Citation Nr: 18156316 Decision Date: 12/07/18 Archive Date: 12/07/18 DOCKET NO. 16-50 794 DATE: December 7, 2018 ORDER Entitlement to service connection for a low back disorder is denied. FINDING OF FACT The Veteran’s low back disorder was not shown during active duty, was not diagnosed for many years post-service, and there is no medical nexus between the Veteran’s service and her current low back disorder. CONCLUSION OF LAW The criteria for service connection for a low back disorder have not been met. 38 U.S.C. §§ 1110, 5107(b); 38 C.F.R. §§ 3.102, 3.303, 3.309. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served honorably in the United States Army from January 1989 until April 1991. This case comes before the Board of Veterans’ Appeals (the Board) from a March 2015 rating decision by the Department of Veteran’s Affairs (VA) regional office (RO). 1. Entitlement to service connection for a low back disorder To establish a right to compensation for a present disability, a Veteran 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—the so-called “nexus” requirement. Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004). An alternative method of establishing the second and third Shedden elements for disabilities identified as chronic diseases in 38 C.F.R. § 3.309(a) is through a demonstration of continuity of symptomatology. 38 C.F.R. § 3.303(b); Walker v. Shinseki, 708 F.3d 1331 (Fed. Cir. 2013). The Board has closely reviewed the medical and lay evidence in the Veteran’s claims file and finds no evidence that may serve as a medical nexus between the Veteran’s service and her claimed low back disorder. As an initial matter, the Board notes that the Veteran was diagnosed with lumbar strain in March 2015. Thus, the first Shedden element is met. Service treatment records (STRs) are associated with the Veteran’s case file. These records reflect that the Veteran was seen on several occasions during service for complaints of back pain. She was seen in May 1989 for low back pain, which was diagnosed as muscle strain and chronic low back pain; however, x-rays of the spine were normal. She was seen in July 1989 for complaints of nonspecific low back pain for one year; no diagnosis was assigned at that time. She was again seen in November 1989 for complaints of upper back pain and was diagnosed with muscle strain in July 1990 following complaints of upper back pain. However, at her February 1991 separation report of medical examination, the Veteran was found to have a normal spine and musculoskeletal system; on her separation report of medical history, she denied using a back brace or support and denied experiencing recurrent back pain. Because the Veteran was seen for complaints of back pain in service, the second Shedden element is met. What is left to consider is whether the Veteran’s current low back disorder is associated with her service. Post-service treatment records reflect that no back pain was reported until January 2011. A VA examination at that time notes a report by the Veteran that she had been experiencing low back pain off and on for the “past three years,” dating back to late 2007. A formal diagnosis of chronic low back pain is noted a few months later in an April 2011 VA examination. A further diagnosis of lumbar strain was reflected in a March 2015 Disability Benefits Questionnaire (DBQ). The Veteran contends that her back pain is due to excessive stress from performing her duties as a record and parts specialist, which included physical training, lifting boxes weighing from 25 to 100 pounds, and being responsible for 5-ton truck parts and plane engines. The Board finds that the Veteran is competent to report as to her specific duties, and that her account is consistent with the circumstances of her service and MOS. Charles v. Principi, 16 Vet. App. 370 (2002). The Board nonetheless concludes that, while the Veteran has a current diagnosis of lumbar strain, and evidence shows that she was treated for low back pain on several occasions in service, the preponderance of the evidence weighs against finding that the Veteran’s diagnosis of lumbar strain began during service or is 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). With respect to a nexus between the Veteran’s lumbar strain and her service, the Board notes that the March 2015 Compensation and Pension (C&P) examiner recorded that the Veteran reported the onset of symptoms as 1989. Nonetheless, the examiner reviewed the entire claims file and opined that it was less likely than not that her current back issues were related to her service. The examiner explains that the remote strains she would have incurred in service would have resolved years ago. However, she did not experience any back issues until a decade after leaving service. The examiner continues by noting that her pain has instead become worse and more frequent as she has aged, has become increasingly physically de-conditioned, and gained significant weight. The examiner concluded that these are the likely causes of her current condition. The examiner’s opinion is probative, because it is based on an accurate medical history and provides an explanation that contains clear conclusions and supporting data. Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 304 (2008). While the Veteran is competent to report having experienced symptoms of back pain, she is not competent to provide a diagnosis in this case or determine the etiology of her symptoms. Jandreau v. Nicholson, 492 F.3d 1372, 1377, 1377 n.4 (Fed. Cir. 2007). Consequently, the Board gives more probative weight to the March 2015 C&P examiner, whose opinion is not contradicted by any competent evidence of record. In light of the above discussion, the Board concludes that the preponderance of the evidence is against the claim for service connection. 38 U.S.C. § 5107(b); 38 C.F.R § 3.102. There is no medical nexus or link between the Veteran’s service and her current low back disorder. As such, the appeal is denied. CAROLINE B. FLEMING Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD A. Stuedemann, Associate Counsel