Citation Nr: 21000078 Decision Date: 01/04/21 Archive Date: 01/04/21 DOCKET NO. 16-40 169 DATE: January 4, 2021 ORDER Service connection for a right wrist disability is denied. Service connection for a left wrist disability is denied. Service connection for a neck disability is denied. Service connection for a right shoulder disability is denied. Service connection for a back disability is denied. Service connection for a right hip disability is denied. Service connection for a left hip disability is denied. FINDINGS OF FACT 1. The Veteran’s current right wrist disability is unrelated to service, including parachute jumps in service and/or possible right wrist tendonitis in 1963; degenerative arthritis was not manifest in service or to a degree of 10 percent within 1 year of separation. 2. Any current left wrist disability is unrelated to service, including parachute jumps in service. 3. The Veteran’s current neck disability is unrelated to service, including parachute jumps in service; arthritis was not manifest in service or to a degree of 10 percent within 1 year of separation. 4. The Veteran’s current right shoulder disability is unrelated to service, including parachute jumps in service; arthritis was not manifest in service or to a degree of 10 percent within 1 year of separation. 5. The Veteran’s current back disabilities, including lumbar spine degenerative disc disease with right lower extremity radiculopathy, lumbar spine degenerative joint disease, and sacroiliac degenerative joint disease were not manifest in service or to a degree of 10 percent within 1 year of separation and are unrelated to service, including parachute jumps in service. 6. Any current right and left hip disabilities are unrelated to service. CONCLUSIONS OF LAW 1. The criteria for service connection for a right wrist disability have not been met. 38 U.S.C. §§ 1101, 1110, 1131, 1137, 5107; 38 C.F.R. §§ 3.303, 3.307, 3.309. 2. The criteria for service connection for a left wrist disability have not been met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. § 3.303. 3. The criteria for service connection for a neck disability have not been met. 38 U.S.C. §§ 1101, 1110, 1131, 1137, 5107; 38 C.F.R. §§ 3.303, 3.307, 3.309. 4. The criteria for service connection for a right shoulder disability have not been met. 38 U.S.C. §§ 1101, 1110, 1131, 1137, 5107; 38 C.F.R. §§ 3.303, 3.307, 3.309. 5. The criteria for service connection for a back disability have not been met. 38 U.S.C. §§ 1101, 1110, 1131, 1137, 5107; 38 C.F.R. §§ 3.303, 3.307, 3.309. 6. The criteria for service connection for a right hip disability have not been met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. § 3.303. 7. The criteria for service connection for a left hip disability have not been met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. § 3.303. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from March 1963 to January 1974. He served in Vietnam from April 1969 to March 1970. He was awarded the Parachute Badge as well as the Vietnam Campaign Medal w/60 Device as reflected by his DD Form 214 for that period of service. The Board is thankful for all of the Veteran's honorable service. The Board remanded the case in September 2019. At the time, the Board indicated that it appeared that it appeared that the current disability requirement appeared to be satisfied for each of the disabilities in question. On further reflection, this does not appear to be the case, as indicated below. The Veteran appeals for service connection for neck, right shoulder, back, and bilateral hip and wrist disabilities, based on claims filed in January 2014 and an August 2014 rating decision denying the claims. The Board remanded the current appeals to the agency of original jurisdiction in September 2019, and denied other appeals at that time. Service Connection Establishing service connection generally requires medical or, in certain circumstances, lay evidence of: (1) a current disability; (2) an in-service incurrence or aggravation of a disease or injury; and (3) a nexus between the claimed in-service disease or injury and the present disability. See Davidson v. Shinseki, 581 F.3d 1313 (Fed.Cir.2009); Hickson v. West, 12 Vet. App. 247, 253 (1999); Caluza v. Brown, 7 Vet. App. 498, 506 (1995), aff'd per curiam, 78 F.3d 604 (Fed.Cir.1996) (table). Service connection may be awarded on a presumptive basis for certain chronic diseases listed in 38 C.F.R. § 3.309(a) that manifest to a degree of 10 percent within 1 year of service separation or during service and then again at a later date. 38 C.F.R. § 3.303(b); see Walker v. Shinseki, 708 F.3d 1331, 1337 (Fed.Cir.2013). Arthritis is considered to be a chronic disease under 38 C.F.R. § 3.309. Evidence of continuity of symptomatology may be sufficient to invoke this presumption if a claimant demonstrates (1) that a condition was “noted” during service; (2) evidence of postservice continuity of the same symptomatology; and (3) medical or, in certain circumstances, lay evidence of a nexus between the present disability and the postservice symptomatology. Barr v. Nicholson, 21 Vet. App. 303, 307 (2007) (citing Savage v. Gober, 10 Vet. App. 488, 496–97(1997)); see 38 C.F.R. § 3.303(b). Service connection for a right wrist disability The Veteran contends generally that his right wrist disability is related to service. Based on the evidence, the Board concludes that service connection is not warranted for the Veteran's current right wrist disability. VA examination reports in 2014 and 2020 diagnosed degenerative