Citation Nr: 18156968 Decision Date: 12/11/18 Archive Date: 12/11/18 DOCKET NO. 16-63 378 DATE: December 11, 2018 ORDER Entitlement to service connection for lumbar spine disability is denied. REMANDED Entitlement to service connection for chronic headaches as secondary to service connected post-operative residuals bilateral retinal detachments with lattice degeneration (eye condition) is remanded FINDING OF FACT The preponderance of the evidence is against finding that the Veteran’s lumbar spine disability began during active service, or is otherwise related to an in-service injury or disease. CONCLUSION OF LAW The criteria for service connection for a lumbar spine disability have not been met. 38 U.S.C. §§ 1110, 5107 (West 2012); 38 C.F.R. §§ 3.102, 3.303, 3.310 (2018). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS Service Connection Service connection may be granted if the evidence demonstrates that a current disability resulted from an injury or disease incurred or aggravated in active military service. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303(a). In general, service connection requires competent and credible evidence of (1) a current disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a nexus between the claimed in-service disease or injury and the current disability. See Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004). Entitlement to service connection for a chronic back condition The Veteran contends that his chronic back condition is a result of his active service. Specifically, he indicates that it is the result of jumping from helicopters. The Veteran was a petroleum supply specialist in an Army Aviation Battalion. The Veteran served on active duty from October 1989 to October 1992. Service treatment records (STRs) indicate 2 occasions in 1990 of complaints and subsequent treatment for back pain. Notably, the remainder of his STRs are silent for any further complaints of back pain. The first post service documentation of a low back complaint is in 2014 VA treatment record indicating low back pain for the previous 2-3 months. September 2014 private medical treatment records from Carolina Neurosurgery and Spine indicate complaints of neck and back pain and subsequent impression of spondylosis with non-surgical management. In May 2015, the Veteran attended a VA Back Conditions Disability Benefits Questionnaire (DBQ) examination. The examiner diagnosed lumbosacral strain, DDD of the lumbosacral spine. The Veteran provided a history that included the following: He states that he first injured his low back while at Fort Hood, when he slipped off the back of a truck. He states he was seen at the ER and that x-rays were negative. He was put on light duty for five days. In 1992 he fell down some steps and injured his right hand, but also noted low back pain. He later noted that he developed worsening low back pain while jogging. Veteran states that he was involved in an MVA during service, but that his back was not injured. Veteran states that over the years his low back pain has worsened. He cannot lie flat on his back without a pillow padding the small of his back. He notes that when he rises from a seated or standing position, he has to brace/stabilize his low back with his hands as his legs feel weak. Pain is localized to the mid aspect of his low back. He notes a constant tightness. Adverse medical opinions were generated following this examination and in June 2017, following a review of the record. It was noted in 2015 that the presentation did not reflect a continuity of complaints as one would anticipate for a disability to be related to service and the absence of documentation of complaints for many years post service likewise supported the adverse conclusion. The opinion in 2017 noted research does not support that being a parachutist will lead to arthritis of the spine, and observed no chronic care for his spine after discharge, and that the Veteran’s arthritis is more consistent with age and does not support any trauma, as people with spine injuries from jumps will progress with pain and arthritis after 20 plus years is normally severe. Based on the foregoing evidence of record, the Board finds that service connection for the Veteran’s lumbar spine disability is not warranted. Indeed, the earliest diagnosis of lumbar spine disability occurs many years after the Veteran’s active service. In addition, the Board finds that the adverse medical opinions to be the most probative on the question before the Board, as it reflects review of all the Veteran’s medical records, and offers reasoned explanation for the conclusion expressed. The Board has considered the Veteran’s lay assertions as to the etiology of his condition. Although the Veteran is competent to attest to his experiences, he is not competent in these circumstances to opine as to the etiology of claimed disability. The Veteran has not been shown to have specialized medical knowledge that would be necessary to provide a competent opinion regarding service connection. The Board finds the VA medical opinions to be more probative in this regard. The examiners considered the Veteran’s statements, and ultimately concluded that from a medical perspective; it is less likely that his current disability is related to service. REASONS FOR REMAND Entitlement to service connection for chronic headaches as secondary to service connected eye condition is remanded. Regarding the chronic headache claim, the Veteran was afforded a VA examination in August 2015, however, the accompanying opinion was limited to a discussion of causation, and did not address whether the Veteran’s claimed disability was aggravated by his service-connected eye condition. An additional opinion should be obtained. The matter is REMANDED for the following action: 1. Ask the Veteran to identify any additional relevant records of treatment he wishes to be considered in connection with this claim. The identified records should be sought. 2. After obtaining all available records, obtain an addendum medical opinion from a qualified person addressing whether the Veteran’s headache disability is at least as likely as not aggravated beyond its natural progression by the Veteran’s service-connected eye condition? The Veteran need not be physically re-examined unless an examination is deemed necessary. The examiner is asked to provide a medical rationale or explanation for the opinion given. MICHAEL E. KILCOYNE Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD R.A. Elliott II, Associate Counsel