lumbar spine, manifested to a compensable degree within one year of service. As noted above, the Veteran contends that he experienced intermittent lumbar spine disorder symptomatology following the November 1967 incident involving the aircraft. At the July 2012 Travel Board hearing, when specifically asked if he had ever experienced a back injury after service, the Veteran explained that he had not experienced such an injury. The Veteran stated that he sought treatment for a back disorder in the late 1970s. The Veteran recalled that, at the time, he was working in management after service so he was not performing any duties that involved heavy lifting. Although the Veteran testified that his post-service employment did not include any heavy lifting, in an undated work history report, provided to SSA, the Veteran indicated that he worked from April 1974 to October 1991 as a store manager. The Veteran indicated that, as part of this job, he had to lift and carry drill bits up to 15 feet six to seven times per week. The Veteran reported that the heaviest weight he lifted in this job was 90 pounds. The Veteran indicated that he also had to frequently lift 25-pound objects for one-third to two-thirds of each workday. The Board notes that the Veteran's statements, indicating that he did not life any heavy objects in the years immediately following his discharge, are not credible as they are inconsistent with the other evidence of record. Caluza, at 511-12; see Madden, at 1481.

The Veteran has reported that he experiencing intermittent or continuous low back disorder symptomatology since the incident in service. However, the record contains no record indicating treatment for such symptomatology until December 2005, approximately 36 years after the Veteran's discharge from service. In the December 2005 VA treatment record, the Veteran reported experiencing low back pain over the previous two months. Therefore, the Board notes that the Veteran's statements, indicating that he experienced continuous low back disorder symptomatology since his December 1969 service discharge, are inconsistent with the medical evidence currently of record. 

In attempting to explain the lack of treatment records regarding his lumbar spine symptomatology since service, the Veteran has contended that he was treated by a chiropractor over a lengthy period after his December 1969 discharge from service. Yet, the Board finds that the evidence submitted regarding the dates of the Veteran's supposed chiropractic treatment are so inconsistent as to lack credibility. See id. 

The Board notes that, in the VA treatment records of record, the Veteran did not make any mention to VA examiners regarding any prior or current private chiropractic treatment. In a July 2009 lay statement, the Veteran indicated that he began taking medication for back problems when he turned 50 years old, but did not mention seeking any medical treatment, to include chiropractic care, prior to seeking help at VA in 2003. The Board notes that the 2003 mentioned in the July 2009 lay statement corresponds to the SSA report in which the Veteran indicated that he was unable to work due to back pain beginning in June 2003 and the VA treatment records indicating onset of low back pain decades after service.

However, at the July 2012 Travel Board hearing, the Veteran testified that he sought treatment for low back symptomatology in the late 1970s when his back started to hurt. In the February 2013 VA medical examination report, the Veteran told the VA examiner that he had seen a chiropractor for back adjustments from 1976 until 1991. Yet, in a July 2012 statement, the Veteran's spouse indicated that he had sought help from a chiropractor from 1972 until 2006. Subsequently, in support of this claim, the Veteran submitted a statement from the Veteran's chiropractor. In this statement, the Veteran's chiropractor wrote that he had treated the Veteran for back pain, with adjustment and treatment, every three months from 1970 to 2006. Yet, in a March 2007 response to an authorized request for documents, the same chiropractor had advised VA that he did not have any records regarding the Veteran's treatment. In the undated statement, the chiropractor did not explain how he knew that the Veteran visited his offices from 1970 to 2006 if the records if he had no records of said treatment and did not explain why the dates he provided were completely inconsistent with those provided by the Veteran and his spouse. Therefore, the Board finds that the dates of chiropractic service provided by the Veteran, his spouse, and the chiropractor are so inconsistent with one another to lack credibility. See id. 

As noted above, the Board finds that the undated chiropractor's statement lacks credibility as it is not corroborated by any other evidence, to include any medical records and the Veteran's own statements. However, if the statement were to be taken at face value, it would indicate that the Veteran sought treatment for a back disorder in 1970, within one year of the Veteran's December 1969 discharge from service. Service connection may be granted for listed chronic diseases, to include arthritis and degenerative joint disease, when they are manifested to a compensable degree within one year of separation from service. 38 U.S.C.A. §§ 1101, 1112, 1113; 38 C.F.R. §§ 3.307, 3.309. However, in this instance, the chiropractor wrote that the Veteran sought treatment solely for "back pain." The chiropractor did not indicate that the Veteran experienced lumbar spine arthritis symptomatology meeting the criteria for a compensable rating within one year of the Veteran's discharge from service. Specifically, the chiropractor did not report that the Veteran experienced lumbar spine arthritis, confirmed by X-ray, resulting in any limitation of motion, as required for a minimum compensatory rating under 38 C.F.R. § 4.71a, Diagnostic Code 5003 (2012). The Veteran has not submitted any medical evidence indicating that he experienced diagnosed lumbar spine arthritis symptomatology resulting in limitation of motion within one year of his December 1969 from service. Therefore, the evidence indicates that the Veteran did not experience arthritis of the lumbar spine, manifested to a compensable degree, within one year of separation from service. 

As noted above, the first medical evidence of record indicating treatment for any low back disorder symptomatology is dated decades after service. The lay statements submitted by the Veteran, to include those of his spouse and a chiropractor, regarding the onset and treatment for his lumbar spine symptomatology are so inconsistent as to lack credibility. Caluza, at 511-12; see Madden, at 1481. Therefore, the Board finds that the preponderance of the evidence weighs against a finding of continuous low back disorder symptomatology since the Veteran's discharge from service. 

