Citation Nr: 21073819 Decision Date: 12/10/21 Archive Date: 12/10/21 DOCKET NO. 17-52 597 DATE: December 10, 2021 ORDER Entitlement to service connection for spondylolisthesis of the back is granted. FINDING OF FACT Resolving reasonable doubt in the Veteran's favor, her spondylolisthesis of the back is at least as likely as not related to service. CONCLUSION OF LAW The criteria for service connection for spondylolisthesis of the back are met. 38 U.S.C. §§ 1110, 5107 (2018); 38 C.F.R. §§ 3.102, 3.303 (2020). REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran had active service from March 1981 to February 1982 as well as from June 1988 to August 1998. This case comes before the Board of Veterans' Appeals (Board) on appeal from a May 2015 rating decision issued by a Department of Veterans Affairs (VA) Regional Office (RO). This case has been before the Board twice before. In April 2006 the Board reopened this claim based upon a finding of new and material evidence. The Board also denied service connection for the back condition. The Veteran did not appeal this decision and it became final. In May 2015 the Veteran filed to reopen this claim but the RO denied reopening. The Veteran appealed this decision, and it reached the Board in April 2019. The Board found that new and material evidence had been received and therefore the claim was reopened. Upon reopening, the Board remanded this matter for additional development to include a new VA examination. The examiner was asked to consider the September 2017 private opinion and the Veteran's lay statements. This case has now been returned to the Board for further appellate action. Service Connection - Spondylolisthesis of the Back The Veteran contends that her years in service as a supply clerk have caused her back issues. The Veteran served as a supply clerk. In her May 2003 correspondence, the Veteran indicated that lifting and carrying heavy objects was part of her role as a storekeeper. She also indicated that large portions of her career were spent on light duty due to back injuries and severe muscle spasms. A review of the Veteran's service treatment records (STRs) shows at least two incidents of back injuries. The Veteran was treated for upper back spasms in December 1993. Then in January 1997 the Veteran was found to have strained her lower and middle back while chopping wood. The official diagnosis was an acute back strain. The Veteran has indicated that she has had low back pain since 1981 due to excessive lifting. No back complaints were noted on the exit examination. The Veteran was afforded a VA examination in April 2003 in which she voiced the same complaints noted above. She also noted recurrent difficulty with her back in 1988 due to excessive lifting. She complained of pain in her back ever since. The examiner found that x-rays of the back from two years prior, 2001, showed early degenerative disc disease. The Veteran submitted numerous buddy statements which buoy her statements regarding her back pain. These statements include language about the Veteran becoming less mobile over time, struggling to lift heavy objects, and the frequency of muscle spasms and other back issues. In September 2017 the Veteran was seen by an orthopedic spine surgeon. The Veteran's history and various radiologic reports were reviewed. The surgeon also noted that the Veteran worked in the United States Navy for 17 years. This work was classified as heavy labor. This work was found to have taken a toll on the Veteran's neck and back. The orthopedic surgeon concluded that the Veteran's in service work was at least partially responsible for the severe degeneration seen in the Veteran's back. Following the April 2019 Board remand, the Veteran was afforded a new VA examination in November 2019. This examiner diagnosed the Veteran with both degenerative arthritis of the spine and spondylolisthesis. At this examination the Veteran's story on when her back pain began shifted slightly. She indicated that her back pain began in the 1990s while lifting objects in service. The Veteran noted symptoms of near constant pain, decreased range of motion (ROM), decrease in strength, muscle spasms, stiffness, and cramps. The Veteran had no surgical history on the back as of this examination but did not that she was seeing a chiropractor. Flare-ups were noted and these were said to cause increased pain. ROM was found to be abnormal and was measured as forward flexion to 60 degrees, extension to 20, bilateral lateral flexion to 15, and bilateral lateral rotation to 20 for a total of 150 degrees. There was additional loss of ROM during flare-ups. Total ROM during flare-ups was found to be 120 degrees. No ankylosis, IVDS, or assistive devices were noted. When providing the nexus opinion for the spondylolisthesis, the examiner is unclear. The examiner found the condition to be less likely than not incurred in or caused by service. However, in the rationale the examiner indicated that a review of STRs found in-service complaints and treatments. The examiner found the Veteran's spondylolisthesis was incurred from the Veteran's in service back injury. The examiner continued by noting that this is not secondary to the Veteran's military service. This logic is internally inconsistent. In this case, the evidence indicates that the Veteran injured her back on numerous occasions while in service and was diagnosed with a back strain in 1997 while in service. She continued to have complaints of back pain throughout her time in service and has noted complaints since exiting the service. Early signs of degenerative disc disease were found in an x-ray from 2001. In September 2017 the Veteran saw an orthopedic surgeon who concluded that the Veteran's in service work was at least partially responsible for the severe degeneration seen in the Veteran's back. The Board notes lay evidence can be competent and sufficient evidence of a diagnosis or to establish etiology if lay testimony describing symptoms at the time supports a later diagnosis of a medical professional. Davidson v. Shinseki, 581 F.3d 1313, 1316 (Fed. Cir. 2009). The Board notes that the November 2019 VA examiner opined that the Veteran's spondylolisthesis was incurred from the Veteran's in service back injury. The examiner continued by noting that this is not secondary to the Veteran's military service. However, this logic is inconsistent and fails to consider the Veteran's continuity of symptomatology. No discussion of the Veteran's own statements or the submitted buddy statements was noted. Therefore, this opinion has limited probative value. Based upon the above, the Board finds service connection for spondylolisthesis of the back is warranted. 38 U.S.C. § 5107; 38 C.F.R. § 3.102; Gilbert v. Derwinski, 1 Vet. App. 49, 53 (1990). R. FEINBERG Veterans Law Judge Board of Veterans' Appeals Attorney for the Board D. Andrew Ledman II 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.