Citation Nr: 18158066 Decision Date: 12/18/18 Archive Date: 12/14/18 DOCKET NO. 17-02 493 DATE: December 18, 2018 ORDER Entitlement to service connection for a low back disability is denied. FINDING OF FACT The Veteran’s current low back disability is not etiologically related to his active duty service. CONCLUSION OF LAW The criteria for entitlement to service connection for a low back disability have not been met. 38 U.S.C. §§ 1112, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty in the U.S. Marine Corps from October 1966 to August 1969. The Veteran maintains entitlement to service connection for a low back disability. He avers that he injured his back at the end of 1966 at the Marine Corps Recruit Depot. He reports that while on the rope obstacle course he slipped and fell approximately forty feet, landing on his tail bone and bending the end of his back. The Veteran states that he was ordered back to the barracks following the accident. He later passed out during formation and was transported to the hospital where he was kept for two days then released. The Veteran affirms that he has continued to experience back pain that radiates down his left leg since that time. Service connection will be granted if it is shown that the Veteran suffers from a disability resulting from personal injury suffered or disease contracted in the line of duty, or for aggravation of a preexisting injury suffered or disease contracted in the line of duty, during active military service. 38 U.S.C. § 1110; 38 C.F.R. § 3.303. Diseases diagnosed after discharge may be service connected if all the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303 (d); see also Combee v. Brown, 34 F.3d 1039, 1043 (Fed. Cir. 1994). Establishing service connection requires evidence of: (1) a current disability; (2) a disease; injury, or event in service; and (3) a causal link (nexus) between the claimed disability and the disease, injury, or event in service and the present disability. See Shedden v. Principi, 381 F.3d 1163 (Fed. Cir. 2004). Competent medical evidence is evidence provided by a person who is qualified through education, training, or experience to offer medical diagnoses, statements, or opinions. Competent medical evidence may include statements conveying sound medical principles found in medical treatises. Competent medical evidence may also include statements contained in authoritative writings, such as medical and scientific articles and research reports or analyses. 38 C.F.R. § 3.159 (a)(1). Competent lay evidence is any evidence not requiring that the proponent have specialized education, training, or experience. For example, lay evidence is competent if it is provided by a person who has knowledge of facts or circumstances and conveys matters that can be observed and described by a lay person. 38 C.F.R. § 3.159 (a)(2). This may include some medical matters, such as describing observable symptoms or relating a contemporaneous medical diagnosis. Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007). VA is responsible for determining whether the evidence supports the claim or is in relative equipoise, with the Veteran prevailing in either event, or whether a preponderance of the evidence is against the claim, in which case the claim is denied. 38 U.S.C. § 5107; Gilbert v. Derwinski, 1 Vet. App. 49 (1990). The Board observes that there is evidence of a current disability. The Veteran has current diagnoses of lumbosacral strain and intervertebral disc syndrome (IVDS). Therefore, the first element of service connection has been met. Second, there is evidence of an in-service event, disease, or injury. The Veteran’s service treatment records (STRs) reveal that he was treated for a lumbar contusion. He was placed on bedrest and given symptomatic therapy. Following treatment, his physical examination was essentially within normal limits. The Veteran was prescribed light duty for 24 hours following his exit from the hospital. No additional complaints, treatments, or diagnoses of a back disability are found in the Veteran’s STRs. Upon separation, the Veteran’s spine and other musculoskeletal areas were assessed as clinically normal. At issue is whether there is a nexus between the Veteran’s current low back disability and the low back injury suffered in service. The medical record indicates that the earliest documented post-service treatment for the Veteran’s claimed low back disability is in 2011, many decades following service. However, the Veteran maintains that he has experienced low back pain consistently since service. While he is competent to report the onset and progression of his symptoms, he is not competent to provide a diagnosis in this case or determine that these symptoms were manifestations of his current lumbosacral strain or intervertebral disc syndrome. The issue is medically complex, as it requires knowledge of the musculoskeletal system and interpretation of complicated diagnostic medical testing. Jandreau v. Nicholson, 492 F.3d 1372, 1377, 1377 n.4 (Fed. Cir. 2007). Further, the Board notes that the Veteran cannot as a matter of law establish the required correlation between his current low back disability and service based on continuity of symptomatology, as neither diagnosis (lumbosacral strain or IVDS) is a considered a chronic disease subject to this form of service connection. 38 C.F.R. §§ 3.303, 3.307, 3.309(a). The record contains conflicting medical opinions regarding whether the Veteran’s low back disability is at least as likely as not related to an in-service injury, event, or disease, including the lumbar contusion he suffered in 1966. Following a review of the claims file, including contemporaneous radiographic testing, and a physical examination of the Veteran, the July 2015 VA examiner opined that it was not. The examiner reasoned that the Veteran’s military treatment records identified isolated treatment for a lumbar contusion in December 1966. No further treatment for a back condition was found in the records and the Veteran’s exit examination did not contain any back complaints. She also observed that the most recent MRI did not reveal any degenerative changes of an old injury. A bulge at L2-L3 was identified and she noted that this was consistent with the Veteran’s increased back pain over the last year. The VA 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). The Veteran’s private practitioner opined that the Veteran’s recurring lumbar spine condition hearkened back to an original injury dating back to 1970. No rationale was provided. This opinion is less probative than the VA examiner’s opinion. There is no indication that the private physician reviewed any of the pertinent medical evidence in the claims file. In fact, the letter has the incorrect date of injury. Instead, the opinion appears to be based solely on the Veteran’s self-reported medical history. The private physician also fails to provide any explanation for his conclusion. Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 304 (2008) (explaining that most of the probative value of a medical opinion comes from its reasoning and that “[n]either a VA medical examination report nor a private medical opinion is entitled to any weight in a service-connection or rating context if it contains only data and conclusions”); Stefl v. Nicholson, 21 Vet. App. 120, 124 (2007) (“[A] medical opinion... must support its conclusion with an analysis that the Board can consider and weigh against contrary opinions”). As the July 2015 VA opinion is shown to have been based on a review of the Veteran’s record, a physical examination, and is accompanied by a sufficient explanation, the Board finds that it is the most probative opinion on whether there is a nexus between the Veteran’s current back disability and the in-service injury. See Nieves-Rodriguez, supra; Stefl, supra. Based on the above, the Board finds that the weight of the evidence is against a finding of service connection. 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 claim, that doctrine is not applicable. 38 C.F.R. § 3.102, Gilbert v. Derwinski, 1 Vet. App. 49, 54-56 (1990). LESLEY A. REIN Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD L. Bush