Citation Nr: 18138158 Decision Date: 09/26/18 Archive Date: 09/25/18 DOCKET NO. 16-21 438 DATE: September 26, 2018 ORDER The claim of entitlement to service connection for a cervical spine disability, claimed as neck strain, is denied. FINDING OF FACT The Veteran’s cervical spine disability did not manifest during service and is not causally related to service. CONCLUSION OF LAW The criteria for establishing entitlement to service connection for a cervical spine disability have not been met. 38 U.S.C. §§ 1110, 1131, 5107 (West 2014); 38 C.F.R. §§ 3.102, 3.303 (2018). REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran had active duty service from March 1996 to August 2005 in the United States Air Force. Entitlement to service connection for a cervical spine disability, claimed as neck strain. Service connection may be established for a disability resulting from disease or injury incurred in or aggravated by service. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303. Evidence of continuity of symptomatology from the time of service until the present is required where the chronicity of a chronic condition manifested during service either has not been established or might reasonably be questioned. 38 C.F.R. § 3.303(b); see also Walker v. Shinseki, 708 F.3d 1331, 1340 (Fed.Cir.2013) (holding that only conditions listed as chronic diseases in 38 C.F.R. § 3.309(a) may be considered for service connection under 38 C.F.R. § 3.303(b)). Regulations also provide that service connection may be granted for any disease diagnosed after discharge, when all the evidence, including that pertinent to service, establishes that the disability was incurred in service. 38 C.F.R. § 3.303(d). Generally, in order to prove service connection, there must be competent, credible evidence of (1) a current disability, (2) in-service incurrence or aggravation of an injury or disease, and (3) a nexus, or link, between the current disability and the in-service disease or injury. See, e.g., Davidson v. Shinseki, 581 F.3d 1313 (Fed. Cir. 2009); Pond v. West, 12 Vet. App. 341 (1999). The Board has reviewed all the evidence in the record. Although the Board has an obligation to provide adequate reasons and bases supporting this decision, there is no requirement that the evidence submitted by the appellant or obtained on his behalf be discussed in detail. Rather, the Board’s analysis below will focus specifically on what evidence is needed to substantiate each claim and what the evidence in the claims file shows, or fails to show, with respect to each claim. See Gonzales v. West, 218 F.3d 1378, 1380-81 (Fed. Cir. 2000) and Timberlake v. Gober, 14 Vet. App. 122, 128-30 (2000). Except as otherwise provided by law, a claimant has the responsibility to present and support a claim for benefits under the laws administered by VA. VA shall consider all information and medical and lay evidence of record. Where there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, VA shall give the benefit of the doubt to the claimant. 38 U.S.C. § 5107; 38 C.F.R. § 3.102; see also Gilbert v. Derwinski, 1 Vet. App. 49, 53 (1990). The Veteran contends that he has a cervical spine disability that is causally related to his active service. The question for the Board is whether the Veteran has a current disability that began during service or is at least as likely as not related to an in-service injury, event, or disease. The Board concludes that, while the Veteran has a current diagnosis of cervical spine C3-C4 stenosis and degenerative disc disease (DDD) status post anterior cervical discectomy and fusion with left cervical radiculopathy, and evidence shows that the Veteran was diagnosed with neck strain during service, the preponderance of the evidence weighs against finding that the Veteran’s diagnosis of a cervical spine disability began during service or is otherwise related to an in-service injury, event, or disease. 38 U.S.C. §§ 1110, 1131, 5107(b); Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009); 38 C.F.R. § 3.303(a), (d). Service treatment records show a diagnosed neck strain with possible facet inflammation after waking up with a stiff neck in February 1998. In January 2002, the Veteran reported neck irritation and soreness in the upper neck. The Veteran attended a separation examination in July 2005. The examiner noted normal neck with no neck symptoms or musculoskeletal symptoms. During another July 2005 examination, the examiner noted a normal neck and normal intervertebral disc examination of C3 through S1. He had no abnormal reflexes or sensory deficit. A July 2005 radiology report showed probable fused lower cervical vertebrae. A September 215 treatment record showed neck pain beginning with a hard landing on a C135. The Veteran reported eight attempted landings to finally set it down on the runway with a strong crosswind. The Veteran was afforded a VA examination in April 2016. The examiner reviewed the claims file and performed a physical examination. The examiner diagnosed cervical spine C3-C4 stenosis and degenerative disc disease status post anterior cervical discectomy and fusion with left cervical radiculopathy. The Veteran reported that in 1997 or 1998 he was told he had a strain. In 2013, after service, he sought medical attention for his neck and was told he had C3-C4 stenosis and DDD. The examiner found that the claimed cervical spine disability was less likely than not incurred in or caused by an in-service injury, event, or illness. The examiner noted the diagnosis of neck strain treated conservatively in February 1998. He noted no other visit documenting chronicity. The examiner acknowledged an EMT note in June 2002 for a motor vehicle accident, which noted upon evaluation lower back pain but no diagnosis of any cervical spine condition. The Veteran was seen for a VA examination in July 2005, which found that there may be fused lower cervical vertebrae. No specific cervical spine condition was definitively diagnosed and no degenerative change or stenosis was noted. The Veteran was subsequently diagnosed in 2013 on cervical spine X-ray with C3-C4 stenosis and DDD, which was after active duty dates. The examiner noted that the neck strain diagnosed during service was due to a muscular condition and his current spinal stenosis with degenerative changes involves the spinal vertebrae, not the muscles. The Board notes that treatment records show the Veteran was not diagnosed with cervical spine stenosis and DDD until 2013, years after his separation from service. While the Veteran is competent to report having experienced symptoms of neck pain intermittently since service, he is not competent to provide a diagnosis in this case or determine that these symptoms were manifestations of cervical spine stenosis and DDD. While the Veteran believes his cervical spine disability is related to an in-service injury, event, or disease, including his neck strain, he is not competent to provide a nexus opinion in this case. The issue is medically complex, as it requires knowledge of the interaction between multiple organ systems in the body and interpretation of complicated diagnostic medical testing. Jandreau v. Nicholson, 492 F.3d 1372, 1377, 1377 n.4 (Fed. Cir. 2007). Further, the April 2016 VA examiner opined that the Veteran’s current cervical spine disability is not at least as likely as not related to an in-service injury, event, or disease, including his neck strain in 1998. The rationale was that the in-service complaint was muscular with no evidence of chronicity and the current diagnosis is spinal, not muscular. The 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). Consequently, the Board gives more probative weight to the VA examiner’s opinion than the Veteran’s lay assertions. Based on the evidence cited above, the Board finds that the preponderance of the evidence is against the claim of service connection for a cervical spine disability. As the preponderance of the evidence is against the claim for service connection for a cervical spine disability, the benefit of the doubt rule does not apply. 38 C.F.R. § 5107; 38 C.F.R. § 3.102. B. MULLINS Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD Patricia Veresink