Citation Nr: 21076697 Decision Date: 12/27/21 Archive Date: 12/27/21 DOCKET NO. 12-05 606 DATE: December 27, 2021 ORDER Entitlement to service connection for a back disorder, to include lumbar degenerative disc disease, is denied. Entitlement to service connection for a neck disorder, to include cervical degenerative disc disease, is denied. FINDINGS OF FACT 1. The preponderance of the evidence is against finding that the Veteran's back disorder, to include lumbar degenerative disc disease, is related to service. 2. The preponderance of the evidence is against finding that the Veteran's neck disorder, to include cervical degenerative disc disease, is related to service. CONCLUSIONS OF LAW 1. The criteria for entitlement to service connection for a back disorder, to include lumbar degenerative disc disease, have not been met. 38 U.S.C. § 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309. 2. The criteria for entitlement to service connection for a neck disorder, to include cervical degenerative disc disease, have not been met. 38 U.S.C. § 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty in the United States Air Force from April 1975 to June 1976. These matters come before the Board of Veterans' Appeals (Board) on appeal from a July 2009 rating decision issued by a Department of Veterans Affairs (VA) Regional Office (RO). In March 2014 and August 2016, the Board remanded the appeal to the RO for further development. Thereafter, in an August 2017 decision, the Board denied the Veteran's claims of entitlement to service connection for back and neck disabilities. The Veteran appealed that decision to the United States Court of Appeals for Veterans Claims (Court). In a January 2019 memorandum decision, the Court vacated the August 2017 Board decision and remanded the claims to the Board. In September 2019, June 2020, and August 2021, the Board remanded the matter to the RO for further development. The Board notes that the Veteran testified at a Board hearing before a Veterans Law Judge (VLJ) in January 2013. A transcript of that hearing is associated with the claims file and will be considered with this appeal. The VLJ who presided over the January 2013 Board hearing is no longer with the Board. In July 2016, VA notified the Veteran that she may request a new hearing in connection with her claims, but the Veteran did not respond to this notification letter indicating that she wished to have another Board hearing. The Board notes that in a February 2020 VA Form 10182 Notice of Disagreement, as well as on an associated document received by VA on the same date, the Veteran indicated that she was appealing a Statement of the Case (SOC) that was dated January 2020 concerning the issue of denial of medical care and requested a Board hearing in conjunction with that specific issue. As that issue is not on appeal with the Board in this legacy decision, as no SOC/Supplemental Statement of the Case (SSOC) concerning the issues on appeal were issued in January 2020 or approximate to that date, and as the Veteran has not otherwise and/or subsequently indicated following June 2020 and August 2021 Board decisions that she wishes to have another Board hearing concerning her back and neck claims currently on appeal, the Board finds that her hearing request does not concern the present issues on appeal and that the Board may proceed with adjudicating the issues on the merits. Service Connection Service connection may be granted for a disability resulting from a disease or injury incurred in or aggravated by active service. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303(a). Service connection may also be granted for any disease diagnosed after discharge from service, when all the evidence, including that pertinent to service, establishes that the disease was incurrent in service. 38 C.F.R. § 3.303(d). Generally, to prove service connection, there must be competent, credible evidence of (1) a current disability, (2) an in-service incurrence or aggravation of a disease or injury, and (3) a nexus, or link, between the current disability and the in-service disease or injury. See, e.g., Davidson v. Shinseki, 581 F.3d 1313 (Fed. Cir. 2009). Service connection may be established on a secondary basis for a disability which is proximately due to or the result of service-connected disease or injury. 38 C.F.R. § 3.310(a). For veterans who have served 90 days or more of active service during a war period or after December 31, 1946, certain chronic disabilities, including arthritis, are presumed to have been incurred in service if manifest to a compensable degree within one year of discharge from service. 38 U.S.C. §§ 1101, 1112; 38 C.F.R. §§ 3.307, 3.309. Alternatively, service connection may also be granted for chronic conditions that have manifested continuous symptomology since separation of service. 38 C.F.R. §§ 3.307, 3.309. When there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, the Secretary shall give the benefit of the doubt to the claimant. 