Citation Nr: 19152147 Decision Date: 07/05/19 Archive Date: 07/05/19 DOCKET NO. 12-24 144A DATE: July 5, 2019 ORDER Entitlement to service connection for a low back disability is denied. Entitlement to service connection for a bilateral hip disability, to include secondary to low back disability is denied. Entitlement to service connection for a neurological disorder, to include radiculopathy of the hands and feet, to include as secondary to a low back disability is denied. FINDINGS OF FACT 1. The preponderance of the probative evidence is against finding that a low back disability is related to active service or events therein, and lumbar arthritis was not compensably disabling within a year of the claimant’s separation from active duty. 2. The preponderance of the probative evidence is against finding that a bilateral hip disability is related to active service or events therein, to include secondary to a low back disability, and arthritis of the hips was not compensably disabling within a year of the claimant’s separation from active duty. 3. The preponderance of the probative evidence is against finding that numbness of the hands and feet is related to active service or events therein, to include secondary to a low back disability. CONCLUSIONS OF LAW 1. A low back disability was not incurred nor aggravated during active service, and lumbar arthritis may not be presumed to have been incurred therein 38 U.S.C. § 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309. 2. A bilateral hip disability was not incurred nor aggravated during active service nor may hip arthritis be presumed to have been incurred therein. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309(a). 3. The criteria for service connection for numbness in the hands and feet have not been met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.310. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran had active service from December 1974 to December 1975. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from the October 2009, and January 2012 rating decisions of the Department of Veterans Affairs (VA) Regional Office (RO) in New Orleans, Louisiana. The Board remanded the appealed issues in September 2015, October 2015 and August 2017 for further development. The Board has held two hearings in this matter, one in August 2014 and the other in March 2015 before different Veterans Law Judges on the issues listed on the title page. The Veteran was advised of his right to a hearing before a third Veterans Law Judge; however, he waived that right in June 2015. The Board finds that there is substantial compliance with its remand directives of August 2017. Service Connection A disability will be service connected if it was incurred or aggravated in the line of duty in the active military, naval, or air service. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. §§ 3.1 (k), 3.303. Every veteran is presumed to have been in sound condition at entry into service except as to defects, infirmities, or disorders noted at the time of such entry, or where clear and unmistakable evidence demonstrates that the injury or disease existed before entry and was not aggravated by such service. 38 U.S.C. § 1111. Where a veteran served continuously for ninety days or more during a period of war, or during peacetime service after December 31, 1946, and arthritis becomes manifest to a degree of 10 percent within one year from the date of termination of active duty, such disease shall be presumed to have been incurred in service, even though there is no evidence of such disease during the period of service. This presumption is rebuttable by affirmative evidence to the contrary. 38 C.F.R. §§ 3.307, 3.309. Service connection may also be granted for a disability that is proximately due to or the result of a service-connected disease or injury. 38 C.F.R. § 3.310 (a). This permits service connection not only for a disability caused by a service-connected disability, but for the degree of disability resulting from aggravation of a disability by a service-connected disability. See Allen v. Brown, 7 Vet. App. 439, 448 (1995). In the case of aggravation by a service-connected disability, a veteran may be compensated for the degree of disability over and above the degree of disability existing prior to the aggravation. Id; see 38 C.F.R. § 3.310 (b). The Veteran contends that his current low back disability was incurred while on active duty, and that bilateral hip and a neurological disorder are due to this low back disorder. During his Board hearings the Veteran testified that he initially injured his back, neck and hip when he fell down a hill during a night training exercise in 1975. The Veteran reported being seen after the injury and given 10 days of light duty to recuperate. He further alleged that because of these injuries he developed neurological problems. A review of the service treatment records reveals that in June 1975 the claimant reported falling down a hill while on a night compass class. Physical examination, to include X-ray studies revealed normal findings, and the clinical impression was “normal exam(ination).” When the appellant returned the following day, the examiner opined that the Veteran’s complaints were out of proportion to their severity. Other medical records concerning other disorders note concerns that the appellant may have been malingering. In July 1975, the claimant returned and reported a one-week history of back pain. The appellant stated that the pain began one month earlier when he fell. No pertinent physical abnormality was found. In October 1975, the claimant was the subject of a medical board. Physical examination revealed that all joints were supple, and that the examination was unremarkable. In February 1981, the appellant was hospitalized at a VA facility for a fractured toe. Physical examination at that time revealed no evidence of a back disorder. In July 1992, the claimant was seen by a private orthopedist. The examiner noted that the claimant injured his hip in 1983 as the result of an accident. It was also noted that the appellant had suffered a neck fracture in a 1985 car accident which left him with neuritic pain. The claimant was provided a general VA medical examination in March 1993. The examiner noted a history of an accident in November 1983 which left the appellant with a right hip strain. The private orthopedist again examined the appellant in August 1993. That examination revealed in pertinent part findings of lumbar degenerative changes. At a November 1993 VA examination the claimant reported a history of low back