Citation Nr: 18161122 Decision Date: 12/28/18 Archive Date: 12/28/18 DOCKET NO. 17-01 793 DATE: December 28, 2018 ORDER Entitlement to service connection for a low back disability is granted. REMANDED Entitlement to service connection for a left hip disability is remanded. FINDING OF FACT The Veteran’s current low back disability resulted from an injury sustained during inactive duty training. CONCLUSION OF LAW The criteria for entitlement to service connection for a low back disability have been met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.304. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served in the United States Marine Corps Reserves October 2009 through April 2014. The current matter comes before the Board of Veterans’ Appeals (Board) on appeal of a September 2015 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO) in St. Paul, Minnesota. Entitlement to service connection for a low back disability Generally, to provide service connection, a Veteran must show: (1) a present disability; (2) an 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). The requirement that a current disability exist is satisfied if the claimant had a disability at the time his claim for VA disability compensation was filed or during the pendency of the claim. McClain v. Nicholson, 21 Vet. App. 319, 321 (2007). Service connection means that the facts, shown by evidence, establish that a particular injury or disease resulting in disability was incurred coincident with service, or if preexisting such service, was aggravated by service. This may be accomplished by affirmatively showing inception or aggravation during service. 38 C.F.R. § 3.303(a). For the showing of chronic disease in service there is required a combination of manifestations sufficient to identify the disease entity and sufficient observation to establish chronicity at the time, as distinguished from merely isolated findings or a diagnosis including the word “chronic.” Continuity of symptoms after discharge is required where the condition noted during service is not, in fact, shown to be chronic or where the diagnosis of chronicity may be legitimately questioned. 38 C.F.R. § 3.303(b); Walker v. Shinseki, 708 F.3d 1331 (Fed. Cir. 2013). Service connection may also be granted for disability shown after service, when all of the evidence, including that pertinent to service, shows that it was incurred in service. 38 C.F.R. § 3.303(d). “Active military service” is defined by VA law and regulations. Active military, naval, or air service includes active duty, any period of active duty training (ACDUTRA) during which the individual concerned was disabled from a disease or injury incurred in the line of duty. 38 U.S.C.A. § 101(21), (24); 38 C.F.R. § 3.6(a). Active military, naval, or air service also includes any period of inactive duty training (INACDUTRA) during which the individual concerned was disabled from an injury incurred in the line of duty. Accordingly, service connection may be granted for disability resulting from disease or injury incurred in, or aggravated, while performing ACDUTRA or from injury incurred or aggravated while performing INACDUTRA. For a member of a Reserve component, ACDUTRA means full-time duty performed by Reserves for training purposes. INACDUTRA means duty (other than full-time) prescribed for Reserves under section 206 of title 37 of the United States Code or any other provision of law. In the case of a member of the National Guard, ACDUTRA means full-time duty for training purposes or field exercises under section 316, 502, 503, 504, or 505 of title 32 of the United States Code. 38 U.S.C.A. § 101 (22). INACDUTRA means duty (other than full-time) duty performed by a member of the National Guard under section 316, 502, 503, 504, or 505 of title 32 of the United States Code. 38 U.S.C.A. § 101 (23). The Veteran contends that his back disability was incurred while performing INACDUTRA. In this regard, the Board notes that the Veteran has been diagnosed as having mild spondylosis, disc degeneration, facet arthropathy and lumbar stenosis. Thus, Shedden element (1) has been met. In addition, there is sufficient evidence to meet Shedden element (2), in-service incurrence. The Veteran stated that he injured his back after moving heavy radio equipment and replacing a truck tire without adequate tools or equipment during a training mission. After the Veteran experienced “unbearable” pain, he was ordered to report for medical treatment. The Veteran further states that since his back injury he has sought treatment which included chiropractic care, magnetic resonance imagining (MRI), and back injections. In addition, according to statements from R.S. and C.A. (servicemembers who both served with the Veteran in the Marine Corps Reserves), they witnessed the Veteran move radio equipment, replace a tire in 2013 while on a training mission, and then receive medical treatment for his back injury. As to Shedden element (3), in a September 2013 statement, Dr. E.E., M.D. opines that the Veteran’s lumbar spondylosis, disc degeneration, facet arthropathy, and lumbar stenosis are advanced for his age. Dr. E.E. explained that the Veteran’s military occupational specialty as a firefighter could have significantly exacerbated his low back disability and could have resulted in chronic low back and leg pain. There is no negative opinion contradicting Dr. E.E.’s opinion. In summary, the Board finds there is competent and probative evidence showing that the Veteran’s low back disability is the result of an injury sustained during his inactive duty. Resolving all reasonable doubt in the Veteran’s favor, the Board concludes that service connection for a low back disability is warranted. REASONS FOR REMAND Entitlement to service connection for a left hip disability is remanded. The Veteran seeks service connection for left hip arthritis. Currently, the record is silent for an opinion as to the origin of his reported condition or diagnostic testing specific to his left hip. Obtaining an opinion is particularly crucial in this case as service treatment records reflect that the Veteran reported left hip problems in May 2013 during a routine military periodic health assessment. In light of the lay statements indicating that the Veteran sustained an injury during a training mission and that this injury manifested low back, hip, and groin pain, this portion of the appeal must be remanded to obtain a VA examination to determine the nature, extent, and etiology of his left hip problems. McLendon v. Nicholson, 20 Vet. App. 79 (2006). The matter is REMANDED for the following action: Schedule the Veteran for a VA examination, by an appropriate medical specialist, to evaluate the nature, extent, and etiology of any left hip disability that he may have. After review of the file, interview with and examination of the Veteran, as well as appropriate testing, the examiner should opine as to: (a.) whether the Veteran presently has, or has had at any time during the appeal period, a left hip disability, to include arthritis of this joint. (b.) If a left hip disability, to include arthritis, is diagnosed, the examiner should opine as to whether it is at least as likely as not (50 percent probability or greater) that such disability was etiologically related to an injury sustained in service. THERESA M. CATINO Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD M. Mahmoudi, Associate Counsel