Citation Nr: 20036634 Decision Date: 05/28/20 Archive Date: 05/28/20 DOCKET NO. 18-34 249 DATE: May 28, 2020 ORDER Entitlement to service connection for right lower extremity peripheral neuropathy is granted. Entitlement to service connection for left lower extremity peripheral neuropathy is granted. Entitlement to service connection for a bladder disability, diagnosed as urinary incontinence, is granted. Entitlement to service connection for a bowel disability, diagnosed as impairment of rectal sphincter control, is granted. FINDINGS OF FACT 1. The Veteran’s right lower extremity peripheral neuropathy is aggravated beyond its natural progression by his service-connected T-6 compression fracture with deformities and kyphosis. 2. The Veteran’s left lower extremity peripheral neuropathy is aggravated beyond its natural progression by his service-connected T-6 compression fracture with deformities and kyphosis. 3. The Veteran’s urinary incontinence is aggravated beyond its natural progression by his service-connected T-6 compression fracture with deformities and kyphosis. 4. The Veteran’s impairment of rectal sphincter control is aggravated beyond its natural progression by his service-connected T-6 compression fracture with deformities and kyphosis. CONCLUSIONS OF LAW 1. The criteria to establish service connection for right lower extremity peripheral neuropathy have been met. 38 U.S.C. §§ 1110, 5103, 5103A, 5107; 38 C.F.R. §§ 3.102, 3.159, 3.303, 3.310. 2. The criteria to establish service connection for left lower extremity peripheral neuropathy have been met. 38 U.S.C. §§ 1110, 5103, 5103A, 5107; 38 C.F.R. §§ 3.102, 3.159, 3.303, 3.310. 3. The criteria to establish service connection for a bladder disability, diagnosed as urinary incontinence, have been met. 38 U.S.C. §§ 1110, 5103, 5103A, 5107; 38 C.F.R. §§ 3.102, 3.159, 3.303, 3.310. 4. The criteria to establish service connection for a bowel disability, diagnosed as impairment of rectal sphincter control, have been met. 38 U.S.C. §§ 1110, 5103, 5103A, 5107; 38 C.F.R. §§ 3.102, 3.159, 3.303, 3.310. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from June 2000 to August 2001. He appeals a July 2017 rating decision by the Agency of Original Jurisdiction (AOJ) denying service connection for bilateral lower extremity neuropathy, loss of use of bowel and loss of use of bladder. A Board hearing was held in April 2020. A transcript is of record. Service Connection A Veteran is entitled to VA disability compensation if there is a disability resulting from personal injury suffered or disease contracted in the line of duty in active service, or for aggravation of a preexisting injury suffered or disease contracted in the line of duty in active service. 38 U.S.C. § 1110. Generally, to establish a right to compensation for a present disability, a Veteran must show: (1) a present disability; (2) an 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, the so-called “nexus” requirement. Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004). Service connection may be granted for any disease diagnosed after discharge, when all of the evidence, including that pertinent to service, establishes that a disease was incurred in service. 38 C.F.R. § 3.303(d). Under section 3.310(a) of VA regulations, service connection may be established on a secondary basis for a disability which is proximately due to or the result of service-connected disease or injury. 38 C.F.R. § 3.310(a). Establishing service connection on a secondary basis requires evidence sufficient to show: (1) a current disability; (2) a service-connected disability; and (3) a nexus between the current disability and the service-connected disability. See Wallin v. West, 11 Vet. App. 509, 512 (1988). As to the third Wallin element, the current disability may be either (a) proximately caused by or (b) proximately aggravated by a service-connected disability. Allen v. Brown, 7 Vet. App. 439, 448 (1995) (en banc). The Veteran has bilateral lower extremity peripheral neuropathy, urinary incontinence, and impairment of rectal sphincter control. See May 2017 VA examination report. He is also service connected for multilevel wedge compression T6 fracture with deformities and kyphosis. Accordingly, the first and second Wallin elements are met. A VA examiner, after determining the baseline level of severity, found the current severity of the Veteran’s bowel, bladder, and lower extremity disabilities were at least as likely as not aggravated beyond their natural progression by the Veteran’s service-connected back disability. See May 2017 VA examination report. He unequivocally reasoned that the Veteran’s service-connected back disability “predisposed” the Veteran to a MRSA infection which likely aggravated his previously non-existent but “now present” bladder and bowel dysfunction as well as bilateral lower extremity peripheral neuropathy “beyond any natural course that was to be expected.” Id. Thus, the May 2017 VA examiner’s opinions provided a link between the Veteran’s service-connected back disability, bilateral lower extremity peripheral neuropathy, urinary incontinence, and impairment of rectal sphincter control. Accordingly, service connection for bilateral lower extremity peripheral neuropathy, urinary incontinence, and impairment of rectal sphincter control is granted. DONNIE R. HACHEY Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board M. Salazar, 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.