Citation Nr: 21070859 Decision Date: 11/26/21 Archive Date: 11/26/21 DOCKET NO. 15-14 665A DATE: November 26, 2021 ORDER Entitlement to service connection for a neck disability is granted. FINDING OF FACT The Veteran's neck disability started during active service and continued to present. CONCLUSION OF LAW The criteria to establish service connection for a neck disability have been met. 38 U.S.C. §§ 1110, 5103, 5103A, 5107; 38 C.F.R. §§ 3.102, 3.303. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from June 1979 to March 1985. In a July 2020 decision, the Board, in relevant part, denied entitlement to service connection for a neck disability. The Veteran appealed to the United States Court of Appeals for Veterans Claims (Court). In a May 2021 Joint Motion for Remand (JMR), the parties agreed to vacate and remand the July 2020 Board decision. Subsequently, the Board remanded the issue in a September 2021 decision. The claim is back before the Board for further appellate proceedings. A Board hearing was held in November 2017. A transcript is of record. A veteran is entitled to the Department of Veteran Affairs (VA) disability compensation if there is a disability resulting from personal injury suffered or disease contracted in the line of duty in active service, or for aggravation of a preexisting injury suffered or disease contracted in the line of duty in active service. 38 U.S.C. § 1110. Generally, to establish a right to compensation for a present disability, a veteran must show: (1) a present disability; (2) an 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 or aggravated during service, the so-called "nexus" requirement. Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004). Service connection may be granted for any disease diagnosed after discharge, when all of the evidence, including that pertinent to service, establishes that a disease was incurred in service. 38 C.F.R. § 3.303(d). The Veteran has a diagnosis of degenerative disc disease of the cervical spine. See September 2021 VA examination report. Thus, the first Shedden element is met. The Veteran's service treatment records (STRs) document neck pain and neck spasms after a May 1980 motor vehicle accident while in service. See May 1980 STR. The Veteran stated that his neck pain began in service after the documented motor vehicle accident and has continued to present. See November 2017 Board hearing tr. at 11. Thus, the second Shedden element is met. As to nexus, the Veteran stated that his neck pain started during service after the May 1980 motor vehicle accident. At his hearing, the Veteran and his wife explained that he did not seek medical treatment for neck pain after service because he lived in a rural small town in Mississippi that did not have a doctor or hospital. Further, he had no transportation at the time and the closest place to seek medical treatment was 40 to 60 miles away. See November 2017 Board hearing tr. at 6. Therefore, he self-medicated his pain with over-the-counter medication until he moved to a larger city. See November 2017 Board hearing tr. at 7-8. Notably, when the Veteran attended his December 2020 VA examination regarding his back disability, the VA examiner supported the Veteran's explanation regarding his inability to seek medical treatment after service. Specifically, the December 2020 VA examiner stated that "it is well known in the medical field that many uninsured claimants, especially those in rural areas, do not seek medical attention unless it is life-threatening." See December 2020 VA opinion. The Board finds this statement persuasive regarding the Veteran's claimed neck disability as well. Overall, the Veteran entered active service without any neck problems. He complained of neck issues during active service. The Veteran continued to have neck issues after separating from active service through the present. The Veteran is competent to attest to this fact. The Veteran provided a logical explanation for the lack of documented treatment after service, which was later supported by a VA medical examiner. The Board finds the Veteran's statements credible as to his neck pain starting during active service and continuing to present. The Board acknowledges the September 2021 VA examiner's opinion that the Veteran's neck disability was not caused by service. However, the examiner appears to simply dismiss the Veteran's complaints of neck pain in service and ever since due to "no other records that demonstrate chronicity of care," and that during his Board hearing "the Veteran's primary problem was focused on his lower back." See September 2021 VA examination report. However, the Veteran is competent to report that he experienced these observable symptoms beginning in service and to the present. See Jandreau v. Nicholson, 492 F.3d 1372, 1377 (Fed. Cir. 2007). Moreover, simply because the Veteran focused more of his testimony on his back pain during his Board hearing, it does not diminish his account of neck symptoms reported in service and ever since. The Veteran also provided a logical explanation for not seeking treatment after service during his Board hearing. Thus, the Board finds that the opinion rendered by the September 2021 VA examiner is incomplete and insufficient for purposes of adjudicating the issue on appeal. The Board finds that the evidence is at least in equipoise as to whether the Veteran's neck disability had its onset in service. Resolving reasonable doubt in the Veteran's favor, the Board finds that the Veteran's neck disability originated during service and continued to present. Accordingly, service connection for a neck disability is warranted. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102. DONNIE R. HACHEY Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Katie Poe, Associate 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.