38 U.S.C. § 5107; 38 C.F.R. § 3.102; see also Gilbert v. Derwinski, 1 Vet. App. 49, 53 (1990). Entitlement to service connection for a back disorder, to include lumbar degenerative disc disease, and entitlement to service connection for a neck disorder, to include cervical degenerative disc disease The Veteran contends that her current neck and back disabilities are related to her active service. Turning to the evidence of record, the Veteran's service treatment records (STRs) are silent for any findings, complaints, or treatment related to a back or neck disability and/or pain. Specifically, a February 1975 enlistment Report of Medical History reflects that the Veteran denied recurrent back pain, arthritis, or other joint deformity. Her February 1975 entrance Report of Medical Examination also indicates that her spine was normal upon clinical evaluation. On her May 1976 separation Report of Medical History, she again denied having (or ever having) recurrent low back pain; bone, joint, or other deformity; or swollen or painful joints. At that time, while she reported a history of several other medical problems, she did not otherwise report any history of back or neck complaints or problems. Thereafter, when the Veteran was in the National Guard, a February 1977 periodic Report of Medical Examination similarly shows that her spine was normal upon clinical evaluation. On the corresponding February 1977 Report of Medical History, she also denied having (or ever having) recurrent back pain; arthritis; or bone, joint, or other deformity. Post-service, the evidence reflects that the Veteran is in receipt of Social Security Administration (SSA) benefits with a disability onset date of October 2001. See March 2010 SSA Inquiry. As such, VA attempted to obtain SSA medical records, but was informed by the SSA National Records Center that the medical records had been destroyed. See July 2014 SSA National Records Center Correspondence. In August 2014, VA informed the Veteran that it was unable to locate and review her SSA records and requested that she submit any available copies of her SSA medical records and any other relevant evidence or information that she believes would support her claim. To date, the Veteran has not submitted these records and, therefore, they are unavailable to review in relation with her claims. Additionally, the Board acknowledges that the Veteran reported treatment with Georgia Correctional Healthcare after her discharge from service. These records are unavailable to review, and the Board finds that there has been substantial compliance with the June 2020 Board remand directives concerning obtaining medical records from Georgia Correctional Healthcare. In this regard, the June 2020 Board remand explained that the Veteran's treatment records from Georgia Correctional Healthcare had been transferred to Inmate Information Services and directed the RO to specifically obtain such treatment records. In a July 2020 letter, the RO expressly asked the Veteran to submit releases to obtain treatment records from Inmate Information Services and invited her to submit the treatment records herself. In response to the July 2020 notification letter, the Veteran's representative requested additional time for the Veteran to submit the release forms. See July 2020 Correspondence. Thereafter, the Veteran completed and submitted release forms for Wellstar, Piedmont Emergency Room, Dr. Prylinski at Piedmont Physicians, and Mercy Care Gateway Primary Care, which were subsequently obtained in August 2020 and October 2020. See July 2020 VA Form 21-4142a. The RO again requested that the Veteran submit release forms for relevant treatment records from Inmate Information Services in January 2021 and March 2021. Instead, the Veteran submitted a release form for Athens Men Medical Center. See April 2021 VA Form 21-4142a. The RO contacted the facility, which was actually the Athens-Clarke County Jail, who responded that no records were found pertaining to the Veteran. See April 2021 VA 21-0820. In August 2021, the RO again requested that the Veteran generally submit release forms for any other relevant private treatment she received related to her claims. To date, the Veteran has not completed the requisite release forms to obtain medical records from Georgia Correctional Healthcare located at Inmate Information Services nor has she sent any records herself. 38C.F.R. §3.159(c)(1)(i), (ii). In this regard, while VA has a duty to assist the Veteran in substantiating her claims, that duty is not a one-way street and it is important that she make efforts to assist VA in gathering evidence relevant to her claims. Woods v. Gober, 14 Vet. App. 214, 224 (2000). To this point, the Veteran has not cooperated in the effort to obtain these additional medical records but rather completed forms for other various providers. Accordingly, the Board finds that the RO substantially complied with the June 2020 remand directives in obtaining treatment records and the duty to assist is satisfied. 