arthritis. The preponderance of the evidence is against a finding that this was manifest in service or to a degree of 10 percent within 1 year of separation or that it is related to service, including the Veteran's possible right wrist tendonitis in October 1963 and/or parachute jumps. In addition, continuity of symptomatology is not alleged or shown. Service treatment records show possible tendonitis in 1963. Examinations of the upper extremities were normal on service examinations in February 1965, January 1968, and December 1973, and he denied having pertinent symptomatology on reports of medical history in February 1965 and January 1968. According to the evidence including the 2014 VA examination report, the Veteran could not recall any specific injury to his right wrist. At the time of his hearing, he testified “Yes, I would say so” to the question whether all his disabilities were due to the jump (parachute) injuries. Given the inconsistencies in the Veteran’s statements, the Board finds his statements with respect to whether he sustained an in-service injury to the right wrist lack credibility. The first indication of the Veteran's current right wrist disability was many years after service and the VA examiners in 2014 and 2020 opined that it was less likely than not incurred in or caused by service. The Board acknowledges that the 2015 physician’s use of the term “for sure” called into question whether the proper standard was employed by the examiner with respect to the impact of parachuting, thus reducing the probative value of the opinion with respect to the impact of parachuting. However, the 2015 examiner is not equivocal with respect to the opinion that medical records show only recent complaints and there is no evidence to relate the Veteran’s recent problems to military service over 40 years earlier. The examiner also noted that someone of the Veteran’s age is at least as likely as not prone to develop degenerative changes in the joints as part of the natural aging process. The VA examiner in 2020 opined that it was less likely than not that the Veteran's current right wrist degenerative arthritis was incurred in or is related to service. The opinion provider noted physical examination had been performed, current research had been reviewed, and service medical records had been reviewed. The clinician explained that there was no record of a chronic right wrist condition after the Veteran left service until he claimed his right wrist pain in 2014 and there were no complaints of a wrist condition on discharge physical examination in 1973. Absent a nexus between a current disability and service or manifestations of arthritis within a year of service separation, service connection cannot be granted. Therefore, the claim is denied. Service connection for a left wrist disability Based on the evidence, the Board concludes that service connection is not warranted for any current left wrist disability. None has been diagnosed, including at the times of the VA examinations in 2014, 2015, and 2020. However, resolving any doubt in the Veteran’s favor, the Board finds that the evidence is at least in equipoise that there has been a functional impairment of earning capacity as a result of any current left wrist disability. The preponderance of the evidence is against a finding that any left wrist disability is related to service, including parachute jumps. Service treatment records do not show any left wrist complaint, treatment or diagnosis. The Veteran's left wrist was normal on service examinations in February 1965, January 1968, and December 1973, and he denied having pertinent symptomatology on reports of medical history in February 1965 and January 1968. The Veteran denied any specific in service injury to his left wrist at the times of his VA examination in 2020. At the time of his 2019 hearing, he testified “Yes, I would say so” to the question whether all his disabilities were due to the jump injuries. Given the inconsistencies in the Veteran’s statements, the Board finds his statements with respect to whether he sustained an in-service injury to the left wrist lack credibility. Thus, there is no competent evidence of an in-service event, which is required for service connection. The 2020 VA examiner’s opinion concluded that the Veteran had no injury to the left wrist while serving on active duty or treatment for the left wrist. Absent an in-service event and a nexus between a current disability and service, service connection cannot be granted. Therefore, the claim is denied. Service connection for a neck disability Based on the evidence, the Board concludes that service connection is not warranted for the Veteran's current neck disability. The 2020 VA examination report diagnosed cervical spine degenerative arthritis. Service treatment records show no neck trouble, and the Veteran’s neck/cervical spine was normal on service examinations in February 1965, January 1968, and December 1973, and he denied having pertinent symptomatology on reports of medical history in February 1965 and January 1968. The Veteran’s July 2019 testimony that he thought he was treated for a neck problem at Fort Richardson (Alaska) is not supported by the service treatment records. Such treatment would be expected to be shown, if it occurred, as other treatment is documented. The preponderance of the evidence is against a finding that the cervical spine disability was manifest in service or to a degree of 10 percent within 1 year of separation or that it is otherwise related to service, including parachute jumps. In