Citation Nr: 21072020 Decision Date: 12/02/21 Archive Date: 12/02/21 DOCKET NO. 19-36 125A DATE: December 2, 2021 ORDER Service connection for the Veteran's low back disability, diagnosed as degenerative arthritis and intervertebral disc displacement of the lumbar spine, is granted. FINDING OF FACT The Veteran's diagnosis of degenerative arthritis and intervertebral disc displacement of the lumbar spine began in, and has progressed since, service. CONCLUSION OF LAW The criteria for entitlement to service connection for the Veteran's low back disability, diagnosed as degenerative arthritis and intervertebral disc displacement of the lumbar spine, are met. 38 U.S.C. §§ 1110, 1112, 1113, 1131, 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 November 1961 to February 1966. This case comes before the Board of Veterans' Appeals (Board) on appeal from a May 2018 rating decision. The matter was previously before the Board in August 2020, February 2021, and June 2021, on which occasions it was remanded for additional development. It has been returned to the Board for appellate review. *** In June 2021, the Board remanded for clarification as to whether the Veteran had a low back disability that predated entry into service. As noted in the Board's June 2021 remand, the VA examiner with whom he met in October 2020 characterized the Veteran's low back condition as "mild congenital spinal stenosis," indicating the condition predated entry into active duty service. By contrast, a March 2021 VA examiner indicated the Veteran's back condition was "[n]ot a congenital defect, [but] a congenital disease," without explaining why the distinction was made, and without opining as to whether the condition was aggravated beyond its normal course of progression by any aspect of active duty service. The June 2021 Board remand further observed that no back condition was noted on entry into service. Moreover, the Veteran has consistently complained of an in-service fall in the wake of which he has experienced low back pain. The Board concluded that no VA examiner had adequately addressed the Veteran's contentions with respect to incurrence or continuity of symptomatology since separation. The Veteran underwent a new VA examination in September 2021. The relevant disability benefits questionnaire (DBQ) shows diagnoses of spinal stenosis, degenerative arthritis, and intervertebral disc displacement (lumbar region). Regarding his injury in service, the Veteran indicated that, while cleaning the inside of a gas tank, he slipped on a step ladder near the top of the tank and fell back into the tank, landing on his back. He reported losing consciousness and waking up in sick bay, where he was told that he had been out for three days. The September 2021 VA examiner opined that the Veteran's congenital spinal stenosis clearly and unmistakably pre-existed entry into service and was clearly and unmistakably not aggravated beyond its natural progression by an injury in service. In this regard, the examiner cited medical literature indicating that congenital stenosis is a narrow spinal canal that is present from birth, which does not cause problems by itself but makes the spinal cord and/or nerve roots more susceptible to acquired lumbar stenosis. The examiner further indicated that the Veteran does not currently have symptoms of spinal stenosis, in other words, that his spinal stenosis is currently asymptomatic. The September 2021 VA examiner also opined that the Veteran's degenerative arthritis of the lumbar spine and intervertebral disc displacement of the lumbar spine was less likely than not caused by the in-service injury. In this regard, the examiner noted that the Veteran's separation examination noted a normal spine and was silent for any symptoms. The examiner cited medical literature regarding disc herniation and spondylosis. Based on this literature, the examiner opined that the Veteran's arthritis and disc herniation were caused by aging and not a traumatic event, such as a fall. The examiner, however, did not discuss the Veteran's report of back symptoms since service. This undermines the opinion's probative value. Based on the competent evidence above, the Board finds that the Veteran's back symptoms are manifestations of his degenerative arthritis of the lumbar spine and intervertebral disc displacement of the lumbar spine, rather than of his spinal stenosis. Regarding the latter, the September 2021 VA examiner explained that this is a congenital defect that had existed since birth but was currently asymptomatic. As summarized above, the September 2021 VA examiner opined that the Veteran's degenerative arthritis and intervertebral disc displacement of the lumbar spine were less likely than not due to the Veteran's in-service injury. The VA examiner, however, did not discuss the Veteran's report of symptoms since service, diminishing its probative value and weight. Certain chronic diseases, to include arthritis, will be presumed related to service if they were shown as chronic in service; or, if they manifested to a compensable degree within a presumptive period following separation from service; or, if they were noted in service, with continuity of symptomatology since service that is attributable to the chronic disease. 38 U.S.C. §§ 1101, 1112, 1113, 1137; 38 C.F.R. §§ 3.303, 3.307, 3.309. Walker v. Shinseki, 708 F.3d 1331, 1338 (Fed. Cir. 2013). In this case, the Veteran has a diagnosis of degenerative arthritis. He has indicated that his back symptoms began in service following his in-service fall. Furthermore, his description of that injury is consistent with the nature, circumstances, and places of his service as diesel mechanic in the Navy. The Board finds no reason to doubt the veracity of the Veteran's competent reports, which when also deemed credible, establish a continuity of symptomatology since service. The Board finds this competent and credible lay evidence is sufficient to establish that the Veteran's current back disability, which has been diagnosed as arthritis, began in, and has progressed since, service. 38 C.F.R. § 3.102, 3.303(b), 3.309(a). Paul Sorisio Veterans Law Judge Board of Veterans' Appeals Attorney for the Board P. López, 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.