Finally, the Board finds that the Veteran's current low back disorder is not related to service or to any incident of service, to include the in-service incident involving the airplane. In a February 2013 VA medical examination report, the VA examiner reported interviewing the Veteran and reviewing the claims file. After a thorough examination of the lumbar spine, the VA examiner diagnosed lumbar spondylosis and stenosis. Having done so, the VA examiner opined that the Veteran's claimed low back disorder was less likely than not incurred in or caused by an in-service injury, event, or illness, to include the accident involving the falling aircraft. In explaining this opinion, the VA examiner noted that the accident in question occurred on November 20, 1967. The evidence, lay and medical, indicated that the Veteran was able to return to work as aircraft mechanic right after the accident and that the Veteran worked with a cast on his left arm for a period of six weeks following the accident. The VA examiner further noted the record contained no indication that the Veteran sought treatment for any back or hip disorder during the remainder of service. The VA examiner indicated that he had read statements from the Veteran and his family concerning his history of back pain. The VA examiner wrote that, although the Veteran reported seeing a chiropractor from 1976 to 1991, there were no contemporaneous medical reports documenting any back or hip problems during that period. The VA examiner noted that the Veteran worked as a shrimper for several years after he left service and then worked as a manager of an oil field until 2007.  

As noted above, the Veteran has submitted a single statement from a chiropractor, indicating that he was treated for back pain from 1970 to 2006. Yet, the Board has found that the chiropractor's statement is not credible as it is inconsistent with both the medical evidence of record and, in this instance, the Veteran's own statements to the February 2013 VA examiner. See id. The VA examiner correctly noted that the service treatment records contained no notation indicating treatment or diagnosis for back disorder symptomatology during service. The VA examiner noted that the Veteran was able to perform not only his in-service duties as a mechanic, but also his duties while working in grueling occupations after service without apparent difficulty for decades. As the February 2013 VA medical examination report was written after an interview with the Veteran, a medical examination, a review of the claims file, and contained specific findings indicating the nature and etiology of the Veteran's claimed low back disorder, based on all evidence of record, the Board finds this opinion has great probative value in this matter. See Prejean, 13 Vet. App. at 448.

Regarding the Veteran's claimed right hip disorder, as noted above, the Veteran has made statements indicating that he experienced right hip disorder symptomatology since service. Yet, the service treatment records contain no notation indicating treatment for right hip disorder symptomatology. Moreover, the post-service treatment records contain no notation indicating diagnosis or treatment for a separate right hip disorder. In the February 2013 VA medical examination report, the VA examiner, having conducted a thorough examination, determined that the Veteran's claimed right hip disorder actually was a pain radiating from the Veteran's diagnosed lumbar spondylosis and stenosis. Therefore, as the Veteran does not have a diagnosed right hip disorder, service connection for a right hip disorder is precluded. See Brammer v. Derwinski, 3 Vet. App. 223, 225 (1992) (finding that in the absence of proof of present disability there can be no valid claim).

As the evidence indicates that the Veteran's current low back disorder and claimed right hip disorder are not related to service or any incident of service, the preponderance of the evidence is against the Veteran's claims for service connection for a low back disorder and claimed right hip disorder, and they must be denied. 
38 U.S.C.A. § 5107(b); Alemany v. Brown, 9 Vet. App. 518 (1996).

Service Connection for a Neck Disorder


The Veteran essentially contends that he developed a neck disorder due to the November 1967 incident involving the aircraft during service. After a review of the evidence, both lay and medical, the Board finds that the weight of the evidence weighs against the Veteran's claim for service connection for a neck disorder. 

The Board notes that a good deal of the evidence reviewed in this section, by necessity, will be repetitive of evidence mentioned in the preceding section.

Briefly reviewing the evidence of record, in a November 1967 service treatment record, the Veteran reported having been pinned under an aircraft in a sitting position with part of the craft over the upper thighs and his left hand "caught up in the nose wheel." At the time, the Veteran reported experiencing moderate pain solely in the right thigh and left hand. Upon physical examination, the service examiner noted that the Veteran was able to walk with difficulty and experienced pain upon making a fist.  

Subsequent service treatment records contain notations indicating treatment for a left hand disorder, treated with a splint and cast. The service treatment records contain no notation indicating treatment for neck disorder symptomatology. In a December 1969 service discharge medical examination report, a service examiner noted that the Veteran's spine and other musculoskeletal systems, and neck were normal. At the time of discharge, the service examiner noted that the Veteran's PULHES profile was all "ones," meaning that the Veteran had a high level of fitness in all areas, to include the cervical spine. 

Reviewing the post-service evidence of record, in an October 2003 VA treatment record, the Veteran reported experiencing constant tension in the right posterior neck, leading to constant headache. 

In a January 2004 VA treatment record, the Veteran reported experiencing right-sided intermittent neck pain, measuring a seven on a scale of 10. 

In a December 2005 VA treatment record, the Veteran reported experiencing popping in his neck, mostly in the morning, and neck pain with onset approximately two months prior to treatment. 

In a March 2006 VA X-ray report, a VA examiner diagnosed mild neural foraminal stenosis due to spondylosis of the cervical spine.  

In a June 2006 VA physical rehabilitation consultation report, the Veteran stated that he had experienced a three year history of neck pain and a one-and-a-half year history of numbness radiating from the neck to the first through third digits of the left hand. 

In an August 2006 lay statement, a fellow service member wrote that he had served with the Veteran at the time of the incident involving the aircraft. The author indicated that he had worked the day shift, performing the same duties as the Veteran, while the Veteran worked on the night crew. The author wrote that the Veteran told him about an incident during which the Veteran was working on a plane when the hydraulic jack and landing gear slipped, catching the Veteran's left arm in the landing gear doors, breaking the Veteran's right wrist. The author wrote that the Veteran had to seek medical care at the dispensary, and was required to wear a cast on his arm and wrist for a while. The author reported that the Veteran incurred this injury in the service of his country.  