addition, continuity of symptomatology is not alleged or shown. The Board acknowledges that the 2015 physician’s use of the term “for sure” called into question whether the proper standard was employed by the examiner with respect to the impact of parachuting, thus reducing the probative value of the opinion with respect to the impact of parachuting. However, the 2015 physician is not equivocal with respect to the opinion that medical records show only recent complaints and there is no evidence to relate the Veteran’s recent problems to military service over 40 years earlier. The examiner also noted that someone of the Veteran’s age is at least as likely as not prone to develop degenerative changes in the joints as part of the natural aging process. According to the evidence including the 2014 and 2020 VA examination reports, there are no documented complaints of neck pain until October 2013, and the Veteran had no prior injuries or medical entries related to neck pain in his medical record, and his physical examination from December 1973, prior to his 1974 separation, showed no complaints of neck pain. For this reason, the VA examiner in 2020 opined that the Veteran's current neck disability is less likely than not incurred in or caused by service. The opinion provider noted physical examination had been performed, current research had been reviewed, and service medical records had been reviewed. Absent a nexus between a current disability and service or manifestations of arthritis in service or within a year of discharge, service connection cannot be granted. Therefore, the claim is denied. Service connection for a right shoulder disability Based on the evidence, the Board concludes that service connection is not warranted for the Veteran's current right shoulder disability. A 2015 VA examination report diagnosed osteoarthritis. The preponderance of the evidence is against a finding that arthritis was manifest in service or to a degree of 10 percent within 1 year of separation or that it is unrelated to service, including parachute jumps. In addition, continuity of symptomatology is not alleged or shown. Service treatment records show no right shoulder trouble, and the Veteran's right shoulder was normal on service examinations in February 1965, January 1968, and December 1973, and he denied having pertinent symptomatology on reports of medical history in February 1965 and January 1968. According to the evidence including the 2015 and 2020 VA examination reports, there are no documented complaints of right shoulder pain until many years after service. Furthermore, there is no documentation of a service related injury to the Veteran's right shoulder in his service treatment records and no complaints of a right shoulder condition on service examination in December 1973. For these reasons, the VA examiner in 2020 opined that it is less likely than not that the Veteran's current right shoulder disability was incurred in or caused by service. The Board acknowledges that the 2015 physician’s use of the term “for sure” called into question whether the proper standard was employed by the examiner with respect to the impact of parachuting, thus reducing the probative value of the opinion with respect to the impact of parachuting. However, the 2015 clinician is not equivocal with respect to the opinion that medical records show only recent complaints and there is no evidence to relate the Veteran’s recent problems to military service over 40 years earlier. The examiner also noted that someone of the Veteran’s age is at least as likely as not prone to develop degenerative changes in the joints as part of the natural aging process. Also, the VA clinician in 2015 noted that while parachuting activity could cause shoulder degenerative problems due to pulling and holding onto the parachute, only the Veteran's right arm is affected by arthritis, and he would have at least as likely as not used both arms equally during service parachute jumps. And the Board notes that contemporaneous service examinations and reports of medical history were normal, with no evidence of the current osteoarthritis until many years after service. The Veteran also reported in May 2015 that bad landing falls are what caused him pain in his right shoulder, but he is not competent, as a layperson, to indicate the cause of his current right shoulder disability, as this is a complex medical matter for which medical training is required. See Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007). Absent a nexus between a current disability and service or manifestations of arthritis in service or within a year of discharge, service connection cannot be granted. Therefore, the claim is denied. Service connection for a back disability Based on the evidence, the Board concludes that service connection is not warranted for the Veteran's current back disability. VA examination reports in 2015 and 2020 diagnosed multilevel degenerative disc disease, facet degenerative joint disease, severe neuroforaminal narrowing, and sacroiliac degenerative joint disease. The preponderance of the evidence is against a finding that the low back disability was manifest in service or, for arthritis, to a degree of 10 percent within 1 year of separation, or that it is related to service, including parachute jumps. Service treatment records show no back trouble, and the Veteran's back was normal on service examinations in February 1965, January 1968, and December 1973, and he denied having pertinent symptomatology on reports of medical history in February 1965 and