Citation Nr: 20004033 Decision Date: 01/16/20 Archive Date: 01/16/20 DOCKET NO. 16-30 591 DATE: January 16, 2020 ORDER Service connection for a chronic lumbar spine disorder is denied. Service connection for a chronic cervical spine disorder is denied. Service connection for a chronic right shoulder disorder is denied. Service connection for a chronic left knee disorder is denied. Service connection for a chronic right knee disorder is denied. FINDINGS OF FACT 1. A chronic lumbar spine disability or a chronic cervical spine disorder was not shown in service, lumbar spine arthritis or cervical spine arthritis was not diagnosed within one year of service discharge, and the weight of the evidence fails to establish that any current lumbar spine disorder or cervical spine disorder is etiologically related to the Veteran’s active service. 2. The weight of the evidence is against a finding that any right shoulder disorder, left knee disorder, or right knee disorder is due to or the result of the Veteran’s active service. CONCLUSIONS OF LAW 1. The criteria for service connection for a chronic lumbar spine disorder have not been met. 38 U.S.C. § 1131; 38 C.F.R. § 3.303. 2. The criteria for service connection for a chronic cervical spine disorder have not been met. 38 U.S.C. § 1131; 38 C.F.R. § 3.303. 3. The criteria for service connection for a chronic right shoulder disorder have not been met. 38 U.S.C. § 1131; 38 C.F.R. § 3.303. 4. The criteria for service connection for a chronic left knee disorder have not been met. 38 U.S.C. § 1131; 38 C.F.R. § 3.303. 5. The criteria for service connection for a chronic right knee disorder have not been met. 38 U.S.C. § 1131; 38 C.F.R. § 3.303. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran had active service from June 1979 to February 1986. In June 2016, the Veteran requested a Board hearing. In July 2019, the Veteran received notification that a hearing was scheduled for September 10, 2019, but he did not appear at the hearing and did not explain his absence. As such, the Veteran’s hearing request is considered to have been withdrawn. See 38 C.F.R. § 20.704. Service Connection Service connection will be granted if the evidence demonstrates that a current disability resulted from an injury or disease incurred in or aggravated by active military service. 38 U.S.C. § 1131; 38 C.F.R. § 3.303. Service connection requires competent evidence showing: (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). Service connection may also be established under 38 C.F.R. § 3.303(b), where a condition in service is noted but is not, in fact, chronic, or where a diagnosis of chronicity may be legitimately questioned. The continuity of symptomatology provision of 38 C.F.R. § 3.303(b) has been interpreted as an alternative to service connection only for the specific chronic diseases listed in 38 C.F.R. § 3.309(a). See Walker v. Shinseki, 718 F.3d 1331 (Fed. Cir. 2013). Service connection may also be established with certain chronic diseases based upon a legal presumption by showing that the disorder manifested itself to a degree of 10 percent disabling or more within one year from the date of separation from service. 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. 38 U.S.C. §§ 1101, 1112, 1113, 1137; 38 C.F.R. §§ 3.307, 3.309(a). While the disease need not be diagnosed within the presumption period, it must be shown, by acceptable lay or medical evidence, that there were characteristic manifestations of the disease to the required degree during that time. Lumbar Spine Disorder and Cervical Spine Disorder The Veteran filed service connection claims for a lumbar spine disorder and a cervical spine disorder, which were denied by a May 2015 rating decision. He asserts that his lumbar spine disorder and cervical spine disorder are due to his active service. The Veteran’s STRs show he started reporting having neck pain in July 1979 and was diagnosed with muscle stress. He reported having back pain in October 1982 and was diagnosed with a muscle spasm. He reported having back pain in November 1983 and had a normal physical examination. At physicals in March 1979 and June 1983, he had normal examinations of his spine. At his November 1985 separation physical, he continued to have a normal examination of his spine, and he reported that he was in good health. The Veteran’s reserve STRs show that in December 1987, more than a year after his separation from active service, he once again had a normal examination of his spine. As such, the Veteran’s STRs do not show that he was diagnosed with any chronic lumbar spine disorder or chronic cervical spine disorder during his active service or within one year of separation from active service. The Veteran’s medical records show that the first evidence of lumbar spine and cervical spine complaints was after he experienced a motor vehicle accident and started treating for back and neck pain in May 2003, over 17 years after his separation from active service. September 2003 MRIs of the lumbar spine and cervical spine showed herniated discs. In April 2015, the Veteran was afforded a VA examination. He reported that his back and neck symptoms began in 1983 and had worsened. After reviewing the Veteran’s claims file, interviewing the Veteran, and conducting an examination, the examiner opined that the Veteran’s lumbar spine disorder and cervical spine disorder were less likely than not incurred in or caused by the Veteran’s active service. The examiner reported that there was documentation of back and neck pain during the Veteran’s active service but the medical records from the 2003 motor vehicle accident did not indicate aggravation of a preexisting back or neck injury. The Veteran has not submitted any medical evidence supporting his assertion that his lumbar spine disorder and cervical spine disorder were due to or the result of his active service. VA obtained a medical opinion in an effort to support the Veteran in establishing his claims. The VA examiner opined that it was less likely than not that the Veteran’s lumbar spine disorder and cervical spine disorder were due to his active service, to include his complaints of back and neck pain during his active service. Moreover, this medical opinion was accompanied by a detailed explanation of how the examiner reached the conclusion, and specifically noted that medical records from the 2003 motor vehicle accident did not indicate aggravation of a preexisting back or neck injury that occurred during the Veteran’s active service. This opinion has not been called into question or