In a December 2006 lay statement, the Veteran recalled the in-service incident during which he claims to have been pinned by an aircraft after a jack holding the aircraft up during repairs failed. In recounting the incident, the Veteran stated that the aircraft "came down on my head and neck area." The Veteran indicated that the aircraft's "nose tires were between my legs and my left hand and arm were stuck up in the wheel well," and that he had all of the weight of the aircraft on him. The Veteran stated that he did not know how long he was trapped, but that he remembered hearing his fellow service members screaming. The Veteran stated that, at the time, the only parts of his body he could move were his eyes and right arm. The Veteran indicated that his fellow service members were able to get the plane off him at which time he "popped out like a cork," landing on his back on the hangar floor. The Veteran wrote that a sergeant cleaned his left arm and hand, both of which were bleeding, and placed bandages on them. The Veteran stated that he could not go to a hospital that night so he had to take a bus to the field hospital 30 miles away the next morning. The Veteran indicated that, although his entire body, to include his neck and back, was in pain, he was unable to see a doctor at the hospital the day after the incident. The Veteran wrote that he was able to see a doctor at the field hospital the following day. The Veteran stated that he told the doctor what had happened and that he had mentioned specifically that he was experiencing pain in his left arm, left hand, back, and neck. The Veteran reported that the doctor merely replaced his arm bandages with a sling and told him to stay in bed for three days. The Veteran indicated that the doctor did not ask him anything about his neck. The Veteran wrote that he was given an arm cast three days later and returned to regular duties. The Veteran stated that he had lived with his neck pain since the in-service incident. The Veteran wrote that he had learned to live with the pain, but that it had reached the point where he could no longer function in everyday life. 

In a March 2007 VA treatment record, the Veteran reported experiencing chronic back pain radiating down to his right hip from his neck. The Veteran indicated that the pain was related to an injury from a fallen aircraft in 1967.  

In a September 2007 work history report, provided for the SSA, the Veteran reported working as a store manager for a drilling fluids operation from 1984 to 1992. In describing his duties in this position, the Veteran stated that he ran all aspects of the store, including inventory, sales, labor, budgets, and billing. The Veteran indicated that he supervised 14 people while holding that position. The Veteran wrote that, as part of his duties, he carried 50-pound sacks of drilling fluid chemicals onto boats, trucks, and helicopters. The Veteran wrote that he had to carry these sacks from 50 to 100 feet twice daily. The Veteran indicated that he also had to frequently lift 25-pound objects for one-third to two-thirds of each workday.  

In the same work history report, the Veteran reported working as an offshore base dispatcher for a drilling rig dispatcher operation from 1996 to 1999. In describing his duties in this position, the Veteran stated that he took care of all incoming and outgoing tools, equipment, and workers for the drilling rig. The Veteran also indicated that he supervised the loading and unloading of boats and trucks with rig equipment. The Veteran indicated that he supervised 10 people while holding that position. The Veteran wrote that, as part of his duties, he carried 20-pound sacks of drilling fluid chemicals onto boats, trucks, and helicopters. The Veteran wrote that he had to carry these sacks from 50 to 100 feet four to five times daily. The Veteran indicated that he also had to frequently lift 10-pound objects for one-third to two-thirds of each workday.  

In the same work history report, the Veteran reported working as a wastewater operator for a shipping port operation from 2000 to 2001. In describing his duties in this position, the Veteran stated that he managed and operated a wastewater and sewer system for a large county-owned shipping port. The Veteran wrote that, as part of his duties, he carried sewer plant chemicals and water sample bottles. The Veteran wrote that the heaviest weight he lifted in this job was 10 pounds. The Veteran indicated that he also had to frequently lift 10-pound objects for one-third to two-thirds of each workday.  

In a separate undated work history report, also provided to SSA, the Veteran indicated that he worked from April 1974 to October 1991 as a store manager. The Veteran indicated that, as part of this job, he serviced offshore oilrigs, and operated a facility that loaded all supplies and personnel onto boats and helicopters. As part of his duties, the Veteran stated that he had to lift and carry drill bits up to 15 feet six to seven times per week. The Veteran reported that the heaviest weight he lifted in this job was 90 pounds. The Veteran indicated that he also had to frequently lift 25-pound objects for one-third to two-thirds of each workday.  

In the same report, the Veteran indicated that he worked in 1992 as a restaurant owner. The Veteran indicated that, as part of this job, he cooked, prepped, served, purchased items, and washed dishes. As part of his duties, the Veteran stated that he had to lift and carry boxes of produce, water, meats, and seafood up to 10 feet every day. The Veteran reported that the heaviest weight he lifted in this job was 50 pounds. The Veteran indicated that he also had to frequently lift 10-pound objects for one-third to two-thirds of each workday.  

In the same report, the Veteran indicated that he worked from 1996 to 1999 as an offshore dispatcher. The Veteran indicated that, as part of this job, he loaded and unloaded equipment, materials, and groceries; inventoried items; made shipping orders; and insured that shipping stands were in place. As part of his duties, the Veteran stated that he had to lift and carry drilling equipment, test plugs, food, and water up to 20 feet daily. The Veteran reported that the heaviest weight he lifted in this job was 75 pounds. The Veteran indicated that he also had to frequently lift 75-pound objects for one-third to two-thirds of each workday.  

In the same report, the Veteran stated that his neck pain began to affect his employment in June 2003. 

In a September 2007 VA treatment record, the Veteran reported experiencing left-sided neck pain for several years. The Veteran indicated that he had received injection therapy from the VA pain clinic without relief. 

