Citation Nr: A19001561 Decision Date: 09/26/19 Archive Date: 09/25/19 DOCKET NO. 190507-23210 DATE: September 26, 2019 ORDER Entitlement to service connection for a low back disability is granted. FINDING OF FACT Resolving reasonable doubt in the Veteran’s favor, his low back disability began during active service and has been continuous ever since. CONCLUSION OF LAW The criteria for entitlement to service connection for a low back disability have been satisfied. 38 U.S.C. § § §§ 1101, 1110, 1112, 1113, 1131 (2012); 38 C.F.R. § § §§ 3.303, 3.307, 3.309 (2018). REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from May 1957 to March 1960. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from an April 2018 rating decision by the by the Department of Veterans Affairs (VA) Regional Office (RO). 1. Entitlement to service connection for a low back disability The Veteran claims that his current low back disability is related to his active duty service in particular when he strained his back during basic training at Fort Polk. Service connection may be granted for a disability resulting from disease or injury incurred in or aggravated by active military, naval, or air service. 38 U.S.C. § § 1110, 1131; 38 C.F.R. § § 3.303 (a) (2018). For the showing of a chronic disease in service, there is required a combination of manifestations sufficient to identify the disease entity, and sufficient observation to establish chronicity at the time. Subsequent manifestations of the same chronic disease at any later date, however remote, are service connected, unless clearly attributable to intercurrent causes. 38 C.F.R. § § 3.303 (b) (2018). Service connection may also be granted for any disease diagnosed after discharge, when all the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § § 3.303 (d) (2018). When all the evidence is assembled, VA is responsible for determining whether the evidence supports the claim or is in relative equipoise, with a veteran prevailing in either event, or whether a preponderance of the evidence is against a claim, in which case, the claim is denied. 38 U.S.C. § § 5107 (b) (2012); 38 C.F.R. § § 3.102 (2018). Where a veteran who served for ninety days or more during a period of war (or during peacetime service after December 31, 1946) develops certain chronic diseases, such as arthritis, to a degree of 10 percent or more within one year from separation from service, such diseases may 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. See 38 U.S.C. § § 1101, 1112, 1113, 1137 (2012); 38 C.F.R. § § 3.307, 3.309 (2018). In this case, arthritis is listed among the “chronic diseases” under 38 C.F.R. § § 3.309 (a); therefore, 38 C.F.R. § § 3.303 (b) potentially applies. Walker v. Shinseki, 708 F.3d 1331 (Fed. Cir. 2013). Where the evidence shows a “chronic disease” in service or “continuity of symptoms” after service, the disease shall be presumed to have been incurred in service. For the showing of a “chronic” disease in service, there is required a combination of manifestations enough to identify the disease entity, and sufficient observation to establish chronicity at the time. With chronic diseases in service, subsequent manifestations of the same chronic disease at any later date, however remote, are service-connected, unless clearly attributable to intercurrent causes. If a condition noted during service is not shown to be chronic, then generally, a showing of “continuity of symptoms” after service is required for service connection. 38 C.F.R. § § 3.303 (b). The Veteran has a current diagnosis for degenerative arthritis. The Veteran’s Service Treatment Records (STRs) show that he sought treatment on multiple occasions in 1957 and 1958 for back pain, and in 1958 suffered a low back strain. Post-service private treatment records show that the Veteran suffers from degenerative disc disease of the lumbar spine. A June 2003 clinic note indicates that the Veteran complained of low back pain. A March 2007 imaging report shows degenerative disc disease of the spine. Additional post-service treatment records show that the Veteran reported sharp pains which are aggravated when standing or running, and was treated with medications and injections. A December 2017 clinic note from the Veteran’s private physician indicates that the Veteran’s back pain began during service when he suffered a hard fall while marching. The Veteran reported to his physician that his symptoms have been chronic. A VA examiner issued opinions regarding the Veteran’s low back disability in April 2018 and November 2018. The VA examiner opined that it is less likely than not that the Veteran’s current low back disability is related to his service, to include the documented in-service injuries. The Veteran claims that his arthritis is related injuries he sustained during basic training. As discussed above, the Veteran’s STRs document that he sought medical attention for back pain on several occasions in service. He has also argued that the back pain he suffered in service has continued ever since. The Board finds the medical evidence of record, along with the Veteran’s credible report of back injuries during service, the documented in-service injuries in his STRs, as well as his credible assertions that he has had continuous symptoms of back pain since service, are enough to support the claim that the Veteran’s current low back arthritis is etiologically related to his injuries in service. For these reasons, and resolving reasonable doubt in the Veteran’s favor, the Board finds that the Veteran’s low back arthritis is related to his active duty service and the criteria for service connection for a low back disability have been met. 38 U.S.C. § 5107; 38 C.F.R. § 3.102. H. SEESEL Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board A. Boal, Associate Counsel 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.