38C.F.R. §3.159(c)(1) The available post-service records show that on an October 2002 chiropractic health center health history, the Veteran indicated that she possibly had a herniated disk. Also, in specific regard to injuries she had, she noted that she had fallen three times in March 2001; had a head injury in December 2001; had broken her thumb and some fingers in 1997; had dislocated her shoulder and hip in 1998 and 1994 respectively; and had surgery on her eye in September 1972. She also indicated that the falls in March 2001 had resulted in injury to her spine. Radiological examination revealed that the Veteran's lateral lumbopelvic had no fractures or pathologies and good disc spaces in the anterior, posterior, and lateral lumbopelvic spine; that her anterior/posterior thoracic was within normal limits; and that her lateral cervical spine showed degenerative joint disease at C4, C5, and C6, with anterior osteophytes and decreased disc space. A subsequent December 2003 private psychiatric report indicates that the Veteran reported pain all over her body, in all joints, for decades. She was assessed with somatoform pain disorder with psychological and physiological components. A March 2004 treatment record also indicates that the Veteran's past medical history includes chronic back pain. On a June 2004, VA Veteran's Application for Pension, the Veteran indicated, among other disorders, that she ruptured a disk in August 1978. Thereafter, a September 2004 VA examination for VA pension purposes reflects that the Veteran complained of lower back pains. The examiner indicated that, upon examination, there was a slight exaggeration of lumbar lordosis but no kyphoscoliosis. She was diagnosed with lower back pain syndrome. An October 2004 private treatment record further shows that the Veteran's past medical history was positive for a ruptured disc and that she was sent to physical therapy. In a November 2004 Statement in Support of Claim, the Veteran indicated that she had an injury of a ruptured disk in 1958 and that she was diagnosed with a spine misalignment in 1996. She also noted that her ruptured disc caused chronic continuous pain. Likewise, in correspondence received by VA in November 2004, the Veteran listed that her major health complaints/symptoms included chronic back pain since 1958, that her spine was unaligned, and that she had fractured vertebrae. January 2005 medical records reflect that the Veteran's active problems included chronic low back pain and that her lumbar spine films showed degenerative joint disease. An August 2005 cervical spine radiological report also reflects that the Veteran had a slight reversal of the usual cervical lordosis, suggesting paraspinal muscle spasm; moderately advanced hypertrophic degenerative disc disease at C4-4 and C5-6; mild hypertrophic degenerative disc disease at C6-7 with small marginal spur; and no fracture, subluxation, or destructive bony lesion identified. Another August 2005 VA treatment record shows that the Veteran had chronic back pain and reported a history of a tumor in her back but that her old medical records showed there was no tumor. A September 2005 VA treatment record similarly reflects that additional medical documentation showed arthritis in the cervical and lumbar spine. Thereafter, an October 2008 VA treatment record indicates that the Veteran had a history of cerebrovascular accident (CVA) in 1993 with mild weakness on the left side, low back pain, and arthralgia. Another October 2008 VA treatment record reflects the Veteran's report of pain on the right side of her neck, right elbow, and head for greater than 20 years. Additionally, in her February 2009 VA Form 21-526, Veteran's Application for Compensation and/or Pension, she indicated that her degenerative disk condition began in 1977. She also stated that degeneration of the spinal disks occurred while delivery and pick-up of mail. A February 2009 VA primary care note shows that the Veteran had degenerative joint disease of the lumbar spine with no abnormal spinal curvature and a diagnosis of chronic low back pain. In April 2011, the Veteran reported pain her lower back for more than 20 years. See April 2011 VA treatment record. However, a June 2011 private treatment record reflects, under the Veteran's past medical history, that she had chronic back and neck pain since 2000. In February 2012, the Veteran reported that she had three damaged discs in her spinal column with one missing entirely and with one damaged during military service. See February 2012 VA Form 9. Moreover, at the January 2013 Board hearing, the Veteran testified that she first injured her back when she was eight years old and that she injured it again when she was in the service. See Board hearing transcript, p. 4. She noted that she had two degenerative discs and one