In an October 2007 service treatment record, the Veteran indicated that he had been working on the control panel under the nose of an F-10 aircraft during service when the nose wheel collapsed while his hand was in the side of the plane. The Veteran stated that the weight of the aircraft's nose fell on him. The Veteran indicated that he believed that he heard men shouting before he passed out during the incident.  The Veteran reported being treated afterwards for injuries to his left hand, but not for his neck and back.  

In a December 2007 VA psychiatric note, the Veteran indicated that he had nightmares about the incident involving the plane. The Veteran indicated that he was trapped under the plane for what witnesses told him was a period of five minutes. The Veteran stated that he did not believe that he was knocked unconscious at the time of the incident, but reported being able to remember nothing about the incident besides the aircraft coming down on top of him.  

In a March 2008 lay statement, the Veteran reported experiencing degenerative joint disease of the cervical spine. The Veteran indicated that, during service, a jet aircraft fell on himself and a fellow service member. The Veteran stated that he would have been killed during that accident if it were not for the service members who rescued him. The Veteran reported experiencing body pains for the previous 40 years due to that incident.

In a June 2008 lay statement, a fellow service member who served with the Veteran indicated that he recalled that the Veteran and an additional service member were injured when a plane collapsed upon them. The author of the letter indicated that he could not recall the date of the incident, as it had occurred 40 years prior to the writing of the letter. The author wrote that he distinctly remembered seeing the Veteran wearing an arm-sling and a bandage around his hand after the incident. The author indicated that he believed that the other service member who was injured in the incident was medically evacuated. 

In an August 2008 VA treatment record, specifically a psychiatric examination report, the Veteran stated that, during service, he was working on an aircraft that was on jacks which fell of the jacks, pinning him to the ground, and injuring his hand. The Veteran indicated that, during the summers prior to entry into service, he worked on shrimp boats during the summer months for his two uncles. In describing his post-service work history, the Veteran reported working in the oil fields for 17 years after his December 1969 discharge from service. The Veteran stated that he also owned and operated two fishing boats with family members. The Veteran indicated that he also built and ran a restaurant with his wife for a couple of years, went into business with a friend as an offshore dispatcher for three years, and went to work of the county navigation district for two years. The Veteran reported doing some remodeling work in 2002 and then running a convenience store with his wife. The Veteran stated that in 2006, after the death of his son, he and his wife moved to another town and he retired due to his chronic pain.  

In a July 2009 lay statement, the Veteran reported that, when the plane fell, he was trapped in the nose landing gear wheel wall. The Veteran indicated that the nose wheel was between his legs and his left arm was stuck in the left side of the wheel wall. The Veteran stated that all of the weight of the aircraft came down on his back area, from his head to his hip area. The Veteran wrote that he was rushed after the incident to the field hospital in Da Nang, at which time doctors worked only on his cuts and bones of the left hand and arm. The Veteran indicated that he specifically told the doctors about his neck pain, but they never performed an X-ray examination. The Veteran stated that he never reported his pain during service, as he was young and strong. The Veteran reported experiencing greater pain as he began to age and starting to take medications when he turned 50 to calm the pain. The Veteran stated that he started to get treatment at VA in 2003.  

In a July 2012 statement, a private chiropractor wrote that he had treated the Veteran for back pain for a number of years through the provision of adjustments every few months. The chiropractor stated that he had treated the Veteran during the years 1970 through 2006.  

At the July 2012 Travel Board hearing, the Veteran indicated that, during the incident involving the airplane, he was standing on the top of the tire in the nose wheel well when the jack holding up the nose fell. The Veteran reported that the jacks holding the wings remained intact at the time. The Veteran stated that he was straddling the tire with his left hand stuck up in the wheel well. The Veteran remembered that he felt blood running down his arm when he blacked out. The Veteran indicated that, after hearing some fellow service members screaming about getting on the tail section of the aircraft, he woke up on the ground to find a corpsman stopping the bleeding. The Veteran indicated that, during the incident, he was stuck, but not flattened. The Veteran stated that he went to the hospital the next morning and told the doctors that he was experiencing back, neck, and hip pain; however, the Veteran indicated that the doctors only treated him for a hand disorder, to include X-ray examinations of the hand. When discussing his neck and back disorder, the Veteran indicated that things did not bother him at the time due to his age. The Veteran testified that he played football at his base after his return from Vietnam. The Veteran stated that he did not handle any heavy objects in the years immediately after service, as he worked in an oilfield in management.  

In a February 2013 VA medical examination report, the Veteran reported being trapped in the wheel well of a plane for about five to 10 minutes when the jack holding up the nose of the plane failed. The Veteran indicated that he was treated at a field hospital primarily for a left arm injury, although the Veteran reported complaining of neck pain to the service examiners at the time. The Veteran stated that his arm was treated by use of a cast for about six weeks and that he continued to work as an aircraft mechanic during that time. The Veteran indicated that he was not provided with any further evaluations of neck pain during service. The Veteran reported experiencing intermittent neck pain following service discharge. The Veteran stated that he had seen a chiropractor for neck adjustments from 1976 until 1991. The Veteran indicated that, when the pain in his lower back worsened, he sought medical treatment from VA in the mid-2000s. After seeking treatment for his back pain, the Veteran also received treatment for his neck, to include injection therapy, from VA examiners. The Veteran stated that he worked as an oil field manager until 2007 when he retired due to low back pain. 

Upon examination of the cervical spine, the VA examiner reported finding limitation of motion of the cervical spine and pain on movement. After a thorough examination of the lumbar spine, the VA examiner diagnosed degenerative disc disease of the cervical spine. 

