Citation Nr: 18157761
Decision Date: 12/14/18	Archive Date: 12/13/18

DOCKET NO. 13-28 799
DATE:	December 14, 2018
ORDER
Entitlement to service connection for a neck disability is granted.
Entitlement to service connection for a back disability is granted
FINDINGS OF FACT
1. A neck disability is attributable to service.
2. A back disability is attributable to service.
CONCLUSIONS OF LAW
1. The criteria for service connection for a neck disability have been met.  38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.303, 3.307, 3.309.
2. The criteria for service connection for a back disability been met.  38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.303, 3.307, 3.309.
REASONS AND BASES FOR FINDINGS AND CONCLUSIONS
The Veteran served on active duty from March 1995 to March 1998.  These matters were previously remanded by the Board of Veterans’ Appeals in November 2017 for additional development.  
1. Entitlement to service connection for a neck disability
2. Entitlement to service connection for a back disability
In order to prevail on the issue of direct service connection, there must be competent and credible evidence of (1) a current disability, (2) in-service occurrence or aggravation of a disease or injury; and (3) a nexus between an in-service injury or disease and the current disability.  See generally Davidson v. Shinseki, 581 F.3d 1313 (Fed. Cir. 2009). 
As discussed in the prior remand, this appeal includes questions of the completeness of the record (to include submissions from the Veteran) and the role of post-service injuries in the development of neck and back disabilities.  After a review of the record, to include carefully considering reasonable doubt, the Board grants these claims.  
Regarding current disabilities, the Board notes that in a March 2018 VA examination report an examiner diagnosed degenerative disc disease of the cervical spine, but found that there was not a current disability of the back.  Other evidence of record includes VA treatment records that document back pain, leading to the question of whether this back pain causes functional impairment.  A private medical document, Dr. FLB, has submitted letters, however, that the Veteran is diagnosed with degenerative disc disease of the lumbar spine.  The prior Board remand noted the current diagnosis of a back disability. Considering this conflicting evidence, resolving reasonable doubt, the Board finds that there is a current back disability.  Therefore, element (1) is met for both disabilities.
As to element (2), the record clearly documents relevant in-service treatment, and therefore, this element is met.  
The main question on appeal, as noted, involves whether other events post-service (namely, a post-service motor vehicle accident), led to the current disabilities. These are questions of nexus, element (3).
Here, in the prior Board remand, the Board indicated that an opinion by Dr. FLB could not be relied upon due to factual inaccuracies.  Post remand, VA obtained an opinion that found that there was no back disability and that the neck disability was unrelated to service.  In September 2018, the agent-representative submitted an additional opinion from Dr. FJB.  In this letter, the medical doctor clarifies points made in his prior opinion (this clarifications, in the judgment of the Board, resolve the issues with the first opinion), confirms diagnoses of both disabilities, and after review of the relevant evidence, finds that these two disabilities had onset in service.  
 
The Board had carefully considered the positive and negative nexus opinion evidence.  Considering the facts used and rationales, these opinions are essentially of equal probative value, each having flaws but also containing logical rationale.  On this basis, the Board finds that this nexus opinion evidence is in relative equipoise and grants the benefits sought.  
 
Nathaniel J. Doan
Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD	Yonelle Moore Lee, Associate Counsel