Citation Nr: 18142431 Decision Date: 10/15/18 Archive Date: 10/15/18 DOCKET NO. 14-44 212 DATE: October 15, 2018 ORDER Entitlement to service connection for a thoracolumbar spine disorder is denied. FINDING OF FACT A thoracolumbar spine disorder is not shown to be causally or etiologically related to any disease, injury, or incident in service and arthritis did not manifest to a compensable degree within one year of service discharge. CONCLUSION OF LAW The criteria for thoracolumbar spine disorder have not been met. 38 U.S.C. §§ 1110, 5107 (2012); 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309 (2017). REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran had active duty service from November 1993 to October 1996. This matter comes to the Board of Veterans’ Appeals (Board) on appeal from a rating decision issued in December 2012 by a Department of Veterans Affairs (VA) Regional Office (RO). In a September 2018 Informal Hearing Presentation, the Veteran’s representative indicated that a claim for service connection for a cervical spine strain was on appeal and provided argument in support of such claim. However, only a claim for service connection for a thoracolumbar spine disorder had been filed and perfected by the Veteran. While this correspondence was not received within one year of any related rating decision, the Board notes that it could be accepted as an informal claim for benefits. The Veteran is advised that effective March 24, 2015, VA requires claims to be submitted on a standard application form prescribed by the Secretary. See 38 C.F.R. §§ 3.1 (p), 3.155, 3.160 (2017). The matter is referred to the agency of original jurisdiction (AOJ) for proper action. See 38 C.F.R. § 3.155 (b) (2017). 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 may also be granted for any disease diagnosed after discharge, when all of the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303(d). Direct service connection may not be granted without evidence of a current disability; in-service incurrence or aggravation of a disease or injury; and a nexus between the claimed in-service disease or injury and the present disease or injury. Id; see also Caluza v. Brown, 7 Vet. App. 498, 506 (1995) aff’d, 78 F.3d 604 (Fed. Cir. 1996). Additionally, for Veterans who have served 90 days or more of active service during a war period or after December 31, 1946, certain chronic disabilities, to include arthritis, are presumed to have been incurred in service if manifest to a compensable degree within one year of discharge from service. 38 U.S.C. §§ 1101, 1112; 38 C.F.R. §§ 3.307, 3.309. Alternatively, service connection may be established under 38 C.F.R. § 3.303(b) by (a) evidence of (i) the existence of a chronic disease in service or during an applicable presumption period under 38 C.F.R. § 3.307 and (ii) present manifestations of the same chronic disease, or (b) when a chronic disease is not present during service, evidence of continuity of symptomatology. However, the use of continuity of symptoms to establish service connection is limited only to those diseases listed at 38 C.F.R. § 3.309(a) and does not apply to other disabilities which might be considered chronic from a medical standpoint. See Walker v. Shinseki, 708 F.3d 1331 (Fed. Cir. 2013). When there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, the Secretary shall give the benefit of the doubt to the claimant. 38 U.S.C. § 5107; 38 C.F.R. § 3.102; see also Gilbert v. Derwinski, 1 Vet. App. 49, 53 (1990). Entitlement to service connection for a thoracolumbar spine disorder. The Veteran contends that his current disability of a thoracolumbar spine strain is a result of his service. Specifically, he states that the disability is as a result of an in-service motor vehicle accident. In the alternative, he asserts that his thoracolumbar spine disorder is the result of lifting heavy equipment during service. The November 2012 VA examination shows a current diagnosis of the Veteran’s thoracolumbar spine strain. The Veteran’s service treatment records (STRs) reveal that, in an April 1993 service entrance examination, a history of low back pain secondary to a muscular strain was noted in his medical records. However, the Veteran’s spine was found to be normal on entrance examination in April 1993. In May 1995, he complained of pain in the right side of his back while lifting a pole and an assessment of right mid-back muscular strain was made. Complaints of lower right back pain while bending over and an assessment of muscle strain with low back spasms were noted in July 1995. He additionally states that in December 1995, he was struck on the neck and the back during an altercation in Mexico. In January 1996, the Veteran was involved in a motor vehicle accident which resulted in treatment for his lower back pain. A January 1996 X-ray revealed a normal lumbar spine. In February 1996 and October 1996, he complained of back pain. An October 1996 service discharge examination found the Veteran’s spine to be normal. In an accompanying Report of Medical History, the