After reviewing the claims file, interviewing the Veteran, and performing a thorough VA medical examination, the VA examiner opined that the Veteran's claimed cervical disorder was less likely than not incurred in or caused by an in-service injury, event, or illness, to include the accident involving the aircraft.  In explaining this opinion, the VA examiner noted that the accident in question occurred on November 20, 1967. The evidence, lay and medical, indicated that the Veteran was able to return to work as aircraft mechanic right after the accident and that the Veteran worked with a cast on his left arm for a period of six weeks following the accident. The VA examiner further noted the record contained no indication that the Veteran sought treatment for any neck disorder during the remainder of service. The VA examiner indicated that he had read statements from the Veteran and his family concerning his history of neck pain. The VA examiner wrote that, although the Veteran reported seeing a chiropractor from 1976 to 1991, there were no contemporaneous medical reports documenting any neck problems during that period. The VA examiner noted that the Veteran worked as a shrimper for several years after he left service and then worked as a manager of an oil field until 2007.  

Having reviewed the evidence of record, both lay and medical, the Board finds that the preponderance of the evidence weighs against the Veteran's claim for service connection for a neck disorder. 

Initially, the Board finds that the Veteran did not experience chronic neck disorder symptomatology during service. As noted above, the Veteran essentially contends that he experienced neck disorder symptomatology with onset at the time of the in-service accident involving an aircraft, which partially fell while he was inside the wheel well. The Veteran has contended that the aircraft pinned him from his lumbar spine to his neck, rendering him unable to move. The Veteran has indicated that he experienced immediate neck pain after the incident and chronic neck pain during the remainder of his service. 

However, the Board finds that the preponderance of the evidence weighs against a finding of in-service neck disorder symptomatology during service. 

The Board notes that the Veteran is considered to have engaged in combat with the enemy, as denoted by the Navy Commendation Medal with a "V" denoting combat listed on his VA Form DD-214. If a veteran is a combat veteran, satisfactory lay or other evidence that an injury or disease was incurred in combat will be accepted as sufficient proof of service incurrence if the evidence is consistent with the circumstances, conditions, or hardships of such service even though there is no official record of such incurrence or aggravation. 38 U.S.C.A. § 1154(b) (West 2002); 38 C.F.R. § 3.304(d) (2012). 

Yet, in this instance, the provisions of 38 U.S.C.A. § 1154(b) and 38 C.F.R. 
§ 3.304(d) again are not applicable as the injuries in question are completely unrelated to any incident noted to involve combat. As noted above, the incident involving the collapse of the jet aircraft did not involve combat nor does the Veteran claim that it did. Therefore, as the accident involving the aircraft collapse was unrelated completely to combat, the provisions of 38 U.S.C.A. § 1154(b) and 38 C.F.R. § 3.304(d) are not applicable. 

In a July 2009 lay statement, the Veteran reported that the nose section of an aircraft fell on him during service, forcing all the weight of the aircraft onto his back area, from his head to his hip area. In this and other statements, the Veteran indicated that he experienced neck pain immediately after the incident. The Veteran also indicated that, upon seeking treatment after the accident, he told service medical personnel about his neck pain, but was only treated for a hand disorder.  

The Board may properly consider internal inconsistency, facial plausibility, and consistency with other evidence submitted on behalf of the claimant. Caluza, at 511-12; see Madden, at 1481. In this instance, the Board finds that the Veteran's reports of an in-service neck injury followed by chronic neck pain during service are not credible as they are inconsistent with the other evidence of record, to include the Veteran's own statements.

Initially, the Board notes that the Veteran has reported that, after the aircraft nose collapsed, the entire weight of the aircraft was placed on his back and neck. Specifically, in a July 2009 statement, the Veteran wrote that, after the failure of the jack, the aircraft came down on his back, from his head to his hips. However, in the November 1967 service treatment record, written within days of the accident, the Veteran reported having been pinned under an aircraft in a sitting position with part of the craft over his upper thighs and his left hand "caught up in the nose wheel." Although the Veteran reported that he told the November 1967 service examiners that he was experiencing neck pain, the service examiners made no notation indicating complaint, diagnosis, or treatment for any neck disorder symptomatology. Moreover, in "buddy" statements submitted by the Veteran in support of his several claims, fellow service members, who were stationed with the Veteran at the time of the accident, mentioned that the Veteran experienced arm and hand injuries due to the incident. The Veteran's fellow service members made no notation indicating that the Veteran reported experiencing any neck pain symptomatology after the accident. Therefore, the Veteran's statements, indicating chronic neck disorder symptomatology immediately following the November 1967 accident and lasting throughout the remainder of service lack credibility as they are inconsistent with both the contemporaneous treatment evidence of record and the recent statements from the Veteran's fellow service members. See id. 

Furthermore, the Board notes that the Veteran's statements regarding the accident itself are so inconsistent with each other as to cast doubt on the credibility of any particular statement. In some statements, the Veteran reported experiencing a hand injury, but did not indicate experiencing any specific neck injury during the incident. Of particular note, in many statements, the Veteran indicated that he had difficulty remembering much of the incident as he blacked out during it. In a December 2007 VA psychiatric note, the Veteran stated that he could not remember anything of the incident besides the aircraft coming down on top of him. At the July 2012 Travel Board hearing, the Veteran stated that he remembered passing out after the plane had fallen on him as he felt blood rushing down his arm. The Veteran reported awakening later on the ground. In fact, the most consistent aspect of the Veteran's accounts of the incident is that he passed out or blacked out almost immediately after its onset. Therefore, the Veteran's accounts of the details of the incident lack credibility due to their inconsistencies with one another and the Veteran's admitted absence of consciousness during the incident in question. See id.

