Citation Nr: 18140946 Decision Date: 10/09/18 Archive Date: 10/09/18 DOCKET NO. 14-02 505 DATE: October 9, 2018 ORDER Entitlement to service connection for a back condition is granted. FINDING OF FACT The Veteran’s back condition is etiologically related to his in-service accident. CONCLUSION OF LAW The criteria for entitlement to service connection for a back condition have been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from April 1968 to June 1970. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from rating decisions of the Department of Veterans Affairs (VA) Regional Office (RO) in Albuquerque, New Mexico. In March 2018, this matter was remanded for additional evidentiary development. Establishing service connection generally requires evidence of (1) a current disability; (2) an in-service incurrence or aggravation of a disease or injury; and (3) a nexus between the claimed in-service disease or injury and the present disability. See Shedden v. Principi, 381 F.3d 1163 (Fed. Cir. 2004). In determining whether service connection is warranted for a disability, VA is responsible for determining whether the evidence supports the claim or is in relative equipoise, with the Veteran prevailing in either event, or whether a preponderance of the evidence is against the claim, in which case the claim is denied. 38 U.S.C. § 5107; Gilbert v. Derwinski, 1 Vet. App. 49 (1990). When there is an approximate balance of positive and negative evidence regarding any issue material to the determination, the benefit of the doubt is afforded the claimant. VA treatment records reflect a current lumbar spine pathology, including diagnoses and treatment of a back condition. As a result, the first element of Shedden has been demonstrated. The record also contains evidence of an in-service injury. In a statement dated October 2011, the Veteran contends he initially injured his back in service and that the injury weakened his back and contributed to the pathology he currently experiences. The Board notes the Veteran is competent to report on factual matters of which he had firsthand knowledge; and the Board finds the Veteran’s reports to be credible. See Washington v. Nicholson, 19 Vet. App. 362, 368 (2005). Indeed, service treatment records do document the Veteran’s complaint of back problems in June 1968. Accordingly, the second element of Shedden has also been demonstrated. The Board is now left to consider whether there is a nexus between the Veteran’s back condition and his active duty service. Affording the Veteran the benefit of the doubt, the Board finds the nexus element has been met. Post-service private treatment record and records associated with the Veteran’s claim for Social Security Administration (SSA) disability benefits also reflects various post-service back injuries. He reportedly injured his back in September 1987 while working as a lineman. He was subsequently involved in a motor vehicle accident in September 1989. An MRI in 1989 shows right-sided L3-4 disc herniation with prolapse and moderate right-sided L4 root compression and bilateral L5-S1 spondylosis. In January 1994, the Veteran was involved in an accident in which he was knocked down by a car driven by his daughter and fell onto his buttocks and back. Old thoracic spondylosis was noted at that time. On VA treatment in April 2010, the Veteran reported a history of disc herniation for many years. He was assessed with degenerative joint disease. A September 2010 VA MRI revealed degenerative disc changes, severe bilateral neural foraminal stenosis, and facet arthroplasty. A January 2012 VA report reflects an assessment of chronic low back pain with lumbar stenosis. A March 2013 VA primary care report reflects an assessment of degenerative joint disease of the lumbar spine. An October 2015 statement from Dr. G. indicates she reviewed the Veteran’s records and noted in-service complaints regarding the back, as well as multiple traumas after service, including two motor vehicle accidents and a work injury. Degenerative changes were noted throughout the years. She concurred there was no apparent diagnosis of back disability in service but noted the Veteran’s treatment over the years showed congoing treatment for lumbar-related pain. The Veteran received a VA examination and opinion in June 2018. The examiner determined it was less likely than not the Veteran’s back condition was incurred in or caused by his active service. The examiner found there was no evidence of a chronic back condition during the Veteran’s active service. Furthermore, the examiner noted the Veteran’s separation exam was negative for a back condition. The examiner also documented that the Veteran suffered additional post-service back traumas. A private physician provided a positive opinion in August 2018. The examiner determined the Veteran’s current degenerative back condition more likely than not began with his initial injury in service. The examiner found the Veteran’s original back injury during service was traumatic and caused the Veteran chronic low back pain in addition to other damage. The examiner explained it is not unusual for an individual who suffered from back pain to power through the pain, and it is not uncommon to find degenerative changes of the back after a traumatic injury, even if the injury occurred many years prior to the manifestation of the symptoms. The examiner acknowledged the Veteran suffered post-service back trauma, but the examiner found, after considering the Veteran’s medical history, that the original injury during active service was the spark that resulted in the Veteran’s current degenerative condition. The examiner provided a medical explanation of how this would occur. While the VA examiner found there was no evidence of a chronic back condition during the Veteran’s active service, the Veteran contends, as noted in an October 2011 statement, he suffered through his back pain during service. The August 2018 examiner noted this, and explained that it is common for individuals with back injuries to power through their back pain. The VA examiner noted the Veteran’s separation exam was negative for any back condition. The August 2018 examiner determined the finding of a normal back on separation was not probative because there is no indication of imaging being conducted to show definitively that the Veteran’s back was indeed normal at separation. That examiner also explained how the Veteran’s initial injury during active service could cause the degenerative changes seen through the Veteran’s medical history. Furthermore, the Veteran maintains he experienced a back pathology during and since service. Indeed, the VA examiner noted the Veteran sought a private provider soon after separation, but the Veteran was unable to obtain those medical records.   In this case, there are medical opinions for and against the Veteran’s claim. Combined with the Veteran’s competent and credible lay statements, the Board finds it is at least as likely as not the Veteran’s back condition is etiologically related to active service. Resolving the benefit of the doubt in favor of the Veteran, service connection for a back disorder is warranted. 38 U.S.C. § 5107(b); 38 C.F.R. §§ 3.102, 3.303. Nathaniel J. Doan Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD Denton, Buck