missing disc in her spine. She explained that when she was in training, one of her squadron members became ill and she had to almost carry her to the hospital, which was over a mile away. See id. She further testified that she was not treated for her back while she was on active duty and was not currently receiving any back treatment at the time of the hearing. See id. at p. 5. Shortly thereafter, at a March 2013 private orthopedic examination, the Veteran was found to have degenerative disc changes in the cervical spine at four levels, some mild degenerative disc changes in the thoracic spine with no evidence of compression fracture, and unremarkable x-rays of the lumbar spine and pelvis. The examination also indicates that there had been no recent or remote history of injury to the cervical spine. The private treating physician further noted that although the Veteran had a variety of complaints for her lumbar spine, he found little objective evidence to go along with her complaints. Nevertheless, she was recommended to consider physical therapy for her neck and back pain. A subsequent April 2015 VA radiology results letter shows that the Veteran underwent a neck x-ray revealing moderate multilevel cervical disc and facet arthropathy with bilateral neural foraminal narrowing. In September 2016, the Veteran underwent VA back and neck conditions examinations. At the time of the examinations, she reported no significant back or neck pain prior to her military service but reported that she had some back pain with menstrual periods. She also reported that she initially injured her back and neck in basic training when she helped carry a fellow serviceman to the hospital for a mile. She reported that after that incident, she began to experience back pain and also reported that carrying her gear may have contributed to/caused her back and neck pain. She reported that she did not receive any treatment in service for her low back or neck and that she was able to complete her training. She further explained that she experienced cramping in her lower back during service and that when she became pregnant with her third child, her back began to bother her more. The Veteran also reported that she did not receive treatment for her lower back after leaving the military and did not begin treatment for her lower back until 2005. She noted that while being evaluated for other medical conditions around this time, it was noted that she had moderate to severe arthritic changes of her lumbar and cervical spine. Approximate to the VA examination, lumbar spine x-rays showed five lumbar-type non-rib-bearing vertebral bodies aligned without significant spondylolisthesis or compression fracture. There was mild disc space narrowing and small endplate spurs at L1-2, L2-3, and L 3-4. There was also facet arthropathy at L5-S1. The sacroiliac joints were congruent with some sclerosis. The September 2016 VA examiner noted that a cervical spine MRI in June 2015 had shown multilevel cervical disc and facet arthropathy causing thecal sac narrowing, central canal stenosis and neural foraminal compromise at multiple cervical disc levels. The September 2016 VA examiner also provided negative nexus medical opinions for the Veteran's neck and back disorders, stating that given the Veteran's history, a nexus could not be formed (between service and current neck and back problems) and noted that the records did not show a continuity of symptomatology. The September 2019 Board decision found that these September 2016 VA opinions were inadequate because the VA examiner did not provide sufficient rationale with consideration of the Veteran's lay statements. As such, the Board will assign no probative weight to these September 2016 negative nexus opinions. Following the September 2016 VA examination, the treatment records continue to reflect reports of back and neck pain. For instance, a May 2018 VA treatment record reflects that the Veteran complained of longstanding and diffuse back pain but that her history was difficult to obtain because she was a tangential historian. A December 2018 VA social worker note also shows the Veteran's report that she sustained an injury to her spine carrying an airman to the hospital for a knee injury in 1975. A July 2019 private treatment record further reflects that the Veteran was evaluated for low back pain and that she had "quite a somewhat convoluted history." Imaging studies of the Veteran's lumbar spine showed some disk collapse at L2-3, L1-2, and then at T12-L1 but that her x-rays revealed actually pretty good, preserved disk space in the lower lumbar spine. She was assessed with thoracolumbar back pain and was noted to have some disk degeneration at this level. The treatment record also notes that the Veteran reported she had a back injury in 1975. Thereafter, the RO obtained additional VA opinions, in March 2020, January 2021, and August 2021, in connection with her claims. The March 2020 VA clinician