Veteran reported that he had or has had recurrent back pain but that this pain was “not present now.” Thus, to establish service connection, there must be probative evidence linking the Veteran’s currently diagnosed thoracolumbar spine strain to his military service, to include his in-service motor vehicle accident injury. However, upon review of the evidence, the Board finds that service connection for such disorder is not warranted. The Board has first considered whether service connection for thoracolumbar spine strain is warranted on a presumptive basis, to include on the basis of a continuity of symptomatology. In this regard, the clinical evidence of record fails to show that the Veteran manifested arthritis to any degree within the one year following his discharge from active duty in October 1996. Moreover, the November 2012 VA examination report indicates that arthritis was not documented on imaging studies of the thoracolumbar spine. While the Board has considered the Veteran’s statements regarding a continuity of back pain since service, the contemporaneous evidence fails to demonstrate that the arthritis manifested within his first post-service year, or that his reports of back pain since service is related to a diagnosis of thoracolumbar spine strain within the first post-service year. As such, presumptive service connection, to include on the basis of continuity of symptomatology, is not warranted for thoracolumbar arthritis. 38 U.S.C. §§ 1101, 1112; 38 C.F.R. §§ 3.307, 3.309; Walker, supra. With regards to direct service connection, the Veteran was afforded a VA examination in November 2012 in connection with his claim. The examiner opined that it is less likely that the Veteran’s thoracolumbar spine strain was connected to his military service. In support thereof, the examiner noted that although the records show the Veteran was seen for low back pain in 1996, there is no objective evidence of a continuity of symptoms or treatment. The examiner explained that the Veteran had acute and transitory symptoms of back pain which were resolved without chronic residuals while in service. He further states that his determination is demonstrated by no objective evidence of a continuity of complaints or symptoms. The examiner also opined that the Veteran’s current low back symptoms cannot be attributed to service when there are multiple other aging/occupational/daily activity factors in the intervening years. Therefore, the Board accords great probative weight to the November 2012 opinion regarding whether the Veteran had a thoracolumbar spine strain directly related to his military service, as it is predicated on a thorough review of the record. Such opinion clearly reflects consideration of the Veteran’s STRs and his statements, and provided a complete rationale supported by the evidence of record. Furthermore, the opinion offers clear conclusions with reasoned medical explanations connecting the two. See Nieves-Rodriguez v. Peake, 22 Vet. App. 295 (2008); Stefl v. Nicholson, 21 Vet. App. 120, 124 (2007). Thus, the Board accords great probative weight to the November 2012 opinion. Notably, there are no contrary medical opinions. In the instant case, the Board finds that the question regarding the potential relationship between the Veteran’s thoracolumbar spine strain and any instance of his service to be complex in nature. Woehlaert v. Nicholson, 21 Vet. App. 456 (2007). Specifically, while the Veteran is competent to describe his current thoracolumbar spine symptoms and his representative is competent to describe his observations of the Veteran’s symptoms, the Board accords their statements regarding the etiology of such a disorder little probative value as they are not competent to opine on such a complex medical question. Specifically, where the determinative issue is one of medical causation, only those with specialized medical knowledge, training, or experience are competent to provide evidence on the issue. See Jones v. Brown, 7 Vet. App. 134, 137 (1994). In this regard, the question of causation involves a medical subject concerning an internal physical process extending beyond an immediately observable cause-and-effect relationship, and requires the administration and interpretation of diagnostic testing. In the instant case, there is no suggestion that the Veteran and/or his representative have had any medical training. As such, the question of etiology in this case may not be competently addressed by lay evidence, and the opinions of the Veteran, and/or his representative are nonprobative evidence. In reaching this decision, the Board has considered the applicability of the benefit of the doubt doctrine. However, the preponderance of the evidence is against the Veteran’s claim of entitlement to service connection for thoracolumbar spine disorder. As such, that doctrine is not applicable in the instant appeal, and his claim must be denied. 38 U.S.C. § 5107; 38 C.F.R. § 3.102; Gilbert, supra. KRISTY L. ZADORA Acting Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD O. Owolabi, Law Clerk