Citation Nr: 18147554 Decision Date: 11/06/18 Archive Date: 11/05/18 DOCKET NO. 17-58 320 DATE: November 6, 2018 ORDER Entitlement to service connection for a low back disability is denied. FINDING OF FACT The evidence is insufficient to show that the Veteran’s low back disability had its onset in service, arthritis manifested to a compensable degree within one year of separation, or a low back disability is otherwise related to service. CONCLUSION OF LAW The criteria for entitlement to service connection for a low back disability have not been met. 38 U.S.C. §§ 1131, 5107(b); 38 C.F.R. §§ 3.102, 3.303(a), (c), 3.307, 3.309. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran had active duty from July 1978 to June 1979. 1. Entitlement to service connection for a low back disability The Veteran claims entitlement to service connection for a low back disability. Specifically, the Veteran reported that while serving as an auto mechanic, he tried to lift a large wheel and felt something tear in his lower back. He reported that the pain has continued since service. See September 2016 Correspondence. Service connection may be granted for a disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. § 1131; 38 C.F.R. § 3.303. To establish service connection for a disability, the evidence must show: (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 (Fed. Cir. 2004). 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). For certain chronic disorders, such as arthritis, service connection may be granted if the disease becomes manifest to a compensable degree within one year following separation from service. See 38 U.S.C. §§ 1101, 1112, 1113, 1131, 1137; 38 C.F.R. §§ 3.307, 3.309. When a disease listed at 38 C.F.R. § 3.309(a) is not shown to be chronic during service or the one-year presumptive period, service connection may also be established by showing continuity of symptomatology after service. See 38 C.F.R. § 3.303(b). 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). The Veteran shows current lumbar spine diagnoses of lumbar strain and degenerative disc disease. See VA Treatment Records; September 2017 VA Examination Report. The issue that remains disputed is whether the Veteran’s current lumbar spine disability had its onset in service, manifested to a compensable degree within one year of separation, or is otherwise related to service. To this end, the preponderance of the evidence is against the claim. An April 1979 service treatment note indicates the Veteran complained of skin irritation on his back. He was diagnosed with and treated for skin dermatitis. The Veteran’s service treatment records are otherwise silent for complaints of or treatment for a low back disability, and this entry is focused on the skin and not the mechanics of the back. During the Veteran’s May 1979 separation examination, he denied recurrent back pain. A clinical evaluation also showed a normal spine, and the Veteran specifically reported that there had been no significant changes in his health between the examination and his separation. A January 2015 VA treatment note indicates the Veteran reported that his low back pain began gradually more than 10 years ago. During a September 2017 VA examination, the Veteran reported that his lumbar condition had its onset in 1979 and has worsened ever since. The examiner opined that it was less like than not that the Veteran’s lumbar spine condition was incurred in or caused by service. The examiner reasoned that based on the Veteran’s service treatment records, there is insufficient evidence of treatment for lower back pain, injury or other related condition. The examiner further noted that the Veteran’s military occupational specialty of a mechanic is an occupation with increased risk for lumbar strain; however, no complaints or treatment are documented during active duty or discharge to support a nexus between his current disability and service. The Board finds the September 2017 VA examination and opinion probative to the question at hand. The examiner considered an accurate history, to include the Veteran’s contentions regarding the onset of his symptoms. The opinion was definitive and supported by a rationale that considered the lay and medical evidence. Nieves-Rodriguez v. Peake, 22 Vet. App. 295 (2008). Significantly, the Veteran has not presented or identified any contrary medical opinion that supports the claim for service connection. VA adjudicators are not free to ignore or disregard the medical conclusions of a VA physician, and are not permitted to substitute their own judgment on a medical matter. Colvin v. Derwinski, 1 Vet. App. 171 (1991); Willis v. Derwinski, 1 Vet. App. 66 (1991). The Board finds that the most persuasive evidence of record shows that the current lumbar spine disability did not have its onset in service and is not related to service. The Veteran is competent to testify to facts or circumstances that can be observed and described by a lay person. 38 C.F.R. § 3.159(a)(2); Kahana v. Shinseki, 24 Vet. App. 428, 438 (2011). It is also well established that lay persons without medical training, such as the Veteran, are not competent to provide medical opinions on matters requiring medical expertise. See Jandreau v. Nicholson, 492 F.3d 1372, 1376-77 (Fed. Cir. 2007) (noting general competence to testify as to symptoms but not to provide medical diagnosis). Whether the Veteran’s current lumbar spine disability is related to service requires medical expertise to determine. The Board has also considered whether the service connection is warranted on a presumptive basis. However, the evidence does not show that the Veteran’s degenerative disc disease of the lumbar spine manifested to a compensable degree within one year of separation. See 38 C.F.R. §§ 3.307, 3.309. (Continued on the next page)   Therefore, the Board finds that the most probative evidence of record shows that the Veteran’s lumbar spine condition is not related to service. Accordingly, entitlement to service connection is not warranted. 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 Veteran’s claim, that doctrine is not applicable. See 38 U.S.C. § 5107(b); Ortiz v. Principi, 274 F.3d 1361, 1364 (Fed. Cir. 2001); Gilbert v. Derwinski, 1 Vet. App. 49, 55-57 (1990). R. FEINBERG Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD J.A. Williams, Associate Counsel