Citation Nr: 18140975 Decision Date: 10/09/18 Archive Date: 10/09/18 DOCKET NO. 16-21 531 DATE: October 9, 2018 ORDER Entitlement to service connection for a back condition is denied. Entitlement to service connection for a right shoulder condition is denied. Entitlement to service connection for neck problems is denied. FINDINGS OF FACT 1. The preponderance of the evidence is against finding that the Veteran has a back condition due to a disease or injury in service, to include specific in-service event, injury, or disease. 2. The preponderance of the evidence is against finding that the Veteran has a right shoulder condition due to a disease or injury in service, to include specific in-service event, injury, or disease. 3. The preponderance of the evidence is against finding that the Veteran has neck problems due to a disease or injury in service, to include specific in-service event, injury, or disease. CONCLUSIONS OF LAW 1. The criteria for entitlement to service connection for a back condition have not been met. 38 U.S.C. §§ 1110, 5107(b); 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309. 2. The criteria for entitlement to service connection for a right shoulder condition have not been met. 38 U.S.C. §§ 1110, 5107(b); 38 C.F.R. §§ 3.102, 3.303(a). 3. The criteria for entitlement to service connection for neck problems have not been met. 38 U.S.C. §§ 1110, 5107(b); 38 C.F.R. §§ 3.102, 3.303(a). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from July 1986 to June 1990. This matter is on appeal from a September 2014 rating decision, which denied entitlement to service connection for the Veteran’s back condition, right shoulder condition, and neck problems. Service Connection Service connection may be granted for a disability resulting from disease or injury incurred in or aggravated by service. 38 U.S.C. § 1110; 38 C.F.R. § 3.303(a). Service connection requires competent evidence showing: (1) the existence of a present disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the present disability and the disease or injury incurred or aggravated during service. Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004); 38 C.F.R. § 3.303. The benefit of the doubt rule provides that a veteran will prevail in a case where the positive evidence is in a relative balance with the negative evidence. Therefore, the Veteran prevails in a claim when: (1) the weight of the evidence supports the claim, or (2) when the evidence is in equipoise. It is only when the weight of the evidence is against the claim that the claim must be denied. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102; Gilbert v. Derwinski, 1 Vet. App. 49 (1990). Certain chronic diseases will be presumed related to service if they were noted as chronic in service; or, if they manifested to a compensable degree within a presumptive period following separation from service; or, if continuity of the same symptomatology has existed since service, with no intervening cause. 38 U.S.C. §§ 1101, 1112, 1113, 1137; Walker v. Shinseki, 708 F.3d 1331, 1338 (Fed. Cir. 2012); Fountain v. McDonald, 27 Vet. App. 258 (2015); 38 C.F.R. §§ 3.303(b), 3.307, 3.309(a). 1. Entitlement to service connection for a back condition is denied. 2. Entitlement to service connection for a right shoulder condition is denied. 3. Entitlement to service connection for neck problems is denied. The Veteran contends that he has a back condition, a right shoulder condition, and neck problems that are related to an in-service injury, event, or disease. The question for the Board is whether the Veteran has a current disability that began during service or is at least as likely as not related to an in-service injury, event, or disease. Additionally, to assess the Veteran’s back condition, the Board must determine whether the Veteran has a chronic disease that manifested to a compensable degree in service or within the applicable presumptive period, or whether continuity of symptomatology has existed since service. The Board concludes that, while the Veteran has a back condition, right shoulder condition, and neck problems, the preponderance of the evidence is against finding that these conditions began during active service, or are otherwise related to an in-service injury, event, or disease. 38 U.S.C. §§ 1110, 1131, 5107(b); Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009); 38 C.F.R. § 3.303(a), (d). In addition, the Board concludes that, while the Veteran has degenerative disc disease of his back, which is a chronic disease under 38 C.F.R. § 3.309(a), it was not chronic in service or manifest to a compensable degree in service or within a presumptive period, and continuity of symptomatology is not established. The Board acknowledges that the Veteran was not afforded a VA examination for his claims for service connection for his back condition, right shoulder condition, or neck problems. Under McLendon v. Nicholson, 20 Vet. App. 79 (2006), in initial service connection claims, the VA must provide a VA medical examination where there is (1) competent evidence of a current disability or persistent or recurrent symptoms of a disability; (2) evidence establishing that an event, injury, or disease occurred in service; (3) an indication that the disability or persistent or recurrent symptoms of a disability may be associated with the veteran’s service; and (4) insufficient competent medical evidence on file for VA to make a decision on the claim. In this regard, the Board finds that the Veteran has submitted insufficient evidence to indicate that his back condition, right shoulder condition, or neck problems are related to an event, injury, or disease that occurred in service. Accordingly, the Board finds that no further development of the Veteran’s claims for service connection for his back condition, right shoulder condition, or neck problems is required. A review of the Veteran’s service treatment records does not reflect any complaints, findings, or treatment for a back condition, right shoulder condition, or neck problems. An April 1990 report of medical history documented the Veteran’s negative responses to whether he had ever had a painful shoulder, recurrent back pain, or arthritis. An April 1990 report of medical examination indicates that the Veteran’s spine and upper extremities were normal. No physical abnormalities were reported by the examiner. The earliest evidence in the Veteran’s claims file of complaints for a back condition, right shoulder condition, and neck problems are his June 2014 application for disability compensation. On his application, the Veteran claimed that his back condition, right shoulder condition, or neck problems were due to lifting heavy objects in service. In September 2015, A VA facility conducted radiographic imaging of the Veteran’s claimed conditions. Radiographic imaging of the Veteran’s lumbosacral spine revealed minimal degenerative disc disease at T12-L1, L1-L2, and L5-S1. Radiographic imaging of the Veteran’s right shoulder revealed unremarkable appearance of glenohumeral and acromioclavicular joint spaces. Radiographic imaging of the cervical spine revealed that vertebral body heights and intervertebral disc spaces are well-preserved. In