Citation Nr: 19134635 Decision Date: 05/03/19 Archive Date: 05/03/19 DOCKET NO. 16-29 205 DATE: May 3, 2019 ORDER Entitlement to service connection for right wrist carpal tunnel syndrome and osteoarthritis is granted. Entitlement to service connection for degenerative disc and facet disease of the lumbar spine is granted. FINDINGS OF FACT 1. The Veteran's right carpal tunnel syndrome manifested to a compensable degree within one year of separation from service and is not attributable to intercurrent causes. 2. The Veteran’s lumbar spine degenerative disc and facet disease is related to an in-service injury. CONCLUSIONS OF LAW 1. The criteria for entitlement to service connection for right carpal tunnel syndrome and osteoarthritis are met. 38 U.S.C. §§ 1110, 1112, 1113, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309. 2. The criteria for service connection for degenerative disc and facet disease of the lumbar spine have been met. 38 U.S.C. §§ 1110, 1112, 1113, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran had active duty service from September 1997 to August 2001. In October 2018, the Veteran testified at a hearing before the undersigned Veterans Law Judge. A transcript of the hearing is of record. Service Connection 1. Service Connection Criteria Service connection may be granted for disability resulting from disease or injury incurred in or aggravated by service. 38 U.S.C. § 1110; 38 C.F.R. § 3.303. Establishing service connection generally requires competent evidence of three things: (1) a current disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship, i.e., a nexus, between the claimed in-service disease or injury and the current disability. Holton v. Shinseki, 557 F.3d 1362, 1366 (Fed. Cir. 2009); 38 C.F.R. § 3.303 (a). Certain chronic diseases, including arthritis and organic diseases of the nervous system, will be presumed related to service if they were shown as chronic (reliably diagnosed) in service; or, if they manifested to a compensable degree within a presumptive period following separation from service; or, if they were noted in service, with continuity of symptomatology since service that is attributable to the chronic disease. 38 U.S.C. §§ 1101, 1112, 1113, 1137; Walker v. Shinseki, 708 F.3d 1331, 1338 (Fed. Cir. 2013); Fountain v. McDonald, 27 Vet. App. 258 (2015); 38 C.F.R. §§ 3.303, 3.307, 3.309. Entitlement to service connection for right carpal tunnel syndrome The Veteran contends that his right wrist disability is related to an injury in service when he fell on his right wrist. In an October 2014 statement, the Veteran noted that he injured his right wrist when he fell and caught himself with his hands. The Veteran stated that a civilian doctor had told him that his right wrist injury was misdiagnosed as a sprain and was actually a scaphoid fracture, which led to carpal tunnel syndrome and loss of feeling in his right hand. Service treatment records reflect treatment for right wrist injuries. In August 1999, the Veteran complained of a fall on his wrist and was treated for wrist sprain. A January 2000 entry noted pain and weakness of the right wrist for approximately two months. The Veteran was diagnosed with non-healing right wrist. The April 2001 separation examination noted a history of wrist injury. A private treatment record dated in March 2002 reflects a diagnosis of carpal tunnel syndrome of the right hand. A VA examination dated in August 2013 reflects a diagnosis of right wrist osteoarthritis and right carpal tunnel release. The examiner opined that the previous history of a right wrist strain resolved, and there was no loss of motion observed. The examiner indicated that the Veteran now had right wrist osteoarthritis. The examiner opined that carpal tunnel syndrome had its onset in 2012. As noted above, the evidence of record indicates that the Veteran was diagnosed with carpal tunnel syndrome in March 2002, shortly after separation from service. The examiner did not consider the evidence reflecting treatment of carpal tunnel syndrome within a year of separation from service. Given the history of a right wrist injury in service and a diagnosis of right carpal tunnel syndrome within a year of separation, the Board finds that right carpal tunnel syndrome manifested to a compensable level within one year of his separation from active duty. Accordingly, right carpal tunnel syndrome is presumed to have been incurred in service, and service connection for a right wrist disability, to include right carpal tunnel syndrome and osteoarthritis, is granted. 2. Entitlement to service connection for degenerative joint disease of the lumbar spine The Veteran contends that his current back disability is related to injuries in service. At the Board hearing, the Veteran testified that he injured his back when he fell while snowboarding. The Veteran testified that he also injured his back during field exercises and was taken to Evans Army Hospital for treatment. The Board concludes that the Veteran has a current disability that is related to in-service back injuries. 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). The Veteran was treated for back pain in service. A September 1999 entry reflects that the Veteran complained of back pain. He reported that he was lifting a soldier above his shoulders and lost his grip and fell. The Veteran was diagnosed with muscle spasm and lower back pain. A February 2000 entry from Evans Army Hospital shows that the Veteran strained his back while in the field doing heavy lifting. Examination showed mild tenderness of the left paralumbar muscles. An April 2000 emergency treatment record shows that the Veteran reported back pain for three weeks. The record noted that the Veteran was out in the field when a temper fell on him. He was diagnosed with persistent back strain. The April 2001 separation examination noted a positive history of “recurrent back pain or any back injury,” with treatment for a back injury in 1999. Thus, the remaining question becomes whether the current disability is related to service. There is evidence for and against the claim. A VA examination in August 2013 provided a negative nexus opinion. The examiner diagnosed L5-S1 degenerative disc disease. The examiner opined that the Veteran’s current back condition is new and separate and does not causally relate to the muscle strain diagnosed in 2000. The evidence in favor of the claim includes an October 2016 opinion from a private physician, Dr. J.W. The opinion noted that the Veteran had been followed since January 2015 for back pain. The Veteran reported that he was struck by a falling tent in May 2000. He described the tent as catching him behind the head, violently bending him forward and compressing his spine. He was seen at the time and diagnosed with “back strain.” The Veteran reported persistent progressive pain since that time and had been noted to have degenerative disc and facet disease. Dr. J.W. opined, that, when he met the Veteran in 2015, he thought that it was odd for a 37-year-old patient to have such advanced degenerative changes. He opined that the compressive force of the original injury 16 years ago was the causal antecedent to his subsequent degenerative disease, and his disease was undoubtedly service-related. In February 2017, a private physician, Dr. S.M., opined that the Veteran’s severe low back pain and findings at the L5-S1 level and T12-L1 levels are related to trauma and repetitive stress, which is more likely a service-related injury. Upon review of the record, the Board finds the evidence to at least be in equipoise as to whether the Veteran’s current lumbar spine degenerative disc and facet disease is related to service. Accordingly, after resolving all doubt in favor of the Veteran, the Board finds that service connection for lumbar spine degenerative disc and facet disease is warranted. 38 U.S.C. § 5107; 38 C.F.R. § 3.102. JENNIFER HWA Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD Catherine Cykowski 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.