Citation Nr: 21062028 Decision Date: 10/06/21 Archive Date: 10/06/21 DOCKET NO. 17-37 078 DATE: October 6, 2021 ORDER Entitlement to service connection for lumbar spine disorder is denied. FINDING OF FACT Currently diagnosed degenerative arthritis of the spine did not manifest on active duty service or within the first post-service year, and is not otherwise related to service. CONCLUSION OF LAW A lumbar spine disorder, to include arthritis, was not incurred in or aggravated by service. 38 U.S.C. §§ 1131, 1137, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty in the United States Army from May 1976 to November 1980. This case is before the Board of Veterans' Appeals (Board) on appeal from a November 2015 rating decision of the agency of original jurisdiction (AOJ) of the United States Department of Veterans Affairs (VA) denying entitlement to service connection for lumbar spine disorder. This matter was previously before the Board in August 2019, at which time it was remanded for additional development. Records from the Social Security Administration (SSA) were subsequently associated with the Veteran's record, and a Subsequent Development Letter was sent to the Veteran in November 2019 to identify any outstanding private treatment records. The claim is once again before the Board. Substantial compliance with the Board's prior remand orders is demonstrated. See Dyment v. West, 13 Vet. App. 141, 146-47 (1999); Stegall v. West, 11 Vet. App. 268, 271 (1998). With respect to the Veteran's claims decided herein, VA has met all statutory and regulatory notice and duty-to-assist provisions. See 38 U.S.C. §§ 5100, 5102, 5103, 5103A, 5106, 5107, 5126; 38 C.F.R. §§ 3.102, 3.156(a), 3.159, 3.326. Neither the Veteran nor his representative has advanced any procedural arguments in relation to VA's duty to notify and assist. See Scott v. McDonald, 789 F.3d 1375 (Fed. Cir. 2015) (holding that "absent extraordinary circumstances...we think it is appropriate for the Board and the Veterans Court to address only those procedural arguments specifically raised by the veteran...."). Service connection is awarded for disability that is the result of a disease or injury incurred in or aggravated by active service. 38 U.S.C. §§ 1110, 1131. Service connection requires competent evidence showing: (1) the existence of a present disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the present disability and the disease or injury incurred or aggravated during service. Shedden v. Principi, 381 F. 3d 1163, 1167 (Fed. Cir. 2004). Lay assertions may serve to support a claim for service connection by establishing the occurrence of observable events or the presence of disability or symptoms of disability that are subject to lay observation. 38 U.S.C. § 1153(a); 38 C.F.R. § 3.303(a); Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007); see also Buchanan v. Nicholson, 451 F.3d 1331, 1336 (Fed. Cir. 2006) (addressing lay evidence as potentially competent to support presence of disability even where not corroborated by contemporaneous medical evidence). Some chronic diseases, including arthritis, may be presumed to have been incurred in service, if they become manifest to a degree of ten percent or more within the applicable presumptive period. 38 U.S.C. §§ 1101(3), 1112(a); 38 C.F.R. §§ 3.307(a), 3.309(a). For those listed chronic conditions, a showing of continuity of symptoms affords an alternative route to service connection. 38 C.F.R. § 3.303(b); Walker v. Shinseki, 708 F.3d 1331 (Fed. Cir. 2013). The applicable presumptive period for arthritis is one year from separation. Here, the Veteran's service treatment records (STRs) note treatment in June 1978 for low back pain with a diagnosis of "traumatic muscle spasm." Following frequent treatment of urinary tract infections (UTIs) and low back pain, a December 1978 intravenous pyelogram x-ray of the kidneys showed "phleboliths." A separation physical examination is not of record. An October 1980 examination for confinement, however, noted no complaints from the Veteran and a normal physical examination. He was "fit for stockade duties." The earliest medical evidence of post-service back pain is a February 2011 SSA exam noting limited motion in Veteran's cervical spine. The earliest medical evidence of post-service lumbar spine pain is a June 2013 VA medical record that includes a lumbar spine x-ray showing scattered degenerative changes. In July 2013, the Veteran received physical therapy after reporting a recent injury causing back pain. In his November 2015 Notice of Disagreement (NOD), the Veteran stated that he never received an exit examination from service and that a doctor told him a year after he exited service that he had a "bad back." In his July 2017 Appeal to the Board of Veterans' Appeals, VA Form 9, the Veteran stated that his back pain started soon after being separated from service because he was "overworked." The Veteran has continued receiving medical treatment at VA medical centers for lower back pain and in 2018 was diagnosed with spondylolysis and degenerative arthritis of the spine. In January 2020, the Veteran was afforded a VA contract back examination. The Veteran reported to the examiner that he injured his back in 1981 while working as a mechanic. The examiner noted the Veteran's diagnoses of degenerative arthritis of the spine, spondylolisthesis, and bilateral lumbar radiculopathy. The examiner noted the Veteran's STRs showed one instance of traumatic muscle spasms in 1978. Regarding the "phleboliths" noted in the 1978 x-ray of the kidneys, the examiner explained that phleboliths are vein calcifications and are not clinically significant to the spine. The examiner opined that spondylolysis and degenerative arthritis of the spine are associated with aging and concluded that the Veteran's lumbar spine conditions were not related to the muscle spasms in service. The Veteran asserts there is a nexus between his currently diagnosed back disability and service. However, he has offered no evidence in support of this belief beyond the temporal closeness of currently reported complaints to service. While a lay person is competent to testify about their symptoms, or to report what a doctor has told him, only a medical professional is competent to provide a diagnosis. As a lay person, the Veteran is not competent to render an opinion as to the etiology of his claimed back disability as he is a layperson lacking the necessary training and knowledge to do so. Kahana v. Shinseki, 24 Vet. App. 428, 435 (2011). Additionally, no medical professional has supported his position. The Boards finds the January 2020 opinion that the Veteran's spondylolysis and degenerative arthritis of the spine are associated with aging and not related to the muscle spasms in service is probative and supported by the evidence of record. The first documented indication of lower back pain and diagnosis of degenerative arthritis of the spine in treatment records occurred approximately 20-25 years after the Veteran's separation from active duty service. STRs do not indicate any continuity of symptoms or complaints; the confinement examination two months prior to separation was normal, and even the Veteran reports onset of back problems in the year following service, while working as a civilian. More recently, he dates complaints to a 2013 work injury. After a careful review of the record, the Board finds that the evidence does not support a determination that spondylolysis and/or degenerative arthritis of the spine is etiologically related to his active duty service. Because there is no diagnosis of lower back disorder in-service, direct service connection is not warranted, and as there is no diagnosis within one year post-separation, presumptive service connection is not warranted. Even assuming the Veteran's reports of back pain in 1981 are credible, he specifically related such to a nonservice injury. As there is no evidence to support any finding of a nexus between service and Veteran's current diagnosis of degenerative arthritis of the spine, entitlement to the benefit sought is not warranted. In reaching this conclusion, the Board has considered the doctrine of reasonable doubt; however, as the preponderance of the evidence is against the Veteran's claim for service connection for lower spine disorder, the doctrine is not applicable. See 38 C.F.R. § 5107 (b); 38 C.F.R. § 3.102; Gilbert v. Derwinski, 1 Vet. App. 49, 56 (1990). WILLIAM H. DONNELLY Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Lauren Barletta 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.