September 2015, the Veteran submitted a notice of disagreement (NOD) in which he reported that he did not receive medical care during service for any of his claimed conditions. Nevertheless, he explained that his military duties required him to constantly carry “quite a few extra pounds of weight,” as each aircraft tiedown weighed 12 pounds. He also reported that, during flight operations, he would be on deck between 12 and 14 hours. Along with his NOD, the Veteran submitted private medical records. An August 2015 medical record documents an office visit for the Veteran’s neck, back, and shoulder pain written by Dr. M.J., the treating physician. Dr. M.J. reported that the Veteran had no history of treatment for neck, back, and shoulder pain at his facility. He noted that the Veteran is “appealing something from the VA” and wanted to talk to a doctor before he “goes and talk to VA.” During the office visit, the Veteran reported that he weighed 150 pounds during his military service and carried as much as 200 pounds of chains for twelve-hour shifts. The Veteran reported that he developed right neck, right shoulder, and lower back pain at that time. These same areas have continued to bother him over the years. He reported that providers “took care of some of these” but that the medical records have been destroyed. The Veteran reported that he did not report these problems during service so as not to interrupt his duties. A review of the musculoskeletal system, during the August 2015 office visit, reported complaints of neck pain, upper back pain, and lower back pain. However, the Veteran denied the following: joint pain, joint swelling, joint stiffness, muscle cramps, muscle weakness, pain radiating down the leg, restless legs, and leg pain with exertion. After describing the Veteran’s recollections, the doctor wrote the following: “[T]hese issues in the same locations are worsening as the patient ages. It is my opinion that they were initiatedausedin [sic] a more likely than not by his military service.” The doctor diagnosed the Veteran with neck pain and low back pain, but did not diagnose shoulder pain. In April 2016, the Veteran submitted a letter along with copies of a government solicitation for lightweight aircraft tiedowns and excerpts from technical manuals. In his letter, the Veteran contended that the U.S. Navy is aware tie down chains “causing damage to persons, not only short term but long term as well.” He explained that the government solicitation he submitted, N103-216, was designed to reduce by half the weight of chains due to the damage it creates. He explained that he worked with those chains as well as tow bars that weighed 170 pounds throughout his military service. The Veteran reported that his body weight during service was between 150 and 160 pounds and that carrying the chains across his shoulders caused “a strain.” He reported that his medical records for the past 25 years have been destroyed because he was told that the offices only maintain records for five years before destroying them. The Veteran conceded that he did not report any injuries during service. He reported that a few years after he was discharged, his “body aches became more and more apparent.” Since being discharged, the Veteran reported that he has worked in sales or management positions, which do not create any extra strain on his body. He reported that, as he ages, “these conditions become worse and the pain doesn’t subside, it just fluctuates from a pain level from 4-8.” According to the Veteran, his medical conditions have been noted for over twenty years but his past medical records have been destroyed. He reported that X-rays show some degenerative changes in the “areas of my complaint;” however, he also believes that soft tissues and muscle groups have also damaged. The acquisition solicitation and the excerpts of technical manuals provided by the Veteran provide only general information about aircraft handling equipment and procedures. This information was not accompanied by any corresponding clinical evidence specific to the Veteran and do not suggest that his back condition, right shoulder condition, and neck problems are related to his service. As previously described, the Veteran’s service treatment records show no evidence of treatment or diagnosis for a back condition, right shoulder condition, or neck problems. The earliest evidence of these conditions is his June 2014 application for disability compensation, which was twenty-four years after his discharge from service. While not dispositive, the passage of so many years between discharge from active service and the objective documentation of a disability is a factor that weighs against a claim for service connection. Maxson v. Gober, 230 F.3d 1330 (Fed. Cir. 2000). Furthermore, there is no medical evidence indicating a link between the Veteran’s back condition, right shoulder condition, or neck problems and service. The Board has considered the August 2015 statement from Dr. M.J. Although Dr. M.J. provided a statement that seems to indicate that there is a nexus between the Veteran’s military service and his back condition, right shoulder condition, and neck problems, he offered no rationale for that conclusion. A medical opinion which contains only data and conclusions, and is not supported by reasons or rationale, is to be accorded no probative weight. Stefl v. Nicholson, 21 Vet. App. 120, 124 (2007) (a medical examination report must contain not only clear conclusions with supporting data, but also a reasoned medical explanation connecting the two). Therefore, the August 2015 statement from Dr. M.J. that seems to indicate a nexus between the Veteran’s military service and his back condition, right shoulder condition, and neck problems, is afforded no probative weight. A lay person is competent to address etiology in some limited circumstances in which nexus is obvious merely through lay observation, such as a fall leading to a broken leg. Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007). In this case, however, the record dates the onset of symptoms of a back condition, right shoulder condition, or neck problems to many years after separation from active service and the question of causation extends beyond an immediately observable cause-and-effect relationship. As such, the Veteran is not competent to address the etiology of his disability. Based on a review of the foregoing evidence and the applicable laws and regulations, the Board finds that the preponderance of the evidence is against the Veteran’s claims for service connection for a back condition, right shoulder condition, or neck problems. In reaching this conclusion, the Board has considered the applicability of the benefit-of-the-doubt doctrine; however, as the preponderance of the evidence is against the claims, that doctrine is not helpful to this claimant. See 38 U.S.C. § 5107 (b); 38 C.F.R. § 3.102; Gilbert v. Derwinski, 1 Vet. App. 49, 53-56 (1990). Service connection has not been established and the claims for a back condition, right shoulder condition, and neck problems must be denied. KELLI A. KORDICH Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD T. Moore, Associate Counsel