Citation Nr: 21005020 Decision Date: 01/28/21 Archive Date: 01/28/21 DOCKET NO. 07-10 808 DATE: January 28, 2021 ORDER Service connection for lumbar strain with intervertebral disc syndrome and degenerative joint disease (back disability) is granted. FINDING OF FACT The preponderance of the evidence supports finding the Veteran’s back disability is aggravated beyond its natural progression by his service-connected left ankle disability. CONCLUSION OF LAW The criteria for service connection for back disability are met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.310. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from November 1968 to August 1970. A December 2012 Board decision, in pertinent part, denied service connection for back condition as secondary to service-connected left ankle disability. The Veteran appealed that decision to the U.S. Court of Appeals for Veterans Claims (Court). In September 2013, the Court issued an order that partially vacated the December 2012 decision and remanded the matter for adjudication consistent with the Joint Motion for Partial Remand (JMPR). A November 2016 Board decision again denied service connection for back disorder, to include as secondary to service-connected left ankle condition. The Veteran appealed that decision to the Court. In June 2019, the Court issued a Memorandum Decision that vacated the November 2016 decision and remanded the matter back to the Board for adjudication consistent with the Memorandum Decision. In January 2020, the Board remanded the claim to obtain an addendum medical opinion. Service connection for back disability The Veteran contends back disability secondary to his service-connected left ankle disability. Specifically, the Veteran contends that his left ankle disability caused altered gait, which caused or aggravated his back disability. Service connection may be granted for a disability or injury incurred in or aggravated by active military service. 38 U.S.C. § 1110; 38 C.F.R. § 3.303. In order to establish service connection for a present disability the claimant must show: (1) the existence of a present disability, (2) an in-service incurrence or aggravation of a disease or injury, and (3) a causal relationship or “nexus” between the present disability and the in-service injury or disease. Shedden v. Principi, 381 F.3d 1163, 1166-67 (Fed. Cir. 2004). Establishing service connection on a secondary basis requires evidence sufficient to show (1) that a current disability exists and (2) that the current disability was either (a) proximately caused by or (b) proximately aggravated by a service-connected disability. See Allen v. Brown, 7 Vet. App. 439, 448 (1995) (en banc). The Board recognizes the Veteran has lumbar strain with intervertebral disc syndrome and degenerative joint disease. See November 2007 MRI and March 2020 VA examination. The Veteran is service connected for left ankle disability. Therefore, the question for the Board is whether the Veteran’s back disability was caused or aggravated beyond its natural progress by his service-connected left ankle disability. The preponderance of the evidence supports finding the Veteran’s back disability was aggravated beyond its natural progression by his service-connected left ankle disability. An August 2020 VA addendum medical opinion found the Veteran’s lumbar disability is at least as likely as not aggravated beyond its natural progression by his left ankle disability. The clinician stated the Veteran has had numerous problems with his left ankle and hindfoot that required braces to prevent ankle flexion and extension. The clinician stated the Veteran has had low back pain for years and his prior treatment visits indicate his ankle pains and low back pains were associated. Specifically, the VA clinician noted an August 2007 visit ordered an MRI of his back and an ankle orthotic device to help control the hindfoot position. The VA clinician noted the Veteran’s complaints of ankle instability and back pain continued into 2017 treatment notes. The Board gives probative weight to the August 2020 VA addendum opinion finding the Veteran’s lumbar disability is as likely as not aggravated beyond its natural progression due to his left ankle disability. The opinion is based on an accurate medical history and provided a clear conclusion and supporting data. Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 304 (2008). The opinion is consistent with treatment records and lay statements showing increased difficulty with left ankle pain, instability and limping, coinciding with the onset of back complaints. See August 2007 and December 2007 VA treatment visits. The Board gives no probative weight to the other medical opinions of record regarding the issue of whether the Veteran’s back disability is as likely as not aggravated by his left ankle disability. The previous medical opinions of record either did not sufficiently address aggravation or did not use the correct aggravation standard. See September 2013 JMPR and June 2019 Memorandum Decision. As the Board finds the preponderance of the evidence shows the Veteran’s back disability is aggravated beyond its natural progression by his service-connected left ankle disability, service connection for back disability is granted. KELLI A. KORDICH Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board T. Winkler, 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.