Citation Nr: 21002332 Decision Date: 01/13/21 Archive Date: 01/13/21 DOCKET NO. 18-37 742 DATE: January 13, 2021 ORDER Entitlement to service connection for a neck disability to include as secondary to a left ankle disability is granted. Entitlement to service connection for a low back disability to include as secondary to a left ankle disability is granted. FINDINGS OF FACT 1. It is at least as likely as not that the Veteran’s chronic musculotendinous strain of the cervical spine was caused by his left ankle lateral collateral ligament sprain to include osteoarthritis and surgical scar. 2. It is at least as likely as not that the Veteran’s chronic musculotendinous strain of the lumbar spine was caused by his left ankle lateral collateral ligament sprain to include osteoarthritis and surgical scar. CONCLUSIONS OF LAW 1. The criteria for service connection chronic musculotendinous strain of the cervical spine to include as secondary to left ankle lateral collateral ligament sprain to include osteoarthritis and surgical scar have been met. 38 U.S.C. §§ 1110, 5107, 38 C.F.R. §§ 3.102, 3.159, 3.303, 3.310. 2. . The criteria for service connection chronic musculotendinous strain of the lumbar spine to include as secondary to left ankle lateral collateral ligament sprain to include osteoarthritis and surgical scar have been met. 38 U.S.C. §§ 1110, 5107, REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty in the United States Army from January 1967 to October 1968. Service Connection Service connection may alternatively be established on a secondary basis for a disability which is proximately due to, or the result of, a service-connected disability. 38 C.F.R. § 3.310 (a). Secondary service connection may also be established for a disorder which is aggravated by a service-connected disability; compensation may be provided for the degree of disability (but only that degree) over and above the degree of disability existing prior to the aggravation. See 38 C.F.R. § 3.310 (b); Allen v. Brown, 8 Vet. App. 374 (1995). In order to prevail on the issue of secondary service connection, the record must show: (1) evidence of a current disability; (2) evidence of a service-connected disability; and (3) medical nexus evidence establishing a connection between the service-connected disability and the current disability. See Wallin v. West, 11 Vet. App. 509, 512 (1998); see also Allen, supra. When there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, the VA shall give the benefit of the doubt to the claimant. 38 U.S.C. § 5107(b). 1. Entitlement to service connection for a neck disability to include as secondary to a left ankle disability At the onset, the Board notes there is no dispute that the Veteran has the current disability of chronic musculotendinous strain of the cervical spine, most recently noted in in April 2017 VA examination. Additionally, there is no dispute that the Veteran is currently service connected for a left ankle lateral collateral ligament sprain to include osteoarthritis and surgical scar per a November 2015 rating decision. The only remaining issue is a nexus between these disabilities. Turning to nexus, the Board finds that the evidence supports the Veteran’s contention that his chronic musculotendinous strain of the cervical spine was caused by his service-connected left ankle lateral collateral ligament sprain to include osteoarthritis and surgical scar. The Veteran has supplied February 2018 and May 2018 private medical opinions from his treating physician which found that his service-connected left ankle lateral collateral ligament sprain caused his chronic musculotendinous strain of the cervical spine. Together these opinions apply valid medical principles and draw sound conclusions with supporting evidence. Furthermore, the Board finds that evidence especially probative given the unique position the Veteran’s private physician is in as a clinical professional that has treated the Veteran over a course of years. He is thus able to provide a more insightful opinion on the nature of the Veteran’s disability. This unique position coupled with the physician’s exhaustive review of the Veteran’s history and medical explanation of how he reached his conclusion bolsters the physician opinion above all others. As the Court of Veterans Claims has held most of the probative value of a medical opinion comes from its reasoning and the Board must be able to conclude that a medical expert has applied valid medical analysis to the significant facts of the particular case in order to reach the conclusion submitted in the medical opinion. See Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 304 (2008). The Board thus considers the Veteran’s physician’s opinions from February and May 2018 together to be the most probative on the matter of the etiology of the Veteran’s chronic musculotendinous strain of the cervical spine disability. Considering the foregoing, the Bord finds that the Veteran’s chronic musculotendinous strain of the cervical spine warrants service connection on a secondary basis. 2. Entitlement to service connection for a low back disability to include as secondary to a left ankle disability At the onset, the Board notes there is no dispute that the Veteran has the current disability of chronic musculotendinous strain of the lumbar spine, most recently noted in in April 2017 VA examination. Additionally, there is no dispute that the Veteran is currently service connected for a left ankle lateral collateral ligament sprain to include osteoarthritis and surgical scar per a November 2015 rating decision. The only remaining issue is a nexus between these disabilities. Turning to nexus, the Board finds that the evidence supports the Veteran’s contention that his chronic musculotendinous strain of the lumbar spine was caused by his service-connected left ankle lateral collateral ligament sprain to include osteoarthritis and surgical scar. The Veteran has supplied February 2018 and May 2018 private medical opinions from his treating physician which found that his service-connected left ankle lateral collateral ligament sprain to include osteoarthritis and surgical scar caused his chronic musculotendinous strain of the lumbar spine. Together these opinions apply valid medical principles and draw sound conclusions with supporting evidence. Furthermore, the Board finds that evidence especially probative given the unique position the Veteran’s private physician is in as a clinical professional that has treated the Veteran over a course of years. He is thus able to provide a more insightful opinion on the nature of the Veteran’s disability. This unique position coupled with the physician’s exhaustive review of the Veteran’s history and medical explanation of how he reached his conclusion bolsters the physician opinion above all others. As the Court of Veterans Claims has held most of the probative value of a medical opinion comes from its reasoning and the Board must be able to conclude that a medical expert has applied valid medical analysis to the significant facts of the particular case in order to reach the conclusion submitted in the medical opinion. See Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 304 (2008). The Board thus considers the Veteran’s physician’s opinions from February and May 2018 together to be the most probative on the matter of the etiology of the Veteran’s chronic musculotendinous strain of the lumbar spine disability. Considering the foregoing, the Bord finds that the Veteran’s chronic musculotendinous strain of the lumbar spine warrants service connection on a secondary basis. GAYLE E. STROMMEN Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board J. Acosta, 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.