Finally, the Veteran's statements involving treatment received after the incident cast doubt on his credibility as a lay witness to these events. In the December 2006 lay statement, the Veteran reported being treated at the scene of the incident with the application of bandages to his hand. The Veteran then indicated that he had to wait until the next morning to go to the hospital and then had to wait another day to see a service examiner. Subsequently, at the July 2012 Travel Board hearing, the Veteran testified that he was not provided with medical care at a hospital until the day after the accident. Yet, in a July 2009 lay statement, the Veteran indicated that he was "rushed" to the field hospital after the incident. The Board notes that the Veteran's July 2009 lay statement, in which he reported being rushed to the hospital after the incident, lacks credibility as it is inconsistent with the other statements of record. See id. 

The Board notes that the lack of urgency the Veteran's superiors showed in sending him to the field hospital for treatment, as described in the December 2006 lay statement, would appear appropriate for a person who had incurred a non-emergency hand/arm injury, as described in the November 1967 service treatment record. Moreover, the record, to include the Veteran's statements, shows that the Veteran was never taken off duty for any period greater than three days after the incident. The Veteran indicates that he still had to perform his regular duties even after service examiners provided him with a cast. The Board also notes that, in lay statements, both the Veteran and a fellow service member indicated that a second service member was injured during this incident. Although the Veteran never talked about what happened to the other individual, in a June 2008 lay statement, the Veteran's fellow service member wrote that the other individual hurt in the incident had to be medically evacuated from the base due to his injuries. The Board notes that this notation, indicating medical evacuation from the Veteran's location, indicates that such actions were possible for individuals who suffered severe injuries at the Veteran's location. Although the Veteran claims to have experienced a neck injury due to what could be defined as a crush accident, the admittedly slow manner in which he sought hospital treatment, the restriction of in-service treatment solely to the Veteran's hand and arm after the accident, and the Veteran's continued performance of his duties after hospital treatment all cast doubt on the credibility of the Veteran's statements, indicating the incurrence of multiple disorders at the time of the incident involving the aircraft. See id. 

The Veteran claims to have experienced neck disorder symptomatology during service. However, the service treatment records contain no notation indicating treatment or diagnosis for any neck disorder symptomatology. In the December 1969 service discharge medical examination report, a service examiner noted that the Veteran's spine and other musculoskeletal systems, and neck were normal; and reported that the Veteran's PULHES profile was all "ones," meaning that the Veteran had a high level of fitness in all areas. As the Veteran's reports of neck disorder symptomatology are inconsistent with the other evidence of record, to include the medical evidence and the Veteran's own statements, the Board finds that they lack credibility. See id. Therefore, the Board finds that the Veteran did not experience chronic neck disorder symptomatology during service. 

The Board also finds that the Veteran did not experience continuous neck disorder symptomatology after service or neck disorder symptomatology manifested to a compensable degree within one year of service. As noted above, the Veteran contends that he experienced intermittent neck disorder symptomatology following the November 1967 incident involving the aircraft. At the July 2012 Travel Board hearing, when specifically asked if he had ever experienced a neck injury after service, the Veteran explained that he had not experienced such an incident. The Veteran stated that he sought treatment for problems with his entire spine, to presumably include the neck, in the late 1970s. The Veteran recalled that, at the time, he was working in management after service so he was not performing any duties which involved heavy lifting. Although the Veteran testified that his post-service employment did not include heavy lifting, in an undated work history report, also provided to SSA, the Veteran indicated that he worked from April 1974 to October 1991 as a store manager. In this work history report, the Veteran indicated that, as part of this job, he had to lift and carry drill bits for up to 15 feet six to seven times per week. The Veteran reported that the heaviest weight he lifted in this job was 90 pounds. The Veteran indicated that he also had to frequently lift 25-pound objects for one-third to two-thirds of each workday. The Board notes that the Veteran's statements, indicating that he did not work in a position requiring any heavy lifting immediately after service, are not credible as they are inconsistent with the other evidence of record. See id. 

Moreover, the Veteran has reported that he experienced intermittent or continuous neck symptomatology since the incident in service. However, the record contains no record indicating treatment for such symptomatology until October 2003, more than 33 years after the Veteran's discharge from service. At that time, the Veteran did not report experiencing neck pain of over three decades duration. In a December 2005 VA treatment record, the Veteran reported experiencing popping in his neck, mostly in the morning, and neck pain with onset approximately two months prior to treatment. The Board notes that the Veteran's statements, indicating that he experienced continuous neck disorder symptomatology since his December 1969 discharge from service, are inconsistent with the medical evidence currently of record and, therefore, lack credibility. See id. 

In attempting to explain the lack of treatment records regarding his lumbar spine symptomatology since service, the Veteran has contended that he was treated by a chiropractor over a lengthy period after his December 1969 discharge from service. Yet, the Board finds that the evidence submitted regarding the dates of the Veteran's supposed chiropractic treatment is so inconsistent as to lack credibility. See id. 

The Board notes that, in the VA treatment records of record, the Veteran did not make any mention to VA examiners regarding any prior or current private chiropractic treatment. In a July 2009 lay statement, the Veteran indicated that he began taking medication for neck problems when he turned 50 years old, but did not mention seeking any medical treatment, to include chiropractic care, prior to seeking help at VA in 2003. The Board notes that the 2003 mentioned in the July 2009 lay statement corresponds to the SSA report in which the Veteran indicated that he was unable to work due to back pain beginning in June 2003 and the VA treatment records indicating onset of neck pain decades after service.

