Citation Nr: 21066892 Decision Date: 11/02/21 Archive Date: 11/02/21 DOCKET NO. 14-27 530 DATE: November 2, 2021 ORDER Entitlement to service connection for lumbar spine disorder also claimed as lumbago is denied. FINDING OF FACT The preponderance of the evidence is against finding that lumbar spine disorder began during active service, or is otherwise related to an in-service injury or disease. CONCLUSION OF LAW The criteria for entitlement to service connection for lumbar spine disorder have not been met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty in the United States Air Force from March 1987 to December 2011. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a July 2012 rating decision issued by the Department of Veteran Affairs (VA) Regional Office (RO). In August 2017, the Veteran testified at a hearing before the undersigned Veterans Law Judge. A transcript of the hearing is associated with the record. The Board issued a remand in June 2021 instructing the RO to obtain an addendum medical opinion to clarify the etiology of the Veteran's disability. A remand by the Board confers upon the Veteran, as a matter of law, the right to compliance with the remand instructions, and imposes upon VA a concomitant duty to ensure compliance with the terms of the remand. See Stegall v. West, 11 Vet. App. 268, 271 (1998). The RO obtained a July 2021 addendum medical opinion. The Board finds the RO substantially complied with the June 2021 remand directives. Entitlement to service connection for lumbar spine disorder. The Veteran contends that he developed a lumbar spine disorder as a result of his military service. During the August 2017 Board hearing, the Veteran testified that the first time he had an incapacitating episode was in Alaska. He couldn't get out of bed and had to get medication. He still experienced flare-ups. His doctors have identified some narrowing of the spine and some spurs on his back during examinations. During his 25 years in the Air Force, he served as a fuel specialist. His duties including driving large trucks and pulling 30 feet hoses for the crew to hook up. It required him to climb into and out of trucks which was jarring on his back. On a December 2019 Statement, the Veteran wrote that he completed the medical authorization release form to obtain records from the Barksdale Clinic and Quick Care facility. At these places, he was seen for extreme back pain. While on active duty, he suffered an incapacitating back issue that required medical attention and then again while retired. See also November 2020 Statement. The Veteran's wife submitted a statement in November 2020. On the statement she wrote that the Veteran never experienced any significant back issues during their marriage until 2009 while on active duty in Alaska. He came home from work mentioning back pain in his lower back. He laid on the floor to relieve the pain and within a few hours he could not get off the living room floor and slowly crawled to bed. The next morning, he could not stand up due to pain. He was provided medication by his physician. In 2016, he experienced the same condition and was unable to get himself off the couch due to back pain. Service connection may be granted for a disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. § 3.303. The three-element test for service connection requires evidence of: (1) a current disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the current disability and the in-service disease or injury. Shedden v. Principi, 381 F.3d 1163, 1166-67 (Fed. Cir. 2004). Service treatment records (STR) indicate the Veteran complained of back pain while in service. See e.g., August 2008 STR (complained of back/flank pain); June 2010 STR (problem list included lumbago); August 2011 STR (complained of back pain that radiated to bladder and then to testicles). Post-service treatment records indicate the Veteran has a current disability of lower back pain, but the lower back pain was not documented to have developed within one year after discharge from service. See e.g., October 2016 Bossier Family Medicine Record (diagnosis of lumbar strain); April 2021 Family Medicine Clinic Record (low back pain); April 2021 Christus Emergency Room Note (primary impression low back pain). In the March 2021 Board remand, the Board acknowledged that the Veteran submitted evidence showing that in October 2016 he was treated for lumbar strain and muscle spasm. He was provided VA examinations in October 2011 and April 2014. Each examination confirmed a lumbar spine diagnosis. However, neither of those VA examiners provided an opinion as to whether the current low back disability was related to the in-service low back condition. Therefore, a remand was issued to obtain a medical opinion. An opinion was obtained in April 2021. However, in the June 2021 remand, the Board determined that the April 2021 VA medical opinion was inadequate for adjudicative purposes because the opinion lacked a complete rationale for the conclusion that the Veteran's current lumbar spine disorder was not incurred in or causally related to service. In the medical opinion, the examiner opined that it was less likely than not that the Veteran currently had a disabling back condition caused by an incapacitating episode of low back pain while stationed in Alaska. In the cited rationale, the examiner noted that the Veteran had one self-limited acute strain from over-exertion during service. The examiner also highlighted the absence of evidence concerning the lumbar spine without any meaningful discussion of the Veteran's lay assertions of back symptomology since his in-service treatment for lumbago. Therefore, the claim was remanded again to obtain an adequate medical opinion. A new medical opinion was obtained in July 2021. The examiner opined that the Veteran's lumbar spine disability was less likely than not (less than 50 percent probability) incurred in or caused by the in-service injury, event, or illness. The examiner explained that the lower back condition was less likely than not incurred from back issues during service based on medical records. An August 2008 kidney, urinary, bladder report showed possible nephrolithiasis for back pain complaint. A June 2010 clinical note reported dyspnea (not back issues). An August 2011 clinical notes reported knee joint issues (not back issues) and the September 2011 compensation and pension mental examination showed the Veteran started a logistic job at the Department of Defense which suggest current lower back condition incurred from his post service job in logistics. Role in logistics is to organize the storage and distribution of goods, ensure that the right products are delivered to the right location on time and at a good cost and involved in transportation, stock control, warehousing and monitoring the flow of goods. Therefore, his lower back condition was not due to the active service alleged back complaint. The Board finds that the grant of service connection for lumbar spine disorder is not warranted. The service treatment records indicate the Veteran complained of acute back pain. However, post-service treatment records do not indicate the Veteran developed a disability within one year after discharge. Medical records and VA examinations confirmed the Veteran has a current lumbar spine disorder but did not support the contention that it was related to service. No objective evidence is of record to oppose this finding. Accordingly, the criteria for entitlement to service connection for lumbar spine disorder have not been established, either through medical or lay evidence. In arriving at the decision to deny the claim, the Board has considered the applicability of the benefit-of-the-doubt doctrine. However, as the preponderance of the evidence is against the claim of entitlement to service connection for back disability, that doctrine is not applicable. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102; Gilbert v. Derwinski, 1 Vet. App. 49, 53-56 (1990). MICHAEL MARTIN Veterans Law Judge Board of Veterans' Appeals Attorney for the Board T. Harris, Attorney Advisor 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.