Citation Nr: 21067580 Decision Date: 11/04/21 Archive Date: 11/04/21 DOCKET NO. 18-46 724 DATE: November 4, 2021 ORDER Service connection for a lumbar spine disorder is denied. FINDINGS OF FACT 1. The Veteran had active duty from October 1988 to October 1992 and from April to July 2003. 2. The Veteran was diagnosed with an injury to low back, possible muscle strain, during service, but symptoms were not shown to be chronic; a current back disorder, diagnosed as lumbar degenerative disc disease (DDD) with right lower extremity radiculopathy is not causally or etiologically related to service. CONCLUSION OF LAW A lumbar spine disorder was not incurred in service. 38 U.S.C. §§ 1110, 1131, 5103(a), 5103A, 5107 (2012); 38 C.F.R. §§ 3.159, 3.303 (2021). REASONS AND BASES FOR FINDINGS AND CONCLUSION In January 2021, the Veteran testified before the undersigned Veterans Law Judge. A copy of the transcript has been associated with the claims file. In May 2021, the Board remanded the appeal for additional development. The case has now been returned to the Board for further appellate action. 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). The Veteran claims that service connection is warranted for a back disability because it was incurred in service. Specifically, she asserts that while she was stationed onboard the USS Alamogordo, ARDM-2, which also had a barge attached to the ship, she slipped and fell while walking down an area of the barge. As to present disability, the July 2015 private clinician diagnosed the Veteran with lumbar DDD with right leg pain due to sciatica. The July 2021 VA addendum opinion noted a current diagnosis of lumbosacral DDD, with right lower extremity radiculopathy. As such, the first element of service connection is met. As to in-service incurrence, the service treatment records (STRs) reflect that in April 1990, the Veteran complained of sharp and constant back pain after falling while on board, "down the 32 barge walkway." She was found to have an injury to lower back, possible muscle strain. There was no further mention of low back pain in the STRs. The October 1992 separation examination noted normal spine evaluation and in the corresponding Report of Medical History, the Veteran denied recurrent back pain. On the April 2003 pre-deployment health assessment, the Veteran indicated that her health in general was good and she did not report any low back disorder. On the June 2003 post deployment health assessment, she reported that her health stayed about the same or got better. She denied any back pain or muscle aches. Nonetheless, because there is evidence of an in-service incurrence of a low back injury during the first period of service, the second element of service connection is met. As to medical nexus, at an October 2012 VA examination, the Veteran reported that she developed low back pain in about 1989 or 1990 while stationed in Charleston. She indicated that she fell on the "32 barge," and she was examined by a corpsman but X-rays were not taken and that, "[i]t took a while to recover and I was fine." Then, she reported in 2010, while in Hawaii, she stumbled on uneven pavement and noted back pain the following day. She stated that she was examined and given medications and placed on light duty. The examiner opined that the Veteran's low back condition was less likely than not due to or the result of the in-service injury. The examiner explained that the Veteran injured her back from a fall in April 1990, but that she had several physical examinations, to include a June 2003 post-deployment health assessment, and all were negative for a back condition. The examiner concluded that there was no evidence of chronicity of complaints or care following the April 1990 fall. The examiner referenced a lumbar spine MRI as the first indication of a back condition noted in the Veteran's medical records but included the incorrect date of the test. A May 2015 Disability Benefit Questionnaire (DBQ) received from the Veteran discussed current diagnoses and medical history as relative to a lumbar spine disorder but did not provide a nexus between the disorder and service. In a July 2015 statement, a private physician diagnosed the Veteran with lumbar DDD with right leg pain due to sciatica. After reviewing her STRs and post-service medical records, the clinician opined that the Veteran's current lumbar DDD was more likely than not manifested and was attributed to active duty and Reserve service and had continued since her release from service. However, the clinician offered no rationale for the opinion. Therefore, the July 2015 private medical opinion is of lesser probative value. In a July 2021 VA medical opinion, the clinician diagnosed the Veteran with lumbar DDD with right lower extremity radiculopathy. After a review of the evidence of record, to include treatment records, statements made in support of the claim, Board hearing transcript, and the July 2015 private medical opinion, the clinician opined that the Veteran's current lumbar spine disability was less likely than not incurred in or caused by injury/fall during service. The clinician noted that the Veteran was evaluated after her April 1990 fall, with a diagnosis of probable muscle strain with no indication for imaging at that time by the provider. The clinician explained that there was no diagnosis or evidence of lumbar DDD or right lower extremity radiculopathy during the Veteran's active duty periods. The first chronic complaint of low back pain was in January 2007, with evidence of sciatica/radiculopathy and MRI performed in September 2007 with evidence of lumbosacral DDD. The clinician indicated that there was no medical nexus for the Veteran's remote low back injury in 1990, diagnosed as muscle strain, to cause the later development of lumbosacral DDD, with right lower extremity radiculopathy in 2007, per the evidence of record and the weight of the medical literature. The clinician noted that lumbar DDD with radiculopathy was most likely due to the nonservice-connected risk factor of age-related degenerative changes with DDD, most commonly occurring between age 30-50 per the weight of the medical literature and the evidence of record cited in the stated medical evidence. The July 2021 VA opinion is assigned greater probative weight as it was based on a thorough review of the evidence, the lay statements of the Veteran, and the service and post-service treatment records. The VA clinician offered a thorough rationale and considered all the evidence of record. While the private opinion found that the lumbar DDD was related to service, no rationale was offered for that opinion. Therefore, the medical evidence weighs against the appeal. The Board has considered the Veteran's lay statements and testimony that her disorder was caused by service. She is competent to report symptoms because this requires only personal knowledge as it comes to her through her senses. However, she is not competent to offer an opinion as to the etiology of her current disorder 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 her statements. In light of the above, the preponderance of the evidence is against the claim for service connection and there is no doubt to be otherwise resolved. As such, the appeal is 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 T. Grzeczkowicz 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.