January 1968. These contemporaneous records are inconsistent with the Veteran's reports, at the time of a VA hip examination in September 2015, of chronic “hip” (shown to be low back) pain since 1969. As a result, the Veteran’s statements as to continuity lack credibility. The Veteran’s statement of chronic back pain since 1969 is not probative, but instead is largely contradicted by the service treatment records, including the December 1973 service examination report, which contemporaneously shows that his low back was normal at that time. The first indication of the Veteran's current back disabilities was many years after service and the VA examiners, including in 2020, opined that they were less likely than not incurred in or caused by service. The VA examiner in 2020 reviewed the service treatment records and current research and considered the Veteran's medical history and noted that there are no documented complaints of low back pain until October 2013, that the Veteran had no prior injuries or medical entries related to back pain in his medical records, and that his discharge physical examination from December 1973 showed no complaints of back pain. And the Board notes that other service examinations and reports of medical history were normal, and there is no probative evidence of the current back disabilities until many years after service. The Veteran reported in May 2015 that bad landing falls are what caused him pain in his lower back, but he is not competent, as a layperson, of indicating the cause of his current back disabilities. Medical training is required to opine on this complex medical matter. See Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007). Service connection for right and left hip disabilities Based on the evidence, the Board concludes that service connection is not warranted for any current right or left hip disability. The 2014, 2015, and 2020 VA examination reports indicate that the Veteran does not have a current hip disability. The VA examiner in 2014 examined the Veteran and found that he had never had a hip condition. At the time, the Veteran endorsed pain in his right upper buttocks and/or iliac region, and in his low back, going down his right leg, when demonstrating what he intended to claim as hip disability, and confirmed that he did not have a condition on the left. The VA examiner indicated that what the Veteran described as his right hip is actually his back, anatomically, pathologically, and for VA examination purposes, and noted that the Veteran confirmed that he did not have such a condition on the left. The VA examiner in 2015 examined the Veteran for hip disability and did not diagnose any. Instead, right and left sacroiliac joint degenerative joint disease were diagnosed at that time. The VA examiner in 2020 examined the Veteran's hips and noted that they had a full range of motion and that the Veteran had been diagnosed with sacroiliac (back, but close to the hips) degenerative joint disease. The VA examiner indicated that there was no diagnosis of a hip disorder. The VA examiner in 2014 did also, noting that internal and external rotation and flexion of the Veteran's hips were normal, without objective pain. Thus, it would appear that the Veteran's complaints of right “hip” area pain actually pertain to sacroiliac degenerative joint disease which has been addressed in the discussion regarding his back appeal above. However, resolving any doubt in the Veteran’s favor, the Board finds that the evidence is at least in equipoise that there has been a functional impairment of earning capacity as a result of any current bilateral hip disability. The preponderance of the evidence is against a finding that any hip disability is related to service, including parachute jumps. There is no indication that any current right or left hip disorder was manifest in service or is related to service. Service treatment records show no hip trouble, other than a superficial soft tissue infection near a hip that was cleaned and dressed in August 1965, the Veteran's hips were normal on service examinations in February 1965, January 1968, and December 1973, and he denied having pertinent symptomatology on reports of medical history in February 1965 and January 1968. The first indication in the records of any chronic hips problem was many years after service and the VA examiner in 2020 opined that the claimed condition was less likely than not incurred in or caused by service. Further, there is no evidence of any hip disabilities until many years after service. The Board has considered the Veteran’s statement in May 2015 that all parts of his body were shaken when he landed from parachute jumps. He also indicated in May 2015 that parts of his body might have been broken as a result of the parachute jumps, without him knowing it. The Veteran also reported in May 2015 that bad landing falls caused his current disabilities, and he provided similar testimony during his hearing before the undersigned in July 2019. However, he is not competent, as a layperson, to opine on causation of the medical disabilities at issue. These are complex matters for which medical training is required. See Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007).   As the preponderance of the evidence is against the claims, there is no reasonable doubt to be resolved in the Veteran's favor. 38 U.S.C. § 5107; Gilbert v. Derwinski, 1 Vet. App. 49, 55 (1991). M. C. GRAHAM Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board C. Lawson 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.