Citation Nr: 19181237 Decision Date: 10/25/19 Archive Date: 10/25/19 DOCKET NO. 15-31 650 DATE: October 25, 2019 ORDER Entitlement to service connection for degenerative changes of the thoracic spine and degenerative disc disease of the lumbosacral spine is granted. Entitlement to service connection for costochondritis is granted. FINDINGS OF FACT 1. The Veteran’s degenerative changes of the thoracic spine and degenerative disc disease of the lumbosacral spine are etiologically related to his active service. 2. The Veteran’s costochondritis is etiologically related to his active service. CONCLUSIONS OF LAW 1. The criteria for entitlement to service connection for degenerative changes of the thoracic spine and degenerative disc disease of the lumbosacral spine have been met. 38 U.S.C. §§ 1110, 1112, 1131, 1137, 5107; 38 C.F.R. § 3.102, 3.303, 3.307, 3.309. 2. The criteria for entitlement to service connection for costochondritis have been met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. § 3.102, 3.303. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty in the Air Force from December 1981 to November 1987 and from September 3, 2002 to September 27, 2002. These matters from before the Board of Veterans’ Appeals (Board) on appeal from a June 2014 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO) in Buffalo, New York. The Veteran testified at a travel board hearing before the undersigned Veterans Law Judge in February 2019. 1. Entitlement to service connection for degenerative changes of the thoracic spine and degenerative disc disease of the lumbosacral spine is granted. 2. Entitlement to service connection for costochondritis is granted. Service connection will generally be awarded when a veteran has a disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303(a). Service connection may be granted for any disease diagnosed after discharge, when all the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303 (d). To establish service connection on a direct basis, the evidence must show (1) a current disability; (2) incurrence or aggravation of a disease or injury in service; and (3) a link or nexus between the in-service disease or injury and the current disability. Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009); Hickson v. West, 12 Vet. App. 247, 252 (1999). In addition, certain chronic diseases, such as arthritis, may be presumed to have been incurred or aggravated during service if they become disabling to a compensable degree within one year of separation from active duty. 38 U.S.C. §§ 1101, 1112; 38 C.F.R. §§ 3.307, 3.309. The Veteran asserts that his back and chest conditions are etiologically related to his active service. Specifically, he asserts that during in-flight training in service his back and chest were injured as a result of spending long periods of time in the unpadded ejection seat of the aircraft. See February 2019 Hearing Transcript. The Veteran provided several buddy statements from fellow service members who served in the Air Force with him. One buddy, who served on the same bomber crew with the Veteran for a year in 1985, stated that poor landings in the aircraft cause significant negative compressive force on the spine. See February 2014 Buddy Statement. The buddy stated that the Veteran was subject to these poor landings, and that he personally observed the Veteran’s back pain during these landings. Additionally, the buddy stated that the type of flying he and the Veteran did required them to be strapped in an ejection seat with a parachute attached to their back for 4 hours each flight, which caused immense strain for extended periods of time on their backs. See id. Another of the Veteran’s fellow service members stated that the ejection seats were a metal frame with little padding, and that spending half their time flying in the seat caused stress strain on their backs. See February 2014 Buddy Statement. The buddy also stated that he and the Veteran still had to move around in their seats while flying, and with the parachute constantly strapped to their backs and pulling them backwards, it was as if they had someone on their back at all times, adding weight and stress to their spines. See id. The Veterans’ service treatment records reflect that in June 1986 he complained of right-sided chest pain and was diagnosed as having costochondritis. In July 1987, he complained of both chest and back pain. He stated that he sprained the muscles in his chest and back while trying to get into his parachute during a flight. The examiner diagnosed muscle sprain of the chest and back. See July 1987 Service Treatment Record (STR). The Veteran again complained of back discomfort in November 1987. Post service in March 1995, the Veteran sought treatment for pain in his mid-upper chest and back. He was diagnosed as having degenerative changes of the thoracic spine, on x-ray, as well as costochondritis. See Treatment records from Purnachandra Popuri, M.D., dated in March 1995. More recent private treatment records from Dr. Popuri dated between 2004 and 2013 show that the Veteran has diagnoses of degenerative changes of the thoracic spine, degenerative disc disease of the lumbosacral spine, and chest wall pain with costochondritis. The first and second elements for service connection, namely a current disability and an in-service incurrence, have been met. 38 C.F.R. § 3.303(a); see Holton, 557 F.3d at 1366; Shedden, 381 F.3d at 1166-67. The Veteran is currently diagnosed as having degenerative changes of the thoracic spine, degenerative disc disease of the lumbosacral spine, and costochondritis. Further, there is competent and credible lay and medical evidence showing in-service injuries and findings related to his back and chest. (Continued on the next page)   Concerning a causal relationship or “medical nexus” between the Veteran’s current back and chest wall conditions and the injuries incurred during his active service, the Veteran’s long-time private doctor, Dr. Popuri stated that his back pain is chronic and could be related to the Air Force duty the Veteran did in the past. See June 2013 Private Medical Treatment Record. Further, the Veteran has consistently reported back and chest wall pain since service, thus showing a continuity of symptomatology. See Walker v. Shinseki, 708 F.3d 1331, 1338 (Fed. Cir. 2012) (observing that a continuity of symptoms after service itself "establishes the link, or nexus" to service and also "confirm[s] the existence of the chronic disease while in service or [during a] presumptive period"). A claimant is entitled to the benefit of the doubt when there is an approximate balance of positive and negative evidence on any issue material to the claim. 38 U.S.C. § 5107; 38 C.F.R. § 3.102. The Board notes that no evidence in the Veteran’s claim file points to any alternate cause for his back and chest wall condition. Thus, resolving reasonable doubt in his favor, the Board finds that the Veteran’s degenerative changes of the thoracic spine, degenerative disc disease of the lumbosacral spine, and costochondritis are related to his active service. Consequently, the benefit-of-the-doubt rule applies, and service connection is granted. See 38 U.S.C. § 5107; 38 C.F.R. § 3.102; Gilbert, 1 Vet. App. at 55. P.M. DILORENZO Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board T. Mohammad The Board’s decision in this case is binding only with respect to the instant matter decided. This decision is not precedential, and does not establish VA policies or interpretations of general applicability. 38 C.F.R. § 20.1303.