provided negative nexus opinions for the Veteran's back and neck disorders. As the August 2021 Board decision found that the March 2020 VA opinions were inadequate, the Board will assign no probative weight to these opinions. Thereafter, after examination of the Veteran, the January 2021 VA examiner found that the Veteran's lumbar spine and neck disabilities were not related to her service. At the January 2021 VA examinations, the Veteran reported that her back and neck conditions began in 1975 as a result of physical training exercises and heavy lifting and rucking with heavy weights on her back. As the August 2021 Board decision also found that the January 2021 negative nexus opinions were inadequate to decide the Veteran's claims, the Board will also assign no probative weight to these opinions. In August 2021, after reviewing the Veteran's claims file and lay statements, a different VA clinician found that the Veteran's neck and back disabilities were less likely than not incurred in or caused by her claimed in-service injury, event, or illness. For the purposes of the opinions, the VA clinician accepted as true the Veteran's statement that she experienced in-service neck and back pain/injury from carrying a soldier for nearly a mile to the hospital during training and from carrying heavy military gear. In reaching his conclusion, the VA clinician determined that the Veteran's in-service neck and back pain/injury were only acute as the Veteran did not report further neck and/or back pain on her 1976 and 1977 Report of Medical Histories nor did her STRs support a significant cervical and/or spinal injury during service. Indeed, the VA clinician explained that the Veteran denied recurrent back pain on her 1976 and 1977 Report of Medical Histories and noted that she did not seek treatment for this pain during service. As such, the VA clinician opined that the Veteran's reported in-service neck and back pains were consistent with a muscular etiology and, thus, were acute during service. The VA clinician further explained that post-service, there is no evidence of chronicity of care as the claims file shows a lack of continued evaluations for her cervical and lumbar conditions and noted a gap in treatment from her reported pain in service and post-service treatment. The VA clinician also explained that an October 2002 private chiropractic note reflects that the Veteran had three post service falls in March 2001 and noted a spinal injury. The clinician further explained that review of the Veteran's lumbar spine x-rays did not indicate that her current degenerative arthritis of the lumbar spine was the result of accumulated trauma sustained during active service. Given this evidence, as well the other evidence discussed above, the VA clinician concluded that a nexus had not been established for the Veteran's claimed disabilities. In light of the above evidence of record, the Board finds that the preponderance of the evidence is against finding that the Veteran's current conditions had an onset during service, were shown to have developed as a result of an in-service injury, event, or are otherwise related to service, despite the Veteran's contentions to the contrary. First, the Board finds that the Veteran has current back and neck disabilities, as reflected in the treatment records and examinations discussed above, for VA compensation purposes. Thus, the first element of service connection is met. Second, the Board acknowledges that the question of whether the Veteran's neck and/or back disorders pre-existed her service has arisen in relation to this claim. Upon review of the Veteran's STRs, the Board finds that the Veteran's back and neck disabilities are presumed to have been sound at the time of her entry into service. In this regard, VA law provides that a Veteran is presumed to be in sound condition, except for defects, infirmities, or disorders noted when examined, accepted, and enrolled for service, or where clear and unmistakable evidence establishes that an injury or disease existed prior to service and was not aggravated by service. 38 U.S.C. § 1111. Once the presumption of soundness attaches, the burden is on VA to rebut the presumption by clear and unmistakable evidence that the Veteran's disability was both preexisting and was not aggravated by service. Wagner v. Principi, 370 F.3d 1089, 1096 (Fed. Cir. 2004). If VA fails to rebut the presumption of soundness under Section 1111, the Veteran's claim is one for service connection. Here, no back or neck pathology is noted on the Veteran's February 1975 enlistment examination or at the actual time of entry into service in April 1975. Significantly, her STRs are silent as to any back or neck complaints, symptoms, or diagnoses. Although, post-service, the Veteran has reported that she had a back injury when she was young and that this pre-existing injury was aggravated by her activities in service, the Veteran's report of the pre-service