pain since 1983 after lifting. He also reported a history of twisting his right hip on stairs. Physical examination yielded diagnoses of posttraumatic arthritis of the right hip, and right upper extremity radiculopathy by history. A review of VA outpatient records shows that in September 2009 the claimant reported injuring his low back inservice. Physical examination yielded diagnoses of low back and left hip pain. An October 2009 MRI revealed Grade 1 retrolisthesis L5 over Sl, multilevel lumbar spondylotic changes, and compression of the L5 and S1 nerves bilaterally. In December 2010 the appellant underwent a L4-L5 intralaminar decompression to treat lumbar stenosis. In July 2011 the Veteran was afforded a VA compensation examination. While the examiner opined that the Veteran was a poor historian the appellant was noted to report a history of low back pain since an inservice fall. Following the examination, the appellant was found to have a low back disorder, however, the examiner stated that he was unable to resolve whether the disorder was related to service without resorting to speculation. The examiner opined that the appellant’s inservice fall did not appear to have been serious, and that perhaps more recent historical events were a more likely etiology for the claimant’s back disorder. The claimant was afforded a VA examination of his hips in May 2012. He reported injuring his back and hips inservice while on night maneuvers. Following the examination, the examiner opined that the Veteran's current hip conditions were less likely than not incurred in or caused by his reported fall in June 1975. The examiner’s reasoning was that after treatment in June and July 1975, at which time the appellant’s lumbar spine was radiologically normal, the service treatment records were void of any additional pertinent complaint. Further, the claims file was void for any postservice complaint for at least 10 years. The examiner noted that in July 1992 the appellant had been injured off shore, and that an insurance claim following that accident had been filed. The examiner opined that osteoarthritis of the hips was most likely due to aging. Following VA examinations in March 2016 the examiner opined that it was less likely than not that the appellant’s low back and hip disorders were related to his inservice fall, that there was a history of an off shore work accident about 1992, that the claimant’s degenerative joint disease of the hips was not related to service but was consistent with the normal aging process, and that it was less likely than not that the hip disorder was related to the claimed back disorder. The examiner further opined that radiculopathy was less likely than not related to service but was at least as likely as not related to postservice injuries sustained in 1983 and 1985. Following VA examinations in November 2017, the examiner opined that the claimant’s low back disorder was less likely than not related to an inservice injury, event or illness. The examiner’s rationale was while the appellant was seen in June and July 1975 for complaints of hip and back pain, by the time of a November 1993 VA examination, the claimant was reporting low back pain since 1983, i.e., since a postservice date. The November 2017 examiner further noted that at the July 2011 VA examination the claimant’s back disorder was attributed to a non-service related injury in the 1980s. The November 2017 examiner noted that the claimant had been involved in a 1985 automobile accident during which time he fractured his neck. There was no mention of a back injury in that 1985 accident, but, the prior 1993 examination noted that the appellant had injured his back in 1983. X-rays done at the 1993 exam were normal. The November 2017 examiner opined that it was safe to assume that, if an injury had occurred almost 20 years prior, there would be some radiographic evidence of traumatic degenerative changes. As the appellant’s low back disorder was not related to service the examiner did not offer an opinion addressing the question of secondary service connection for a hip disorder due to the back disorder. Finally, the examiner noted that there was no indication of a peripheral nerve or hip condition inservice, and that the claims file was void of any documentation of a hip disorder for at least 10 years postservice. In this case, the service medical records show that the appellant did report complaints of back pain in 1975. The service treatment records do not, however, reveal any documentation of a chronic hip disorder or a neurological disorder. Moreover, the appellant’s medical board did not find evidence of a chronic back, hip or neurological disorder, and there is no evidence of compensably disabling arthritis of either the lumbar spine or hips within one year of separation from active duty. Postservice the appellant did not report any pertinent pathology until July 1992 when the claimant was seen by a private orthopedist. At that time, he noted a history of a postservice hip injury in 1983, and a postservice neck fracture in 1985 which left the appellant with neuritis. Pertinent evidence of a lumbar disorder was not noted until 1993 when degenerative changes were noted. While the appellant may sincerely believe that all of these disorders are related to his active duty service, as a lay person he is not competent to offer an opinion which requires specialized medical knowledge and training. Kahana v. Shinseki, 24 Vet. App. 428, 435 (2011). Moreover, it is well to note that the overwhelming preponderance of the competent medical opinion evidence concludes that the claimed disorders are not related to service, but rather are due to age and postservice events. Accordingly, given the foregoing, the Board concludes that all of the claims must be denied. In reaching these opinions the Board carefully considered the hearing testimony of the Veteran as well as statements submitted in support of these claims. While the appellant is competent to report a history of pain since service, he is not competent to offer a medical opinion addressing the cause of his current disabilities. See Jandreau v. Nicholson, 492 F.3d 1372, 1376-77 (Fed. Cir. 2007).   Finally, as the preponderance of the evidence is against the claims, the benefit of the doubt doctrine is not for application and the claims are denied. 38 U.S.C. § 5107 (b). MICHAEL A. HERMAN Veterans Law Judge Board of Veterans’ Appeals MICHAEL D. LYON Veterans Law Judge Board of Veterans’ Appeals DEREK R. BROWN Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD Allen M. Kerpan, Associate Counsel