Citation Nr: 21000606 Decision Date: 01/05/21 Archive Date: 01/05/21 DOCKET NO. 15-43 752 DATE: January 5, 2021 ORDER Entitlement to service connection for a back disorder (previously claimed as a tailbone injury) is denied. FINDING OF FACT The Veteran’s back disorder is not related to service. CONCLUSION OF LAW The criteria for entitlement to service connection for a back disorder have not been met. 38 U.S.C. §§ 1131, 5107(b); 38 C.F.R. §§ 3.102, 3.159, 3.303. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served active duty service from September 1978 to March 1979. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a March 2013 rating decision by the Department of Veteran Affairs (VA) Regional Office (RO). In the July 2020 Board remand, the RO was requested to provide a supplemental medical opinion addressing the Veteran’s in-service back injury. In August 2020, an adequate medical opinion was provided addressing the in-service back injury. The examiner addressed the in-service motor vehicle accident and provided a rationale for her opinion. Therefore, there has been substantial compliance with the Board’s remand directives. See Stegall v. West, 11 Vet. App. 268 (1998); Dyment v. West, 13 Vet. App. 141, 146-47 (1999). Neither the Veteran nor his representative have raised any issues with the duty to notify or duty to assist. See Scott v. McDonald, 789 F.3d 1375, 1381 (Fed. Cir. 2015) (holding that “the Board’s obligation to read filings in a liberal manner does not require the Board... to search the record and address procedural arguments when the veteran fails to raise them before the Board.”); Dickens v. McDonald, 814 F.3d 1359, 1361 (Fed. Cir. 2016) (applying Scott to a duty to assist argument). Entitlement to service connection for a back disorder is denied. The Veteran contends his back disorder is related to service. In particular, he has consistently stated that during service an unusual, softball size bump protruded out of his spine after hitting a major road bump while riding in a steel flatbed truck. Additionally, the Veteran’s wife has consistently stated she remembers the Veteran calling her about the back injury, and she did not know how bad it was until he returned home. She described his lower back as badly bruised, purple, and the bump was really big. Also, she stated that he grimaced a lot and complained when he sat down. 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 service. 38 U.S.C. § 1110; 38 C.F.R. § 3.303. Service may also be granted for any disease diagnosed after discharge, when all evidence, including that pertinent to service, establishes that the disease was incurred in-service. 38 C.F.R. § 3.303(d). Establishing service connection generally requires competent evidence of three things: (1) current disability; (2) in-service disease or injury; and (3) a causal relationship between the current disability and the in-service disease or injury. Saunders v. Wilkie, 886 F.3d 1356, 1361 (Fed. Cir. 2018). Consistent with this framework, service connection is warranted for a disease first diagnosed after discharge when all of the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303 (d). A veteran is entitled to the benefit of the doubt, standard of proof for benefit claim decisions. 38 U.S.C. § 5107(b). The benefit of the doubt is applicable when there is an approximate balance of positive and negative evidence. 38 C.F.R. § 3.102. When a veteran seeks benefits and the evidence is in relative equipoise, the veteran prevails. Gilbert v. Derwinski, 1 Vet. App. 49, 53 (1990). The preponderance of the evidence must be against the claim for benefits to be denied. Alemany v. Brown, 9 Vet. App. 518, 519 (1996). In the November 2015 VA treatment record, degenerative changes in the posterior facet of lower LS-spine were noted. Additionally, in the October 2020 private treatment record, Dr. B.D. determined the Veteran has subluxations of the lower lumbar vertebral complicated by degenerative changes to the lower lumbar discs. Therefore, the Veteran has a current back disability. The Veteran was provided two VA medical opinions. First, in the November 2019 VA medical opinion, the VA examiner opined that the Veteran’s back disorder is less likely than not incurred in or caused by the claimed in-service injury, event, or illness. The VA examiner reasoned that given a 40 year interval from the examination and the Veteran’s separation, denial of any recurrent back pain at separation, and lack of documentation of the back pain in his military record; he could not establish a relationship between the back disorder and service. This opinion is afforded less probative weight because the lay assertions were not considered. Second, in the August 2020 VA medical opinion, the VA examiner opined that the Veteran’s back disorder is less likely than not incurred in or caused by the claimed in-service injury, event, or illness. The VA examiner referenced that the 2013 report, more than 20 years post-service, indicates a tailbone injury. However, the 2015 x-rays do not show any old fracture, trauma, or traumatic arthritis to the coccyx or lower back. The VA examiner reasoned that that the 2015 images showing lumbar degenerative arthritis changes are consistent with wear and tear and age-related arthritis, not resulting from an in-service military vehicle injury in 1978. Based upon review of the record, the Board finds the Veteran’s back disorder is not related to service. The August 2020 VA medical opinion is probative because it is based upon review of the complete record, including statements about the in-service injury. Also, a sufficient rationale was provided for the negative etiology of the Veteran’s back disorder. Less probative weight is given to the November 2019 VA medical opinion because it was primarily based upon no documentation of an in-service back injury and did not address the Veteran’s lay statements. The Board has considered the Veteran’s and his wife’s statements that his back disorder is due to service. They are competent to report symptoms such as bumps and pain, and their descriptions are credible. However, they are not competent to provide an opinion as to the etiology of his back disorder. This question involves inquiry into internal processes and anatomical relationships that are not readily observable and are not within the competent of the Veteran and his wife in this case, because they have not been shown to have the skills, experience, or medical training to make such a complex determination. See Layno v. Brown, 6 Vet. App. 465, 470 (1994); Jandreau v. Nicholson, 492 F.3d 1372, 1377 (Fed. Cr. 2007). Therefore, the Board assigns low probative weight to these lay statements. (Continued on the next page)   Given that the preponderance of the evidence is unfavorable to the claim, VA’s benefit-of-the-doubt doctrine is not for application. 38 U.S.C. § 5107(b); 38 C.F.R. § 4.1. Accordingly, the Board finds the preponderance of the evidence is against the claim and service connection is denied. D. Martz Ames Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board L. Willoughby, 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.