undermined by any competent evidence. Therefore, after weighing all the evidence, the Board finds the greatest probative value in the VA examiner’s opinion, but also notes that the entirety of the medical evidence weighs against the conclusion that the Veteran’s lumbar spine disorder or cervical spine disorder either began during or was otherwise caused by his active service. Thus, the evidence fails to establish service connection for any lumbar spine disorder or cervical spine disorder. Consideration has been given to the Veteran’s assertions that his lumbar spine disorder and cervical spine disorder are the result of his active service. He is clearly competent to report symptoms of back and neck pain as well as injury. See Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007). However, while the Veteran may describe back and neck pain, he lacks the medical training or qualification to either diagnose a chronic lumbar spine disability or chronic cervical spine disability or opine as to its etiology. Id. His opinion therefore cannot provide the requisite nexus and does not refute the medical opinion of record. The record does not contain evidence of a diagnosis of an ongoing chronic lumbar spine disability or chronic cervical spine disability related to his active service, as the first evidence of any lumbar spine or cervical spine complaints do not appear until the Veteran experienced the May 2003 motor vehicle accident, over 17 years after his separation from active service. Furthermore, his separation physical did not document any lumbar spine or cervical spine disability at that time, and the Veteran reported he was in good health. Furthermore, the Veteran’s reserve STRs show that at a physical in December 1987, more than a year after his separation from active service, he continued to have a normal examination of his spine. As such, the Board does not find that the evidence of record shows continuous lumbar spine or cervical spine symptomatology. The Board also notes that the Veteran is not entitled to presumptive service connection for a lumbar spine disorder or a cervical spine disorder. The record contains no objective medical evidence of a chronic lumbar spine disorder and a chronic cervical spine disorder until the September 2003 MRIs, again over 17 years after his separation from active service. In addition, the record does not contain evidence that any back or neck injury in service resulted in a diagnosis of arthritis within one year of separation from the service. Therefore, the presumption of service connection has not been triggered. Consideration has also been given to the Veteran’s assertions that his lumbar spine disorder and cervical spine disorder were the result of his active service. He again is noted to be competent to report his own symptoms or matters within his personal knowledge. However, the Veteran was found to have normal examination of his spine at his November 1985 separation physical and again at a December 1987 reserve service physical, which serves to sever any continuity from service. Accordingly, the criteria for service connection have not been met for a chronic lumbar spine disorder or a chronic cervical spine disorder. That is, the evidence does not show that a chronic lumbar spine disorder or a chronic cervical spine disorder was diagnosed in service or within a year of service, and the weight of the evidence is against a finding that a chronic lumbar spine disorder or a chronic cervical spine disorder has existed continuously since service. Therefore, the claims are denied. Right Shoulder Disorder and Bilateral Knee Disorder The Veteran filed service connection claims for a right shoulder disorder, a left knee disorder, and a right knee disorder, which were denied in a May 2015 rating decision. He asserts that his right shoulder disorder and bilateral knee disorder are due to his active service. The Veteran’s STRs do not show any symptoms, complaints, or treatment for a right shoulder or bilateral knee disorder during his active service. He had normal physical examinations of his upper and lower extremities in March 1979 and June 1983. At his November 1985 separation physical, he continued to have a normal examination of his upper and lower extremities but for his right thumb, and he reported that he was in good health. The Veteran’s reserve STRs show that in December 1987, more than a year after his separation from active service, he once again had a normal examination of his upper and lower extremities. As such, the Veteran’s STRs do not show that he was diagnosed with any chronic right shoulder disorder or chronic bilateral knee disorder during his active service or within one year of separation from active service. The Veteran’s medical records show that the first evidence of a right shoulder disorder was after he experienced a motor vehicle accident in May 2003. He treated for right shoulder pain after the motor vehicle accident, over 17 years after his separation from active service. The Veteran’s medical records show that the first evidence of a bilateral knee disorder was in September 2004 after he fell. MRIs of his knees showed bilateral quadricep tendon ruptures and he underwent surgery for repair in October 2010, which is over 18 years after his separation from active service. The record does not show any complaints, treatment, or diagnoses of any right shoulder disorder or bilateral knee disorder in service of for many years after his separation from service. His medical records show he started treating for complaints of these condition in 2003, over 17 years after his separation from active service. Finally, there is also no competent medical opinion of record which even suggests that any right shoulder disorder or bilateral knee disorder even might be related to his service. (Continued on the next page)   Consideration has been given to the Veteran’s assertion that his right shoulder disorder and bilateral knee disorder are due to his active service. He is clearly competent to report symptoms of these conditions. See Jandreau, 492 F.3d 1372. However, while the Veteran may describe symptoms, he lacks the medical training or qualification either to diagnose a chronic disorder or to relate it to any in-service event. Id. Accordingly, the criteria for service connection for a chronic right shoulder disorder and a chronic bilateral knee disorder have not been met, and the Veteran’s claims are denied. Thomas H. O'Shay Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board T. Berryman, 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.