injury does not constitute clear and unmistakable evidence that she had any current back or neck injury at the time of entrance into service in light of her enlistment examination reflecting a normal spine; her February 1975 Report of Medical History denying the presence of any recurrent back pain and not noting any pre-existing back (or neck) injury, while noting a history of other injuries and illness (e.g., an orbital blowout in her left eye due to an auto accident in September 1972 and undergoing prior obstetrical surgery); and her lack of any subsequent reporting of such injury prior to or at the time of entrance into service in April 1975. Thus, the presumption of soundness has not been rebutted (i.e., the evidence is not undebatable that the Veteran had a pre-existing back or neck injury at the time of her entrance into service). Consequently, for purposes of her claim for service connection, her back and neck must be considered to have been sound at the time she entered service and her claims essentially become one for service connection based on service incurrence. 38 U.S.C. § 1111; Wagner, 370 F.3d at 1096. In this vein, the Board acknowledges that the September 2019 Board remand directives requested a VA examiner to opine whether it is clear and unmistakable that the Veteran's back and/or neck disorder existed prior to service, and if, so whether it is clear and unmistakable that a back and/or neck disorder was not aggravated in service beyond its natural progression. Following the September 2019 Board remand, a March 2020 VA opinion was obtained, which discussed whether the Veteran's disorders pre-existed service but did not utilize the correct standard (clear and unmistakable) in so doing. However, as the presumption of soundness has not been rebutted in this case, the Board finds that another remand for this opinion is unnecessary and would serve only to delay the Veteran's claims while there was substantial compliance with the prior remand directives as the VA opinion addressed the question of pre-existence. Next, although the Veteran's STRs are silent for any complaints, diagnoses, and treatment for a back or neck injury/pain, the Board concedes that the Veteran experienced neck and back pain in service from carrying a fellow serviceman to the hospital and from carrying/wearing heavy gear during training. In this regard, the Board acknowledges that the Veteran is competent to report the symptoms that she has experienced, including pain. As such, the second element of service connection is met. However, the Board finds that the last element of service connection, a nexus or link between her current disabilities and the in-service disease or injury, is not met in this case. In this regard, the probative medical evidence of record does not indicate that her current neck and back disorders are related to her time in service or reported incidences of neck and back pain in service. The Board finds that the August 2021 VA opinions of record constitute the most probative evidence concerning whether the Veteran's back and neck disabilities are related to service, as these opinions were based upon a review of the Veteran's documented medical history, assertions, and other medical evidence of record. See Nieves-Rodriguez, 22 Vet. App. at 295. Specifically, the August 2021 VA opinions set forth, with detailed rationale, that the Veteran's current disorders are not caused by service, in part, because the Veteran's in-service injuries and pain were not chronic (i.e., acute) and because there is a lack of chronicity of care from these in-service reports. The August 2021 VA clinician's rationale not only reflects consideration of the Veteran's reports of in-service symptoms but also reflects consideration of the post-service evidence showing that the Veteran had a post-service spinal injury in 2001. As the clinician's opinion contains sufficient rationale based upon both the medical and lay evidence of record, the Board finds that this opinion is probative evidence against the claim. Therefore, while the Board concedes that the Veteran experienced in-service neck and back pain from carrying a fellow soldier to the hospital and from wearing heavy gear, the probative medical opinion of record does not show that the Veteran's neck and back disorders are related to such or her active-duty service. There is also no medical opinion to the contrary (i.e., an opinion tending to indicate that the Veteran's current neck or back disability is related to service). Further, the available medical evidence of record does not show any complaints or symptoms related to the Veteran's neck and back disorders until over a decade after her active service. Even assuming the Veteran's report of the 1996 treatment by a chiropractor for spine misalignment is accurate, this treatment occurred approximately 20 years after her service. The Board is cognizant that to establish a nexus, there is no requirement that