Citation Nr: 21065737 Decision Date: 10/27/21 Archive Date: 10/27/21 DOCKET NO. 17-22 890 DATE: October 27, 2021 ORDER Service connection for lumbosacral strain is granted. FINDING OF FACT The Veteran's lumbosacral strain had its onset in service and has continued since service. CONCLUSION OF LAW The criteria for service connection for lumbosacral strain have been met. 38 U.S.C. §§ 1110, 5107 (2018); 38 U.S.C. §§ 3.102, 3.303 (2021). REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from March 1995 to September 2002. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a February 2016 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO). In October 2021, the Veteran testified at a Board hearing before the undersigned Veterans Law Judge. The RO has considered the Veteran's claim of service connection for a back disability as a claim to reopen. The Board notes, however, that subsequent to the initial (September 2003) determination, and the February 2016 rating decision on appeal, additional relevant service records were received. In accordance with 38 C.F.R. § 3.156(c)(1), the claim will be reviewed de novo. The Veteran initiated, but did not perfect, his appeal with respect to his claim of service connection for right leg neuropathy and a left toe disability; accordingly, those issues are not before the Board. Service connection for lumbosacral strain is granted. Service connection may be established for a disability resulting from a disease or injury incurred in or aggravated by active service. 38 U.S.C. § 1110; 38 C.F.R. § 3.303. Service connection requires evidence showing: (1) a current disability; (2) incurrence or aggravation of a disease or injury in service; and (3) a nexus between the current disability and the disease or injury incurred or aggravated in service. See Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004). Service connection may be granted for any disease diagnosed after discharge, when all the evidence, including that pertinent to service, establishes that the disability was incurred in service. 38 C.F.R. § 3.303(d). When there is an approximate balance of positive and negative evidence regarding the merits of an issue, the benefit of the doubt shall be given to the Veteran. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102. The Veteran's service treatment records (STRs) document an in-service report of a back injury. A June 1996 STR includes his report of low back and groin pain for one week. A November 1996 STR notes a complaint of low back pain for five months. He was placed on a 30-day profile. An August 1999 STR notes his complaint of low back pain for the prior three days. His prior medical history included a fall from a fast rope at Fort Campbell in 1996; he complained of paralysis in his bilateral legs at the time of the injury, with no problems in the past year. A June 2000 STR included a complaint of a pulled back muscle. Shortly after his separation from service, the Veteran filed a claim of service connection for a back disability in June 2003 based on a fast-roping incident in service. During his July 2003 VA general medical examination (10 months postservice), he reported chronic low back pain since this incident. He explained that he fell while fast-roping and that the guy behind him also slipped and fell on top of him. He was treated with medications and given exercises to do, but had chronic low back pain since then. The examiner diagnosed stable low back pain with no evidence of residual problems related to his injuries during service. An April 2015 private treatment record includes a diagnosis of mild L4-5 degenerative disc disease and facet arthropathy. During his January 2016 VA examination, the Veteran reported the same injury after fast roping; his treatment at the time was minimal because he was in the field. Since service, his back gives out several times a year. He sought treatment once or twice since discharge; however, in March 2015, he had "such terrible pain he had to seek treatment." The VA examiner diagnosed degenerative arthritis of the spine and lumbosacral sprain. She noted the Veteran's report that his back pain went out 20 years after service and that an MRI at the time noted mild degenerative changes, "which would be consistent with the biology of aging." Accordingly, she opined that his degenerative arthritis was less likely related to service. The Board finds this examination inadequate as the examiner only provided an etiological opinion regarding the Veteran's degenerative arthritis, but not his lumbosacral strain. She also based her negative opinion on the fact that the Veteran reported his back "going out" 20 years after service, but seemingly ignored his consistent reports of pain in and since service. In his February 2016 notice of disagreement, the Veteran reported living with this injury since it occurred during training. In a February 2016 statement, he explained that the only time he sought medical treatment was when the pain was too much to bear. He emphasized that his military training taught him to ignore pain to complete a mission, regardless of circumstances. This attitude of living with the pain affected his decision not to seek medical care until he was in desperate circumstances. He repeated that he has had back pain since 1996. In a March 2017 private treatment record, the Veteran reported lumbar spine pain that had been chronic since 1997 with worsening pain beginning in 2016. A 2016 MRI revealed two bulging discs and degenerative disc disease. During his October 2021 Board hearing, the Veteran testified that he carried a lot of gear during service but hurt his back the worst when he fell 20 feet from a rope, with someone then falling on top of him. He complained during service but not as much as he should have, knowing that doing so would cause trouble when it came to advancing and could have led to a medical discharge. He dealt with the pain through over-the-counter medications and pushed through. He continued to self-medicate until he could no longer take the pain. However, he has continued to have pain since service and only sought treatment when he could no longer tolerate it. Based on the foregoing, the Board is left with an inadequate medical opinion and the Veteran's competent and credible statements and testimony that he experienced back pain in and since service. He has consistently reported that he injured his back during service, which is well documented in the STRs, and has consistently reported back pain since service, credibly explaining why he did not seek consistent treatment postservice. Accordingly, and after resolving any reasonable doubt in his favor, the Board finds the evidence reflects the Veteran's lumbosacral strain began during service and has continued since his discharge, and service connection is therefore warranted. See 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102. E. I. VELEZ Veterans Law Judge Board of Veterans' Appeals Attorney for the Board T. Matta, 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.