Citation Nr: 19132995 Decision Date: 04/26/19 Archive Date: 04/26/19 DOCKET NO. 18-03 556 DATE: April 26, 2019 ORDER Entitlement to service connection for mild degenerative disc and joint disease (DDD/DJD) at L4-5, L5-S1 with intermittent radiculitis, right lower extremity and right SI joint dysfunction is denied. FINDING OF FACT Currently-diagnosed mild DDD/DJD at L4-5, L5-S1 with intermittent radiculitis, right lower extremity and right SI joint dysfunction was not first manifested on active duty service or within any applicable presumptive period, and is not otherwise shown to be related to military service or any service- CONCLUSION OF LAW The criteria for service connection of mild DDD/DJD at L4-5, L5-S1 with intermittent radiculitis, right lower extremity and right SI joint dysfunction are not met. 38 U.S.C. §§ 1101, 1110, 1112, 1113, 5107 (2012); 38 C.F.R. §§ 3.102, 3.303, 3.304, 3.307, 3.309 (2018). REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty in the United States Marine Corps from April 2009 to December 2009. This matter is before the Board of Veterans’ Appeals (Board) on appeal from an October 2016 decision issued by a Department of Veterans Affairs (VA) Regional Office (RO). Service connection will be granted if it is shown that the Veteran suffers from a disability resulting from personal injury suffered or disease contracted in the line of duty, or for aggravation of a preexisting injury suffered or disease contracted in the line of duty, during active military service. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303. Disorders diagnosed after discharge will still be service connected if all the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303 (d); see also Combee v. Brown, 34 F.3d 1039, 1043 (Fed. Cir. 1994). In order to establish service connection on a direct basis, the record must contain competent evidence of: (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 or aggravated during service. Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004). In the absence of proof of a present disability there can be no valid claim. Brammer v. Derwinski, 3 Vet. App. 223, 225 (1992). Some chronic diseases may be presumed to have been incurred in service, if they become manifest to a degree of ten percent or more within the applicable presumptive period. 38 U.S.C. §§ 1101 (3), 1112(a); 38 C.F.R. §§ 3.307(a), 3.309(a). For those listed chronic conditions, a showing of continuity of symptoms affords an alternative route to service connection. 38 C.F.R. § 3.303 (b); Walker v. Shinseki, 708 F. 3d 1331 (Fed. Cir. 2013). Arthritis is a chronic disease and DJD is a synonym for arthritis. Greyzck v. West, 12 Vet. App. 288, 291 (1999) (“the term osteoarthritis is a synonym of the terms degenerative arthritis and degenerative joint disease”). Finally, a disability which is proximately due to or the result of a service-connected disease or injury shall be service connected. When service connection is thus established for a secondary condition, the secondary condition shall be considered a part of the original condition. 38 C.F.R. § 3.310. The Veteran has a diagnosis of mild DDD/DJD L4-5, L5-S1 with intermittent radiculitis right lower extremity and right SI joint dysfunction reflected in current medical records, establishing the existence of a present disability. The Veteran complained of lower back pain during service. At examination for entry, her back was normal, and there was no history of back problems or complaints. In August 2009, during Boot Camp, the Veteran reported low back pain, and described a “backache” in repeated sick call visits through early October 2009, but did not reference any specific back injury. She in fact indicated she had back pain in relation to her right knee injury, and in connection with her October 2009 medical board examination stated her low back pain had resolved. At all times physical examination of her back was listed as normal. Nevertheless, these entries are evidence of an in-service incident or incurrence of injury. The remaining question involves a nexus between the current disability and in-service complaints. A July 2016 examiner found it less likely than not that the Veteran’s low back disabilities were incurred in or caused by her service. The examiner’s rationale included a chiropractic health summary, documenting back problems since 2007, which predated her service by two years. Additionally, the examiner noted that other than a one-time mention of low back pain resolved during medical board (MEB) history, service treatment records are negative for acute, recurrent, chronic low back pain in service. The MEB exam was negative. Post-military records were negative for low back pain until almost one year after separation, and this directly caused by driving long distances. The examiner additionally reasoned that post service records documented low back pain on only a few occasions, mostly falling on ice and during pregnancy. She stated that records clearly are negative for the falls to be caused by the service-connected right knee. The examiner explained that aside from expected altered gait immediately after right knee surgery, the Veteran demonstrated normal gait, good tone of lower extremities, and has normal leg measurements bilaterally. She had been seen by orthopedics on numerous occasions for the right knee without any clinical findings, correlation, and/or symptoms regarding her back. Lastly, the July 2016 examiner opined that the Veteran’s current back injuries are more likely than not related to several post-military injuries. The Veteran takes issue with the July 2016 examiner’s findings. She argues that she was seen for her back in October 2010, within a year of her active duty service, and that her back pain after service has no etiology besides her in-service injury. The Board first notes that there is no diagnosis of arthritis at this time to satisfy the requirements for presumptive service connection. Further, the Veteran’s argument ignores the contemporaneous statements to the treating doctor that she had driven 1,000 miles in the last three days and was sore all over; a diagram next to the note highlighted affected portions of the spine. The July 2016 examiner reasonably attributed her soreness on that date to her driving. Similarly, the record reflects numerous potential causes of low back problems outside of the in-service problems. October 2010 chiropractic treatment records show that the Veteran reported that she had been in a motor vehicle accident in 2000, and had never been the same since. In a May 2013 treatment note, the Veteran reported an achy back during her pregnancy. In July 2011 treatment notes, the Veteran reported that her symptoms of sore back, hips, and knees began when she fell on ice on December 7, 2010, in bad weather. She attributed her fall to bad weather and knee surgery. These past statements are inconsistent with current allegations relating problems solely to service. In summary, while there is some evidence of low back injuries prior to service, none were noted at entry the Veteran was accepted as sound for service with respect to her spine. She experienced low back pain in service, but this resolved completely, and was not due to a specific injury of the back; it was referred pain related to her right knee injury which eventually cut her military career short. Following service, she has sustained a number of low back injuries and insults, none of which are shown to be related to service or a service-connected disability. Although she has at times alleged such, her allegations have varied and contradicted each other too markedly to be given any probative weight. The sole competent and credible evidence of record regarding a nexus is the July 2016 VA examination an opinion, which found a relationship to service to be less likely than not. The examiner conducted a thorough review of the record, considered fully the available evidence, and recognized the variances in presentations (noting, for example, altered gait or unequal limbs at times) in rendering her opinion. The weight of the evidence is against the claim, and service connection for a low back disability is denied. WILLIAM H. DONNELLY Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD K. McDermott, Associate Counsel