Citation Nr: 18145045 Decision Date: 10/26/18 Archive Date: 10/25/18 DOCKET NO. 14-25 902 DATE: October 26, 2018 ORDER Service connection for lumbar spine disability (“low back disability”) is granted. FINDING OF FACT The evidence is a least in equipoise as to whether the Veteran has had a continuity of symptomology of low back pain since service. CONCLUSION OF LAW The criteria for entitlement to service connection for lumbar spine disability are met. 38 U.S.C. §§ 1110, 1112, 1113, 5107(b); 38 C.F.R. §§ 3.102, 3.303(b), 3.307, 3.309(a). REASONS AND BASES FOR FINDING AND CONCLUSION The Board remanded the matter in June 2016 for additional development. The Board finds that the remand directives have been substantially complied with and therefore will adjudicate the matter. Stegall v. West, 11 Vet. App. 268 (1998). There is competent and credible medical evidence of record showing a current diagnosis of degenerative lumbar disc disease/arthritis. As there is a current diagnosis of a low back disability, the remaining question before the Board is whether there is an in-service disease or injury to which such disability is etiologically related. Arthritis is considered a chronic disease. See 38 C.F.R. § 3.309(a). Although degenerative changes are not, the United States Court of Appeals for Veterans Claims (Court) has long recognized that degenerative joint disease and degenerative changes denote the presence of arthritis. See Giglio v. Derwinski, 2 Vet. App. 560, 561 (1992) (“Degenerative joint disease, or osteoarthritis is defined as ‘arthritis of middle age characterized by degenerative and sometimes hypertrophic changes in the bone and cartilage of one or more joints and a progressive wearing down of apposing joint surfaces with consequent distortion of joint position usually without bony stiffening’”). Thus, service connection may be based on credible evidence of continuity of symptomatology alone under 38 C.F.R. § 3.303(b). Walker v. Shinseki, 708 F.3d 1331 (Fed. Cir. 2013). The Veteran contends that service connection is warranted for his low back disability. The record indicates that there are service treatment records showing complaints of and treatment for low back pain, to include a diagnosis in-service related to low back pain. A September 2012 VA examiner noted a 1990 diagnosis of lumbar spine strain. Imaging studies were performed of the thoracolumbar spine and arthritis was documented. The examiner concluded that the Veteran’s low back disability impacted his ability to work. She also opined that it was not related to service, rationalizing that there was no documentation of chronicity in service or post-military service. February 2016 and May 2016 VA medical treatment records indicate that the onset of the low back pain occurred earlier that year. VA medical treatment records indicate ongoing treatment for low back pain from 2009 to 2017. During the June 2016 Board remand, it was noted that service treatment records indicate the Veteran was seen on three occasions for complaints of low back pain and that he was found to have a sprain in July 1978. A February 2017 VA medical record notes the diagnosis as chronic low back pain. An April 2017 VA examination reflects that imaging studies of the thoracolumbar spine had been performed and did not document arthritis. However, the initial diagnosis noted in the report is “degenerative lumbar disc disease/arthritis” with the date of diagnosis stated as 1976. This examiner also opined that the Veteran’s low back disability was not related to service and based his opinion on the same rationale as the September 2012 examiner—lack of documentation of treatment for low back pain. The examiner noted there were three entries in the service treatment records where the Veteran was evaluated for low back pain (April 1975, April 1976, and July 1978). A July 2017 VA medical record indicates a diagnosis of lumbar degenerative disc disease. The Board notes that the Veteran is competent to provide lay evidence of his symptomatology, to the extent his symptoms are directly observable by him and do not require specialized medical or other training to describe. 38 C.F.R. § 3.159(a)(2); see Layno v. Brown, 6 Vet. App. 465, 467-69 (1994). The Board finds the Veteran a credible report of the onset of his low back disability symptoms and accords considerable weight to the statements he provided. Jandreau v. Nicholson, 451 F.3d 1331 (Fed. Cir. 2006). On review of the evidence of record, the Board finds that a low back disability is shown to be caused by in-service events. In other words, service connection for low back disability is warranted. The Board notes that there are two VA medical opinions of record, that both conclude the Veteran’s low back disability was not related to service. The examiners’ conclusions are based on the lack of documentation of treatment for low back pain in service after 1978. This is the entire basis, as the examiners stated it was conclusive proof that the Veteran’s low back disability was not chronic and did not continue after service. Given, the rationales provided, the Board does not find these opinions to be probative. As stated above, there are service treatment records that document complaints of and treatment for low back pain. Further, VA and private treatment records show that he continued to complain of and seek treatment for the same symptoms during the applicable presumptive period, and for years after. Looking at the record as a whole, the Board finds that there is sufficient, competent evidence to show the long-standing nature of his disability symptoms, presenting a continuity of symptomatology. Given that this disability is a form of arthritis, this continuity of symptomatology serves as the necessary nexus between the Veteran’s current low back disability and his active duty service. Service connection is accordingly granted. H.M. WALKER Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD T. Talamantes, Associate Counsel