Citation Nr: 21066712 Decision Date: 11/02/21 Archive Date: 11/02/21 DOCKET NO. 10-14 378 DATE: November 2, 2021 ORDER Entitlement to service connection for a low back disability is granted. FINDING OF FACT The Veteran has current diagnoses of spinal stenosis and degenerative disc disease with intervertebral disc syndrome of the lumbosacral spine which is due to an in-service injury. CONCLUSION OF LAW The criteria for entitlement to service connection for spinal stenosis and degenerative disc disease with intervertebral disc syndrome of the lumbosacral spine have been met. 38 U.S.C. §§ 1110, 1112, 1113, 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 from December 1976 to November 1985 and from October 1986 to May 1991. This matter comes before the Board of Veterans' Appeals (Board) on appeal from an August 2010 rating decision of a Regional Office (RO) of the Department of Veterans Affairs (VA). In a September 2017 decision, the Board denied the Veteran's service connection claim for a back disability. He subsequently appealed this determination to the U.S. Court of Appeals for Veterans Claims (Court). In an April 2019 memorandum decision, the Court vacated the Board's denial and remanded the appeal to the Board for further consideration. This claim was previously remanded by the Board on several occasions, most recently in May 2021. Entitlement to service connection for a low back disability The Veteran seeks service connection for a low back disability. He asserts he injured his low back after a fall in service, and service connection is therefore warranted. Service connection may be granted for a disability resulting from disease or injury incurred in or aggravated by active military, naval, or air service. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303(a). Service connection may be granted for any disease diagnosed after discharge, when all the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303(d). As a general matter, service connection for a disability requires evidence of: (1) the existence of a current disability; (2) the existence of the disease or injury in service, and; (3) a relationship or nexus between the current disability and any injury or disease during service. Shedden v. Principi, 381 F.3d 1163 (Fed. Cir. 2004). Where the evidence shows a "chronic disease" in service or "continuity of symptoms" after service, the disease shall be presumed to have been incurred in service. For the showing of "chronic" disease in service, there is required a combination of manifestations sufficient to identify the disease entity, and sufficient observation to establish chronicity at the time. With chronic disease as such in service, subsequent manifestations of the same chronic disease at any later date, however remote, are service-connected, unless clearly attributable to intercurrent causes. If a condition noted during service is not shown to be chronic, then generally, a showing of "continuity of symptoms" after service is required for service connection. 38 C.F.R. § 3.303(b); Walker v. Shinseki, 708 F.3d 1331 (Fed. Cir. 2013). Additionally, where a veteran served ninety days or more of active service, and certain chronic diseases become manifest to a degree of 10 percent or more within one year after the date of separation from such service, such disease shall be presumed to have been incurred in service, even though there is no evidence of such disease during the period of service. 38 U.S.C. §§ 1101, 1112, 1113; 38 C.F.R. §§ 3.307, 3.309(a). While the disease need not be diagnosed within the presumption period, it must be shown, by acceptable lay or medical evidence, that there were characteristic manifestations of the disease to the required degree during that time. Id. As noted above, the Veteran has stated he initially injured his back in the late 1980s when he fell off a ladder. He stated he was treated at a naval medical facility on base; however, the service treatment records are absent any evidence of such treatment. Post-service, the Veteran has been diagnosed with spinal stenosis and degenerative arthritis of the lumbosacral spine, first diagnosed in approximately 2005. In May 2021, the Veteran was afforded a VA examination and medical opinion regarding the etiology of any current low back disability. The examiner reviewed the claims file in conjunction with the examination. After reviewing the record and examining the Veteran, the examiner concluded it was at least as likely as not that current low back disabilities, diagnosed as spinal stenosis and degenerative disc disease with intervertebral disc syndrome of the lumbosacral spine, were due to in-service injuries. The examiner noted that while these disabilities were not noted in service, injuries to the spine increase the risk of developing degeneration, which often leads to lumbar stenosis. As such, these diagnoses were likely the result of the Veteran's reported injury. In reviewing the record, the Board notes that other, contrary medical opinions are of record. These opinions are supported by adequate rationale. Ultimately, the Board finds the evidence to be in relative equipoise, and after affording the Veteran the benefit of the doubt, the award of service connection for spinal stenosis and degenerative disc disease with intervertebral disc syndrome of the lumbosacral spine is warranted. See 38 U.S.C. § 5107. M. Donohue Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Thomas D. Jones, 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.