Citation Nr: 19164792 Decision Date: 08/21/19 Archive Date: 08/20/19 DOCKET NO. 15-42 758 DATE: August 21, 2019 ORDER Entitlement to service connection for back disability is denied. FINDING OF FACT The evidence of record does not show that is as at least as likely as not that the Veteran’s current back disability is related to service. CONCLUSION OF LAW The criteria for entitlement to service connection for a back disability have not been met. 38 U.S.C. §§ 1101, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from January 1976 to February 1980. This matter comes before the Board of Veterans’ Appeals (Board) on appeal of a December 2014 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO) in Muskogee, Virginia. This case was previously remanded by the Board in September 2018. A review of the claims file shows that there has been substantial compliance with the Board’s remand directives. See Stegall v. West, 11 Vet. App. 268 (1998). The case has been returned to the Board for review. Service connection for a back disability is denied Service connection may be established for disability resulting from disease or injury incurred in or aggravated by active military service. 38 U.S.C. § 1131; 38 C.F.R. § 3.303. To establish service connection for a disability, the Veteran must show: (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). The Veteran contends that he has a back disability that is directly related to his service. Specifically, the Veteran contends his back has bothered him continuously since 1978. The evidence of record shows that the Veteran was diagnosed with multilevel degenerative disk disease and multilevel neuroforaminal stenosis in 2012. Therefore, there is evidence of a current disability. As to an in-service event, injury or disease, the Veteran’s service treatment records reveal complaints of back pain and an assessment of a possible muscle strain and herniated nucleus pulposus (HNP) in 1978. Accordingly, there is evidence of an in-service injury and the issue remaining for consideration is whether the Veteran’s current back disability is etiologically related to the in-service injury. With respect to a nexus between the current disability and in-service event, the only competent medical opinions of record are the November 2015 and June 2019 VA opinions, which weigh against the Veteran’s claim. The November 2015 VA examiner stated the Veteran’s claimed condition was less likely than not (less than 50 percent probability) incurred in or caused by the in-service injury, event, or illness. The examiner reasoned the only documentation of a back condition was the November 1978 report and a normal examination is the assessment. The examiner stated there was no continuity of symptoms or record of trauma that would cause post-traumatic degenerative joint disease. The Veteran’s history of 30 years of heavy road equipment operation is more likely than not the etiology of his osteoarthritis. In September 2018 the Board remanded the Veteran’s claim for service connection for back disability for a new VA opinion because the November 2015 VA examiner noted the Veteran’s report of back pain since service, but also stated there was no continuity of symptoms. The June 2019 VA examiner stated the Veteran’s claimed condition was less likely than not (less than 50 percent probability) incurred in or caused by the in-service injury, event, or illness. The examiner reasoned the Veteran’s back pain was a trapezius muscle strain on October 26, 1978. The Veteran complained of low back pain the next day, and “possible muscle strain” was the diagnosis. On November 16, 1978, it’s noted that Veteran was transferred to Coronado for 2 weeks, saw a civilian chiropractor, had negative x-rays, and diagnosis was “low back pain related to HNP, doubt.” The 2019 VA examiner stated the Veteran was discharged in 1980 without any other record of back symptoms after the 1978 incident. In 1998 (20 years later), he reported back and neck pain. There is no continuity of symptoms. During his years after discharge, he worked heavy road equipment for 29 years. It is more likely than not that his back condition is due to age and occupation. It is a medically known fact that age and life experience cause degenerative changes over time. In my medical opinion, based on 30 years of practicing medicine, it is more likely than not that the Veteran’s back condition is due to 29 years of labor and life in general. There is nothing to support his claim other than he did serve time in the military and blames his back condition on it. The only evidence indicating an association between the current back disability and service are the Veteran’s own assertions. It is well established that a layperson without medical training is not qualified to render a medical opinion regarding the diagnosis or etiology of certain disorders and disabilities. See 38 C.F.R. § 3.159(a)(1). In certain instances, lay testimony may be competent to establish medical etiology or nexus. See Jandreau v. Nicholson, 492 F. 3d 1372, 1377 (Fed. Cir. 2007). However, as the origin or cause of a back disability is not a simple question that can be determined based on personal observation by a lay person, the Veteran’s lay testimony is not competent to establish medical etiology or nexus. Id. As such, the Board finds the question of whether the Veteran’s current back disability had its onset during service does not lie within the range of common experience or common knowledge but requires special experience or special knowledge. It is not shown that the Veteran is otherwise qualified through specialized education, training, or experience to offer a medical opinion as to the etiology of his back disability. Grottveit v. Brown, 5 Vet. App. 91, 93 (1993). In summary, the most probative evidence of record does not support a finding that it is at least as likely as not that there is a causal relationship between the Veteran’s current back disability and his service. In light of the above, the preponderance of the evidence is against the claim and the benefit-of-the-doubt doctrine is not for application. The claim therefore must be denied. 38 U.S.C. § 5107 (b); see also Gilbert v. Derwinski, 1 Vet. App. 49, 57 (1990). M. Donohue Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board A. St. Laurent 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.