However, at the July 2012 Travel Board hearing, the Veteran testified that he sought treatment for spine disorder symptomatology in the late 1970s when his back started to hurt. In the February 2013 VA medical examination report, the Veteran told the VA examiner that he had seen a chiropractor for back adjustments from 1976 until 1991. Yet, in a July 2012 statement, the Veteran's spouse indicated that he had sought help from a chiropractor from 1972 until 2006 for low back and hip pain. Of note, in the July 2012 statement, the Veteran's spouse did not indicate that the Veteran had experienced neck pain since 1972. Subsequently, in support of this claim, the Veteran submitted a statement from the Veteran's chiropractor. In this statement, the Veteran's chiropractor wrote that he had treated the Veteran for back pain, with adjustment and treatment, every three months from 1970 to 2006. Yet, in a March 2007 response to an authorized request for documents, the same chiropractor had advised VA that he did not have any records regarding the Veteran's treatment. In the undated statement, the chiropractor did not explain how he knew that the Veteran visited his offices from 1970 to 2006 if the records if he had no records of said treatment and did not explain why the dates he provided were completely inconsistent with those provided by the Veteran and his spouse. Therefore, the Board finds that the dates of chiropractic service provided by the Veteran, his spouse, and the chiropractor are so inconsistent with one another to lack credibility. See id. 

As noted above, the Board finds that the undated chiropractor's statement lacks credibility, as it is not corroborated by any other evidence, to include any medical records and the Veteran's own statements. However, if the statement were to be taken at face value, it would indicate that the Veteran sought treatment for a neck disorder in 1970, within one year of the Veteran's December 1969 discharge from service. Service connection may be granted for listed chronic diseases, to include arthritis and degenerative joint disease, when they are manifested to a compensable degree within one year of separation from service. 38 U.S.C.A. §§ 1101, 1112, 1113; 38 C.F.R. §§ 3.307, 3.309. However, in this instance, the chiropractor wrote that the Veteran sought treatment solely for "back pain." Even if the Board were to assume that the word "back" referred to the entire spine, to include the neck, the chiropractor did not indicate that the Veteran experienced neck arthritis symptomatology meeting the criteria for a compensable rating within one year of the Veteran's discharge from service. Specifically, the chiropractor did not find that the Veteran experienced cervical spine arthritis, confirmed by X-ray, resulting in any limitation of motion, as required for a minimum compensatory rating under 38 C.F.R. § 4.71a, Diagnostic Code 5003. The Veteran has not submitted any medical evidence indicating that he experienced diagnosed cervical spine arthritis symptomatology resulting in limitation of motion within one year of his December 1969 from service. Therefore, the evidence indicates that the Veteran did not experience arthritis of the cervical spine, manifested to a compensable degree, within one year of separation from service.

As noted above, the first medical evidence of record indicating treatment for any neck disorder symptomatology is dated decades after service. The statements submitted by the Veteran, to include those of his spouse and a chiropractor, regarding the onset of his neck disorder symptomatology are so inconsistent as to lack credibility. Caluza, at 511-12; see Madden, at 1481. Therefore, the Board finds that the preponderance of the evidence weighs against a finding of continuous neck disorder symptomatology since discharge from service. 

Finally, the Board finds that the Veteran's current neck disorder is not related to service or to any incident of service, to include the in-service incident involving the airplane. In a February 2013 VA medical examination report, the VA examiner reported interviewing the Veteran and reviewing the claims file. After a thorough examination of the lumbar spine, the VA examiner diagnosed degenerative disc disease of the cervical spine. Having done so, the VA examiner opined that the Veteran's claimed neck disorder was less likely than not incurred in or caused by an in-service injury, event, or illness, to include the accident involving the aircraft. In explaining this opinion, the VA examiner noted that the accident in question occurred on November 20, 1967. The evidence, lay and medical, indicated that the Veteran was able to return to work as aircraft mechanic right after the accident and that the Veteran worked with a cast on his left arm for a period of six weeks following the accident. The VA examiner further noted the record contained no indication that the Veteran sought treatment for any neck disorder during the remainder of service. The VA examiner indicated that he had read statements from the Veteran and his family concerning his history of neck pain. The VA examiner wrote that, although the Veteran reported seeing a chiropractor from 1976 to 1991, there were no contemporaneous medical reports documenting any back or hip problems during that period. The VA examiner noted that the Veteran worked as a shrimper for several years after he left service and then worked as a manager of an oil field until 2007.  

The Veteran has submitted a single statement from a chiropractor, indicating that he was treated for neck from 1970 to 2006. Yet, as noted above, the chiropractor's statement is not credible as it is inconsistent not only with the medical evidence of record and, in this instance, the Veteran's own statements to the February 2013 VA examiner. See id. In this instance, the VA examiner correctly noted that the service treatment records contained no notation indicating treatment or diagnosis for neck disorder symptomatology during service. The VA examiner noted that the Veteran was able to perform not only his in-service duties as a mechanic, but also work in grueling occupations after service without apparent difficulty for decades after service. As the February 2013 VA medical examination report was written after an interview with the Veteran, a medical examination, a review of the claims file, and contained specific findings indicating the nature and etiology of the Veteran's claimed neck disorder, based on all evidence of record, the Board finds this opinion has great probative value in this matter. See Prejean, at 448.

As the evidence indicates that the Veteran's current neck disorder is not related to service or any incident of service, the preponderance of the evidence is against the Veteran's claim for service connection for a neck disorder and it must be denied. 
38 U.S.C.A. § 5107(b); Alemany, 9 Vet. App. at 518.



ORDER

Service connection for a lumbar spine disorder is denied.

Service connection for a cervical spine disorder is denied.  

Service connection for a right hip disorder is denied. 



REMAND

The Board finds that additional development is required before the Veteran's claim for service connection for a gastrointestinal disorder may be adjudicated. 38 C.F.R. § 19.9 (2012). The Veteran has alleged that he developed a gastrointestinal disorder, specifically GERD, as the result of medication used to treat his disabilities. The Veteran has been granted service connection for multiple disabilities, specifically a psychiatric disorder, diabetes mellitus, bilateral tinnitus, bilateral peripheral neuropathy related to diabetes mellitus, a fractured finger, and bilateral hearing loss. 

