Citation Nr: 21000209 Decision Date: 01/04/21 Archive Date: 01/04/21 DOCKET NO. 09-07 743 DATE: January 4, 2021 ORDER Entitlement to a cervical spine disorder, to include as secondary to a service-connected thoracic spine disorder, is denied. FINDING OF FACT A cervical spine disorder is not related to service, or to a service-connected disorder. CONCLUSION OF LAW The criteria for service connection for a cervical spine disorder are not met. 38 U.S.C. §§ 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.310. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from April 1988 to March 1990. In March 2020, the Board remanded the issue in order to obtain an addendum opinion to a September 2019 examination. The requested development was completed, and the issue is ready for adjudication. Service Connection for a Cervical Spine Disorder is Denied The Veteran contends that he has a cervical spine disorder due to heavy lifting during service. Alternatively, the Veteran contends that he has a cervical spine disorder which is a result of, or which was aggravated by his service-connected thoracic spine disorder. Service connection may be granted for disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. § 3.303. The three-element test for service connection requires evidence of: (1) a current disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the current disability and the in-service disease or injury. Shedden v. Principi, 381 F.3d 1163, 1166 -67 (Fed. Cir. 2004). Service connection may additionally be granted for a disability that is proximately due to, or aggravated by, service-connected disease or injury. 38 C.F.R. § 3.310. The question for the Board is whether the Veteran has a current disability that began during service or is at least as likely as not related to an in-service injury, event, or disease, or due to or aggravated by the Veteran’s service-connected thoracic spine disorder. The Board concludes that, while the evidence demonstrates cervical spine disordersTHO, the preponderance of the evidence is against finding that it is related to service or to a service-connected disability. The evidence of record includes the Veteran’s service treatment notes which include a March 1987 complaint of lower thoracic pain, there was no acute bone injury and there were no significant arthritic changes present. Service treatment notes also include a March 1988 complaint of back pain, a diagnosis of myositis, right rhomboid muscle was provided. In his February 1990 report of medical history for separation, the Veteran reported that he had recurrent back pain, it was noted that the Veteran had recurrent low back pain with no trauma. Service treatment records are silent as to a cervical spine disability. An October 1990 VA examination noted no spine diagnosis or complaints. The Veteran submitted a claim for service connection for back pain from his cervical spine down to his lumbar spine in May 1991. The Veteran was afforded a VA examination of the spine in March 2007, however the VA examiner noted that the claims file was unavailable for review. The examiner noted that the Veteran had pain in the cervical, thoracic and lumbar spine for more than ten years ago unrelated to any trauma but attributed to his military service. X-rays were found to find mild degenerative disc disease at the C5-C7 vertebra. A June 2008 private treatment note reported findings of minimal mid-cervical degenerative changes and some osteopenia. In a December 2009 letter, the Veteran’s former employer, J.R., stated that the Veteran was employed by him in 1990 for a year and a half and that the Veteran’s performance was poor due in part to lower lumbar pain due to vertebral dislocations. The Veteran testified before a decision review officer in February 2010. During his hearing, the Veteran testified that he had to lift thirty to forty pounds at a time in service, picking up parts of planes to a maintenance area and that his cervical spine problem began during service. In a March 2011 finding, the Social Security Administration determined that the Veteran was unable to work due to the severe impairments of degenerative lumbar disc disease, hearing loss and depression. In his application for Social Security disability, the Veteran reported working as a mail clerk between 1995 and 2005 which he described requiring that he frequently lifted boxes weight fifty pounds. In a September 2015 letter from the Veteran’s VA doctor, Dr. J.L. it was noted that the Veteran was under her care including chronic back pain and that the Veteran had back pain since she met him in 2009 and that she could not determine from the available medical record when this condition began. At a February 2018 hearing, the Veteran reported that he believed he was diagnosed with developing arthritis of the cervical spine when he was x-rayed in service in 1987. The Veteran was afforded a VA examination in September 2019 for his cervical spine. The Veteran’s claims file was reviewed. The Veteran explained during his examination that he had a history of cervical pain and that during service he was exposed to heavy weight handing activity as part of his military tasks. Following examination, the examiner found that the Veteran’s cervical spine disorder was less likely than not related to service. The examiner explained that the Veteran’s cervical spine condition seen on evaluation correlated with the classic normal atraumatic degenerative changes that occurred as part of aging. The examiner further noted that the Veteran’s records were silent as to cervical degenerative spondylosis and discogenic disease during service and for several years thereafter. In September 2020, an addendum opinion from the September 2019 VA examiner was received. The VA examiner noted that the Veteran’s service treatment records did not demonstrate any cervical region injury, cervical complaints or condition during service or years thereafter. It was noted that degenerative changes were documented in the Veteran’s neck more than 15 years after the Veteran’s active duty service, that they were atraumatic and at least as likely as not attributed to or due to his natural aging process and the passage of time. The examiner further noted that the Veteran was service connected for thoracolumbar strain and that medical literature did not demonstrate that thoracolumbar strain lead to or caused degenerative changes in the cervical spine or cervical discs. The examiner stated that the Veteran’s cervical spine disability was less likely as not aggravated beyond its natural progression by his service-connected thoracolumbar condition and that the Veteran’s cervical spine degenerative changes were unremarkable degenerative changes routinely seen in aging adults. The Board finds that the preponderance of the evidence weighs against the Veteran’s claim for service connection. In so finding, the Board notes that the Veteran may sincerely believe that his cervical spine disorder is due to service. However, the evidence against his claim, findings that x-rays did not show a cervical spine disability in service, that lower back, but not cervical spine, complaints are shown in service and post-service findings that the Veteran’s cervical spine disorder is consistent with aging is most probative. Further, while the Veteran reported pain in the whole of his spine in May 1991, a cervical spine disorder is not shown until years later and the Veteran is shown by his 1990 employer, J.R. to have less functional ability due to lumbar spine complaints. (Continued on the next page)   While the Veteran may earnestly believe that his cervical spine condition is related to his service or to his service-connected thoracic spine disorder, in this case the Veteran is not competent to provide a nexus opinion regarding this issue. The issue is medically complex, as it requires knowledge of the interaction between anatomical relationships. Therefore, it is outside the competence of the Veteran in this case because the record does not show that he has the medical training or credentials to make such a determination. Jandreau v. Nicholson, 492 F.3d 1372, 1377 n.4 (Fed. Cir. 2007); see also Kahana v. Shinseki, 24. Vet. App. 428 (2011). Consequently, the Board gives more probative weight to the findings of the VA examiner, finding that the Veteran’s cervical spine disorder is neither related to service nor to a service-connected disability but is instead consistent with aging. Accordingly, service connection is denied. KELLI A. KORDICH Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board G. Slovick, 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.