Citation Nr: 19124014 Decision Date: 04/02/19 Archive Date: 03/30/19 DOCKET NO. 15-04 652 DATE: April 2, 2019 ORDER Entitlement to service connection for a cervical spine disability is granted. FINDING OF FACT Resolving all reasonable doubt in favor of the Veteran, the evidence supports a finding that the Veteran has a cervical spine disability that is directly related to active service. CONCLUSION OF LAW The criteria for service connection for a cervical spine disability have been met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.303. REASONS AND BASES FOR FINDING AND CONCLUSION 1. Entitlement to service connection for a cervical spine disability Service connection may be established for disability caused by disease or injury incurred in or aggravated by active service. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303. In order to establish service connection for a claimed disability, there must be (1) medical evidence of a current disability; (2) medical, or in certain circumstances, lay evidence of in service incurrence or aggravation of a disease or injury; and (3) evidence, generally medical, of a causal relationship between the claimed in service disease or injury and the current disability. Hickson v. West, 12 Vet. App. 247 (1999). Service connection may also be established for any disease initially diagnosed after service, when the evidence establishes that the disease was incurred in service. 38 U.S.C. § 1113(b); 38 C.F.R. § 3.303(d); Cosman v. Principi, 3 Vet. App. 503 (1992). The disease entity for which service connection is sought must be chronic rather than acute and transitory in nature. For the showing of chronic disease in service, a combination of manifestations must exist 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. Furthermore, service incurrence will be presumed for certain chronic diseases if manifest to a compensable degree within the year after active service. 38 U.S.C. § 1112; 38 C.F.R. §§ 3.307, 3.309. A Veteran need only demonstrate that there is an approximate balance of positive and negative evidence in order to prevail. To deny a claim on its merits, the preponderance of the evidence must be against the claim. Alemany v. Brown, 9 Vet. App. 518 (1996); Gilbert v. Derwinski, 1 Vet. App. 49 (1990). Here, the Veteran claims that he has a current cervical spine disability as a result of numerous parachute jumps, falls, and SERE training while on active duty. He made those contentions at the November 2018 Board hearing. The service medical records are negative for any signs, symptoms, or treatment for any neck or upper back disorder. However, the Veteran’s service personnel records show that he was awarded the Senior Parachutist Badge, Parachutist Badge, and Canadian Parachutist Badge. The service personnel records further show that the Veteran served as a health services material specialist with a special forces unit. Additionally, the Veteran is competent to describe the circumstances surrounding the claimed in-service neck and upper back injury and to report the neck and upper back symptoms that he experiences because those actions come to him through his senses and require only personal knowledge rather than medical expertise. Layno v. Brown, 6 Vet. App. 465 (1994); Buchanan v. Nicholson, 451 F.3d 1331 (Fed. Cir. 2006) (lay evidence does not lack credibility simply because it is unaccompanied by contemporaneous medical evidence). Therefore, the Board accepts the Veteran’s account of experiencing some neck and upper back symptoms and injury after a parachute jump while on active duty, and finds those contentions credible and consistent with the circumstances of the Veteran’s service. The Board additionally notes that the Veteran has current diagnoses of mild C3-C7 disc bulging, cervical spondylosis, and cervical degenerative multi-level disk disease. The remaining question is whether any current cervical spine disability was caused by or is otherwise related to service. At a June 2013 VA examination, the examiner diagnosed chronic upper back strain. The examiner noted that the Veteran served in the special forces and retired as a Captain. The examiner further noted that the Veteran performed many parachute jumps. However, the examiner provided no opinion regarding the etiology of the diagnosed chronic upper back strain. As the VA examiner gave no opinion regarding the etiology of the Veteran’s disability, the June 2013 VA examination report weighs neither for nor against the claim. In a November 2018 letter, T.M.P., M.D., noted that the Veteran had cervical degenerative multi-level disk disease, cervical spondylosis, cervical radiculopathy/brachial neuritis, and cervical stenosis. Dr. P. acknowledged that the Veteran did not have documented treatment specifically for upper back or neck pain in the service medical records, but Dr. P. noted multiple documented musculoskeletal injuries and muscle pains that were shown in the service medical records. Dr. P. opined that although the Veteran did not complain during active duty of upper back and neck pain, the Veteran’s current chronic conditions were more likely than not to be service-related. The private examiner specified that it would come as no surprise that the Veteran was now suffering the sequelae of rigorous and robust activities while on active duty. The Board finds that the November 2018 letter from Dr. P. constitutes probative, persuasive evidence that supports the Veteran’s claim. Dr. P. acknowledged what the service medical records did and did not show, and Dr. P. had the expertise to provide competent evidence of a relationship between the currently demonstrated neck and upper back disability and the Veteran’s service. Based on all the evidence of record, and resolving all reasonable doubt in favor of the Veteran, the Board finds that the Veteran has a cervical spine disability that is directly related to service. Notably, the June 2013 VA examiner offered no etiology opinion concerning the claimed disability, although noting the parachute jumps during service, and the November 2018 private examiner gave reasoning to support the positive opinion. That examiner also cited to the Veteran’s medical evidence and lay statements to support the opinion. No other evidence of record contradicts the November 2018 private opinion. Accordingly, the Board finds that the evidence is at least in equipoise regarding whether a currently diagnosed cervical spine disability was caused by the Veteran’s service. Accordingly, the Board will resolve reasonable doubt in favor of the Veteran, and find that entitlement to service connection for a cervical spine disability is warranted. Gilbert v. Derwinski, 1 Vet. App. 49 (1990); 38 U.S.C. § 5107. Harvey P. Roberts Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD S. Layton, Counsel