Briefly reviewing the evidence of record, in a March 2004 VA treatment record, the Veteran reported experiencing heartburn symptomatology unrelieved by over-the-counter medication. In a November 2004 VA treatment record, a VA examiner diagnosed the Veteran as having asymptomatic GERD. In a March 2007 VA esophagogastroduodenoscopy report, a VA examiner diagnosed the Veteran as having "multiple small erosions in the antrum on the stomach probably from  
... NSAID [nonsteroidal anti-inflammatory drug] (sulindac) and ASA [Aspirin]."

In a November 2012 Remand, the Board, in pertinent part, remanded the issue of service connection for a gastrointestinal disorder to the AMC for the provision of a VA medical examination to determine the nature and etiology of the Veteran's claimed gastrointestinal disorder. In so doing, the Board specifically noted the stomach erosions diagnosed in the March 2007 VA report and asked the VA examiner performing the VA medical examination to provide an opinion as to whether the erosions were caused or aggravated by medications used in treating the Veteran's service-connected disabilities.

In a February 2012 VA medical examination report, a VA examiner noted reviewing the claims file, interviewing the Veteran, providing an examination, and diagnosing the Veteran as having GERD. Having done so, the VA examiner opined that the Veteran's GERD was less likely than not related to any service-connected disability. In explaining this opinion, the VA examiner wrote that the Veteran's GERD was diagnosed in 2004 according to VA records. The VA examiner noted the March 2007 VA esophagogastroduodenoscopy report, diagnosing multiple stomach erosions consistent with gastritis, probably due to Sulindac or ASA usage. The VA examiner wrote that the Veteran's currently diagnosed GERD was not evident at the time of the 2007 study and the Veteran no longer used NSAIDs or ASA; however, the VA examiner noted, the Veteran's gastrointestinal complaints continued. Therefore, the VA examiner wrote, the evidence implied that the Veteran's currently diagnosed GERD was not related to NSAID or ASA usage.

Under VA regulations, the presence of a chronic disability at any time during the claim process can justify a grant of service connection, even where the disability resolves prior to adjudication of the claim. See McClain v. Nicholson, 21 Vet. App. 319 (2007). In this instance, the Veteran was diagnosed as having multiple stomach erosions consistent with gastritis, probably due to Sulindac or ASA usage, during the pendency of the claim in March 2007. The Board notes that the February 2012 VA examiner did not note any evidence indicating that the diagnosed stomach erosions had actually healed or were not present at this time. Yet, the VA examiner did not provide an opinion as to whether the Veteran's diagnosed stomach erosions were caused or aggravated by medications used in treating the Veteran's service-connected disabilities, despite being requested to do so in the November 2012 Remand. Under these circumstances, the Veteran must be afforded an additional VA examination to determine if any diagnosed gastrointestinal disorder is the result of medications used to control his service-connected disabilities. See Barr, 21 Vet. App. at 311-12 (holding that once VA undertakes the effort to provide an examination for an opinion, it must ensure the examination and opinion are adequate); Stegall, at 268.

Accordingly, the case is REMANDED for the following action:

1. The AMC/RO should schedule the Veteran for a VA medical examination by a physician with appropriate expertise. The purpose of the examination is to determine the nature of any gastrointestinal disorder diagnosed during the pendency of the Veteran's claim and whether such disorder is related to any service-connected disability or the medications prescribed therefore. 

The following considerations must govern the examination: 

a. The claims file and a copy of this remand must be made available to the physician, who must acknowledge receipt and review of these materials in any report generated. 

b. The physician must review all medical evidence associated with the claims file. In particular, the Board draws the physician's attention to the March 2007 VA esophagogastroduodenoscopy report which states that the Veteran has multiple small erosions in the antrum on the stomach probably from his NSAID and ASA use, and the February 2012 VA medical examination report. 
 
c. All indicated tests and studies must be performed, including a stress test (or a pharmacological stress test, if required) and an echocardiogram. 

d. The physician must provide a diagnosis for any gastrointestinal disability found from considering the claims file and from examining the Veteran. 

e. For any gastrointestinal disability diagnosed or diagnosed during the pendency of the claim, to include both GERD and stomach erosions, the physician must specifically opine whether that disability was caused or aggravated (permanently worsened beyond normal progression) by a service-connected disability, to include the medication prescribed therefore. 

f. In all conclusions, the physician must identify and explain the medical bases of his or her opinion with reference to the claims file. 

g. The mere statement of the examiner's expertise and/or a bare summary conclusion is not alone sufficient under the law to accomplish VA's legal obligation to assist the Veteran. By law, the Board must evaluate multiple factors in determining whether medical opinions are sufficient to evaluate a claim. These factors include but are not limited to whether the examiner was aware of all facts of record; reviewed the claims folder; conducted any necessary clinical testing or interview with the Veteran, and whether the examiner explained the factual and medical bases for any opinion

2. After completing all indicated development, the AMC/RO must readjudicate the Veteran's claim in light of all the evidence of record. If the benefits sought on appeal remain denied, then the Veteran and his representative must be furnished a fully responsive Supplemental Statement of the Case (SSOC) and afforded a reasonable opportunity for response. Thereafter, if indicated, the case must be returned to the Board for the purpose of appellate disposition.

The appellant has the right to submit additional evidence and argument on the matter or matters the Board has remanded.  Kutscherousky v. West, 12 Vet. App. 369 (1999).

This claim must be afforded expeditious treatment.  The law requires that all claims that are remanded by the Board of Veterans' Appeals or by the United States Court of Appeals for Veterans Claims for additional development or other appropriate action must be handled in an expeditious manner.  See 38 U.S.C.A. §§ 5109B, 7112 (West Supp. 2012).




______________________________________________
VITO A. CLEMENTI
Veterans Law Judge, Board of Veterans' Appeals


Department of Veterans Affairs