Citation Nr: 18130232 Decision Date: 08/29/18 Archive Date: 08/28/18 DOCKET NO. 16-03 097 DATE: August 29, 2018 ORDER Service connection for low back pain, currently diagnosed as narrowing at L5-S1, is granted. FINDING OF FACT It is at least as likely as not that the Veteran’s low back pain, currently diagnosed as narrowing at L5-S1, began during service and has been ongoing ever since. CONCLUSION OF LAW The criteria for service connection for low back pain, currently diagnosed as narrowing at L5-S1, have been met. 38 U.S.C. §§ 1110, 1112, 1113 (2012); 38 C.F.R. §§ 3.303, 3.307, 3.309 (2018). REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from May 2006 to December 2013. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a July 2015 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO). Service connection for low back pain, currently diagnosed as narrowing at L5-S1 Service connection may be granted on a direct basis as a result of disease or injury incurred in service based on nexus using a three-element test: (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 in or aggravated by service. 38 C.F.R. §§ 3.303(a), (d); Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009). Service connection may be granted on a presumptive basis for diseases listed in § 3.309 under the following circumstances: (1) where a chronic disease or injury is shown in service and subsequent manifestations of the same disease or injury are shown at a later date unless clearly attributable to an intercurrent cause; or (2) where there is continuity of symptomatology since service; or (3) by showing that the disorder manifested itself to a degree of 10 percent or more within one year from the date of separation from service. 38 C.F.R. § 3.307. The Veteran essentially claims that service connection for low back pain is warranted because it began during service and has been present ever since. At a June 2015 VA examination, the Veteran reported low back pain beginning in service in 2008-2009 after ambulating or standing for long periods of time or moving heavy objects. He denied in-service injury. The examination report notes mild decreased range of motion on examination and no current diagnosis, but X-rays studies revealed narrowing L5-S1 without evidence of arthritis. As such, and consistent with the decision by the United States Court of Appeals of the Federal Circuit in Saunders v. Wilkie, No. 2017-1466 (Fed. Cir. Apr. 3, 2018), the Board notes that pain alone can constitute disability. Therefore, the requirement of a current disability has been met. The service treatment records do not contain any entries noting low back injury. However, the October 2013 service separation examination report of medical history reflects that the Veteran reported recurrent back pain/problems. It was noted that for several years he had low back stiffness with prolonged standing or walking. It was also noted that he had mild pain for three weeks which resolved on its own. The examiner noted low back pain, no injury, no radiation. The November 2013 separation examination report reflects mild, intermittent low back pain. No X-rays were taken. The June 2015 VA examination report notes that per the Veteran’s report, he first developed low back pain in the military, but he denied any injury. The examiner stated that the Veteran has musculoskeletal lower back pain which may or may not be related to his military service. A June 2015 VA opinion report indicates that the claimed low back condition was less likely as not incurred in or caused by the claimed in-service event, injury, or illness. The examiner reasoned that the Veteran denied any lower back injury in service and no service treatment records note a low back injury. He reported occasional lower back pain and stiffness during the separation physical examination. He underwent a Compensation and Pension General Medical Screening examination in July 2014 but he did not mention any lower back pain at that time. His X-rays showed narrowing of L5-S1 with no arthritis, but he may or may not develop arthritis in the future. Lastly, the examiner noted that he has a family history of undiagnosed lower back pain. After reviewing the evidence of record, the Board finds that it is at least as likely as not that the Veteran’s low back pain, currently diagnosed as narrowing of L5-S1, began during service and has continued ever since. In this regard, the service treatment records reflect that the Veteran reported mild, ongoing low back pain at service separation. The post-service medical evidence shows that he has current low back pain/narrowing of L5-S1 and it may or may not be related to service. While the Veteran did not report any back problems on other VA examinations in May 2014 and July 2014, the Veteran has competently and credibly indicated that his back pain is minor and he did not report it on these examinations for that reason. He even indicated that he did not file a claim for service connection for a back disorder for that reason. Additionally, the Board notes that these examinations (May 2014 and July 2014 VA examinations) were conducted specifically for claims of entitlement to service connection for other disabilities (hernia, eyes, headaches, allergic rhinitis), not a back disability. Further, the June 2015 medical opinion against the claim does not address the Veteran’s ongoing low back pain since service, his report that the pain is only mild, or the fact that the July 2014 Compensation and Pension screening examination cited to for lack of back complaints was specifically for other claims. Importantly, the lay evidence is credible and consistently reports that the Veteran’s low back pain began during service and has been ongoing ever since. The lay contentions are generally supported by the medical evidence of record. Accordingly, the Board finds that the evidence is at least in equipoise with respect to the Veteran’s claim of entitlement to service connection for low back pain, currently diagnosed as narrowing of L5-S1. As such, the Board resolves any reasonable doubt in favor of the Veteran, and service connection for low back pain, currently diagnosed as narrowing of L5-S1, is granted. 38 U.S.C. § 5107 (b); 38 C.F.R. § 3.102; see also Gilbert v. Derwinski, 1 Vet. App. 49 (1990). K. A. KENNERLY Acting Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD E. Redman, Counsel