a Veteran seek immediate post-service medical treatment for a neck or back condition. The mere absence of medical records does not contradict a Veteran's statements about her symptom history. See Buchanan v. Nicholson, 451 F.3d 1331, 1336 (Fed. Cir. 2006). But here, a prolonged period without medical or lay complaint can be considered, along with other factors concerning a claimant's health and medical treatment during and after military service, as evidence of whether an injury or a disease was incurred in service which resulted in any chronic or persistent disability. See Maxson v. Gober, 230 F.3d 1330, 1333 (Fed. Cir. 2000). In short, this long period without lay or medical evidence of back or neck complaints also weighs against her service connection claims. As noted above, the Board acknowledges that the Veteran is competent to report the symptoms that she has experienced. However, the Veteran is not competent to opine that the symptoms that she experiences are related to specific diagnoses or to provide an opinion as to the nature and causes of her disabilities. These issues are medically complex, as they require specialized medical education and interpretation of medical test results. Jandreau v. Nicholson, 492 F.3d 1372, 1377 (Fed. Cir. 2007). As the Veteran is not shown to have appropriate training and expertise, she is not competent to render a persuasive opinion as to such matters. See id. Moreover, although the Veteran has asserted that she has continued to experience back and neck pain/symptoms ever since her reported in-service incidents during training, the Board finds that these reports, while competent, are insufficient to warrant service connection on the Veteran's statements alone. In this regard, continuity is not established based on the clinical evidence of record, which shows a diagnosis several years after service. This, in conjunction with the fact that her lay statements concerning onset and symptomatology are internally inconsistent, belies the assertions of continuous symptoms and weigh against the credibility of the Veteran's lay assertions. Specifically, although the Veteran has reported a history of back and neck problems stemming from service, in reporting her history of spine problems during the October 2002 private chiropractic visit, the Veteran did not report any history of back or neck problems since service. Rather, she reported that she had experienced falls in 2001, which had resulted in injury to her spine. Moreover, the May 2013 private orthopedic examination indicates that the Veteran did not report a recent or remote history of injury to the cervical spine. She has also inconsistently reported the onset of and treatment for back and neck pain throughout the appeal period. See e.g., November 2004 Statement in Support of Claim (reporting that she had an injury of a ruptured disk in 1958 and that she was diagnosed with a spine misalignment in 1996); June 2011 private treatment record (reflecting, under the Veteran's past medical history, that she had chronic back and neck pain since 2000); September 2016 VA examinations (reflecting that she reported no significant back or neck pain prior to her military service and that she did not receive treatment for her lower back after leaving the military and did not begin treatment for her lower back until 2005). Accordingly, the Board assigns less credible weight to the Veteran's report of continuous neck and back pain since service. Specifically, given the above reported inconsistencies, the Board assigns less probative weight to the Veteran's reports of symptomatology and diagnosis onset and, instead, finds the contemporaneous medical evidence to be more probative evidence in this case. See Curry v. Brown, 7 Vet. App. 59, 68 (1994) (finding that contemporaneous evidence was more probative than history as reported by the claimant). Therefore, when weighing the medical evidence, which does not reflect a diagnosis of a back or neck disorder nor complaints of back or neck pain until years after service, with the Veteran's lay statements, which have been assigned less probative weight due to internal inconsistencies, the Board finds that continuity is not established based on the evidence of record. Finally, as the record does not reflect that the Veteran's current neck and/or back disorders had an onset during the Veteran's active-duty service or within one year after her separation from service., presumptive service connection for these disabilities, on the basis of a chronic disease, is not warranted. Accordingly, the record does not indicate that the Veteran's neck or back disorders are related to service. As the weight of the evidence is against the claims, entitlement to service connection for these disorders is denied. 38 U.S.C. § 5107; 38 C.F.R. § 3.102; Gilbert, supra. MARJORIE A. AUER Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Amanda Purcell, 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.