Citation Nr: 20006401 Decision Date: 01/28/20 Archive Date: 01/27/20 DOCKET NO. 17-00 568 DATE: January 28, 2020 ORDER Entitlement to service connection for a back disorder, diagnosed as sclerotic lesions in lumbar vertebrae, iliac wings, and sacrum, with arthritis is granted. FINDING OF FACT The competent evidence of record is in equipoise as to whether the Veteran’s current back disorder, diagnosed as sclerotic lesions in lumbar vertebrae, iliac wings, and sacrum, with arthritis began during active service or is otherwise related to an in-service injury or disease. CONCLUSION OF LAW The criteria for service connection for a back disorder, diagnosed as sclerotic lesions in lumbar vertebrae, iliac wings, and sacrum, with arthritis have been met. 38 U.S.C. §§ 1110, 1111, 5107; 38 C.F.R. §§ 3.102, 3.303. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran had active service from March 1998 to October 2002. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a September 2015 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO) Newnan, Georgia. In November 2019, the Veteran testified at a Board hearing conducted by the undersigned Veterans Law Judge. A transcript of the hearing has been associated with the Veteran’s VA claims file. Although the Veteran testified to having received a laceration to his head and medical evidence discusses issues with his cervical spine, the claim on appeal is limited to entitlement to service connection for a back disorder. 1. Entitlement to service connection for a back disorder, diagnosed as sclerotic lesions in lumbar vertebrae, iliac wings, and sacrum, with arthritis. In this case, the Veteran contends he is entitled to service connection for sclerotic lesions in lumbar vertebrae, iliac wings, and sacrum, claimed as a back disorder. In order to establish service connection for a claimed disability, the following three elements must be satisfied: (1) the existence of a current disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship (nexus) between the present disability and the disease or injury incurred or aggravated during service. Hickson v. West, 12 Vet. App. 246 (1999). Service connection may be granted for a disability resulting from disease or injury incurred in or aggravated by service. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303. If a condition noted during service is not shown to be chronic, then generally a showing of continuity of symptomatology after service is required for service connection. 38 C.F.R. § 3.303(b), Walker v. Shinseki, 708 F.3d 1331 (Fed. Cir. 2013). Service connection may also be granted for any disease diagnosed after discharge from service when all the evidence, including lay evidence, establishes that the disease was incurred in service. 38 C.F.R. § 3.303(d). Lay statements may serve to support a claim for service connection by supporting the occurrence of lay-observable events or the present of disability or symptoms of disability subject to lay observation. 38 U.S.C. § 1153(a); 38 C.F.R. § 3.303(a); Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007). Although lay persons are considered competent to provide opinions on some medical issues, some medical issues fall outside of the realm of common knowledge of a lay person. Kahana v. Shinseki, 24 Vet. App. 428 (2011). Here, the Veteran was afforded a VA examination in November 2016. The examiner diagnosed the Veteran with non-granulomatous lesions of the iliac crest, lumbar vertebrae, and sacrum. The examiner stated this condition is most likely secondary to sarcoidosis. Additionally, the examiner diagnosed the Veteran with mild degenerative disease of the lumbar spine. Therefore, for purposes of service connection, the Board finds adequate evidence of a current disability. As it pertains to an in-service event or injury, the Veteran contends that this disorder is the result of his military occupational specialty (MOS), as an Inventory Manager for a helicopter squadron. His MOS required him to regularly lift heavy equipment and crawl into small places in order to retrieve various items. In November 2019, the Veteran was afforded a VA hearing conducted by the undersigned Veterans Law Judge. He testified that over the course of his service, and while conducting two tours, he regularly had to lift and maneuver heavy objects and crawl into tight spaces to obtain heavy boxes. In the course of a physical training exercise, he suffered a fall that resulted in injury to his back and a laceration to his head. He stated that prior to entering service he did not sustain any back injuries, nor any injuries during basic training. The Board finds the Veteran competent and credible to discuss the extent of his experiences and symptoms. To collaborate, the Veteran submitted a lay statement from a friend whom he served with aboard the U.S.S. Wasp. The statement, provided by D.D., said the Veteran complained of lower back pain during various activities and the “highest level” of complaints of lower back pain were during the Veteran’s deployment. Therefore, affording the Veteran the benefit of the doubt, given his testimony and the lay statement provided by D.D., the Board finds adequate evidence of an in-service event of injury. With regard to the final element, a nexus, the Board finds the evidence to be in relative equipoise as to whether the Veteran’s current back disorder, diagnosed as sclerotic lesions in lumbar vertebrae, iliac wings, and sacrum, with arthritis began during active service or is otherwise related to an in-service injury or disease. The November 2016 examiner failed to provide an etiological opinion and opine on whether the Veteran’s current lower back disorder was related to the Veteran’s active duty service and his MOS. The examiner stated the etiology for sarcoidosis is unknown and the arthritis is a condition consistent with the advancement of age. The Board finds this opinion to be of little probative value given the lack of an etiological opinion and rationale. In support of the Veteran’s contentions, an opinion from his chiropractor was provided from November 2019. The chiropractor stated, “I am familiar with his history and have examined [the Veteran] often while he has been under my care. . . [i]t is my professional opinion that . . . [the Veteran’s] condition is at least as likely as not due to his military service.” He provided the rationale that, within his experience and in medical literature, it is known that chronic low back pain follows a traumatic injury, and the Veteran has no other known risk factors that may have precipitated his condition. The Board finds this opinion to be of more probative value than the VA opinion. Although the chiropractor provides a limited explanation for his opinion, he does consider the Veteran’s in-service experiences and medical literature to provide that it is at least likely as not related to his military service. The Veteran also credibly testified to continuing symptoms to his back since service. Accordingly, given the conflicting medical opinions, the Board finds the competent evidence of record is at least in equipoise as to whether the Veteran’s current back disorder, diagnosed as sclerotic lesions in lumbar vertebrae, iliac wings, and sacrum, with arthritis began during active service or is otherwise related to an in-service injury or disease, and that entitlement to service connection for such disability is therefore warranted. Michael J. Skaltsounis Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Christopher J. DeBoer, 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.