Citation Nr: 21065635 Decision Date: 10/26/21 Archive Date: 10/26/21 DOCKET NO. 17-48 089 DATE: October 26, 2021 ORDER Service connection for a cervical spine disorder is denied. Service connection for a lumbar spine disorder is denied. FINDINGS OF FACT 1. The Veteran served on active duty from June 1979 to June 1987. 2. The Veteran had complaints of neck and back pain in service; symptoms of a neck or back disorder were not chronic in service, were not continuous since service, and were not shown to a compensable degree within one year of service. Current neck and back disorders, diagnosed as osteoarthritis, have not been causally or etiologically related to service. CONCLUSIONS OF LAW 1. A cervical spine disorder was not incurred in service and may not be presumed to have been incurred therein. 38 U.S.C. §§ 1131, 5103(a), 5103A, 5107 (2012); 38 C.F.R. §§ 3.159, 3.303, 3.307, 3.309 (2021). 2. A lumbar spine disorder was not incurred in service and may not be presumed to have been incurred therein. 38 U.S.C. §§ 1131, 5103(a), 5103A, 5107 (2012); 38 C.F.R. §§ 3.159, 3.303, 3.307, 3.309 (2021). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Board remanded the appeals in May 2019. In this regard, the May 2019 remand specifically directed the RO to schedule the Veteran for an examination or obtain an addendum opinion regarding the etiology of his cervical and lumbar spine disorders. The examinations were scheduled but cancelled at the request of the Veteran without cause. As no cause was given and no further correspondence was received requesting the examinations be rescheduled, the Board will decide the appeals based on the available evidence. Turning to the relevant laws and regulations, service connection may be granted on a direct basis as a result of disease or injury incurred in service based on nexus using a three-element test: (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 in or aggravated by service. See 38 C.F.R. §§ 3.303(a), (d); Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009). Service connection may be granted on a presumptive basis for diseases listed in 38 C.F.R. § 3.309 under the following circumstances: (1) where a chronic disease or injury is shown in service and subsequent manifestations of the same disease or injury are shown at a later date unless clearly attributable to an intercurrent cause; or (2) where there is continuity of symptomatology since service; or (3) by showing that the disorder manifested itself to a degree of 10 percent or more within one year from the date of separation from service. See 38 C.F.R. § 3.307. The Veteran asserts that he has cervical and lumbar spine disorders which originated in service and have persisted since that time. Since the conditions and theories of entitlement are similar, they will be discussed jointly. Initially, VA and private medical records reveal diagnoses for osteoarthritis of the lumbar and cervical spines, at the earliest, in January 2003. As such, current diagnoses are shown, and the first element of service connection is met. Next, the Veteran's service treatment records (STRs) reveal several complaints for "popping" and pain in the neck and back. Specifically, in July 1980 and January 1985, he complained of back pain with popping after lifting weights. In January and July 1982, he reported popping in his neck. Once more in August 1984, he sought treatment for neck pain which he reported had subsided after two days. At the Veteran's March 1986 separation examination, the neck and back were clinically normal upon examination. Nonetheless, as complaints are noted, in-service incurrences have been shown, and the second element of service connection is met. As to a medical nexus between the in-service complaints and current diagnoses, a January 2017 VA examiner reviewed the Veteran's medical history and conducted an examination and opined it was less likely than not that the cervical and lumbar spine disorders were due to service or originated in service. The examiner reasoned that records were scant and the available records did not show enough evidence of chronicity that occurred during his service years that would relate to supporting service connection. By contrast, the examiner noted that there were very regular visits beginning in 2003 that supported chronicity. An addendum opinion was obtained in July 2017. A different clinician again opined that it was less likely than not that the Veteran's lumbar and cervical spine disorders were due to, or originated during, service. The clinician reasoned that available records revealed popping in the neck during service and that medical literature did not support that cracking or popping of the joints caused osteoarthritis. The clinician noted that the Veteran was seen for neck and low back pain during service which seemingly resolved without sequelae. Additionally, the examiner remarked that transient neck and back pain was an extremely common finding in the population in general. The clinician also stated that the Veteran left service in 1987, and since then worked as in the post office as a mail handler, with complaints noted over 13 years after leaving service. As such, the clinician opined it was more likely that this low back pain and neck pain/arthritis were due to a progression of aging and post-military activities. The examiner also went on to cite to medical literature which discussed the age-related changes and degeneration of the spine. The Board finds the January 2017 examination and July 2017 opinion reports are adequate because the examiner and clinician thoroughly reviewed the claims file and discussed the evidence of record to include whether the evidence of record established a nexus between the Veteran's current disorders and service, considered his assertions, and provided a thorough supporting rationale for the conclusions reached. Finally, there is no available medical opinion which contradicts these findings. As such, the examination and medical opinion are assigned great probative value and weigh against the appeals. As to presumptive service connection, arthritis (DJD) is considered a chronic disease under 38C.F.R. §3.309(a) and presumptive service connection will be considered. While degenerative changes of the spine have been shown, they did not manifest to a compensable degree in service or within a presumptive period, and continuity of symptomatology has not been established. Further, while the Veteran's final period of service ended in 1987, degenerative arthritis was not shown by X-ray records until 2017. Even considering the Veteran's assertions and notations for treatment beginning earlier for which he did not have the records, the earliest date listed by him is January 2003. Further, private medical records likewise note onset as 2003. This evidence reasonably suggests an onset in 2003. As such, the medical evidence does not support a finding that the back disorder manifested to a compensable degree in service or within the one-year presumptive period. Additionally, continuity of symptomatology has not been established. The medical evidence shows that the Veteran did not seek treatment for a back disorder until, at the earliest, 2003, approximately 16 years after separation from service. The absence of complaints relating to back pain for many year following service weighs against continuity of symptomatology. As such, the medical evidence does not support service connection on a presumptive basis. The Board has also considered the Veteran's lay statements that his disorders were caused by service. To that end, he submitted statements outlining his duties at the Post Office following service and noting that he was a clerk at a desk job for many years and only was a mail handler for a short time. He is competent to report symptoms because this requires only personal knowledge as it comes to him through his senses. However, he is not competent to offer an opinion as to the etiologies of his current disorders due to the medical complexity of the matter involved. Such competent evidence has been provided by the service records, clinical evidence, and examinations obtained and associated with the claims file. Here, the Board attaches greater probative weight to the clinical findings than to his statements. In addition, the issues were remanded for additional examination but the Veteran failed to report and apparently chose to cancel the examinations. Thus, the Board has based its decision on the evidence of record. In light of the above, the preponderance of the evidence is against the claims for service connection and there is no doubt to be otherwise resolved. As such, the appeals are denied. Finally, the Veteran has not raised any other issues, nor have any other issues been reasonably raised by the record, for the Board's consideration. See Doucette v. Shulkin, 28 Vet. App. 366, 369-370 (2017) (confirming that the Board is not required to address issues unless they are specifically raised by the claimant or reasonably raised by the evidence of record). L. HOWELL Veterans Law Judge Board of Veterans' Appeals Attorney for the Board M. Yacoub, 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.