Citation Nr: 21077465 Decision Date: 12/29/21 Archive Date: 12/29/21 DOCKET NO. 20-18 877 DATE: December 29, 2021 ORDER Entitlement to service connection for loss of balance, to include as due to service-connected disabilities, is granted. FINDING OF FACT Resolving reasonable doubt in his favor, the Veteran's loss of balance is due to his service-connected intervertebral disc syndrome, degenerative arthritis, lumbosacral strain, degenerative disc disease, facet arthropathy and L2-L5 laminectomy, bilateral lower extremity radiculopathy, and bilateral lower extremity sciatic nerve paralysis with radiculopathy and neuropathy. CONCLUSION OF LAW The criteria for service connection for loss of balance, to include as due to service-connected disabilities, are met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.310. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from February 1966 to February 1986. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a July 2018 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO). In January 2021, the Veteran testified at a hearing before the undersigned Veterans Law Judge; a transcript is of record. As pertinent to this appeal, this matter was previously remanded by the Board in March 2021 for further development of the evidence. This appeal has been advanced on the Board's docket. 38 U.S.C. § 7107(b). Entitlement to service connection for loss of balance, to include as due to service-connected disabilities The Veteran seeks service connection for loss of balance, to include as due to his service-connected back and bilateral lower extremity disabilities. Service connection may be granted for a disability resulting from disease or injury incurred in or aggravated during active service. 38 U.S.C. § 1110; 38 C.F.R. § 3.303(a). Generally, to establish service connection, there must be competent, credible evidence of (1) a current disability, (2) in-service incurrence or aggravation of an injury or disease, and (3) a nexus, or link, between the current disability and the in-service disease or injury. See 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 a service-connected disease or injury. 38 C.F.R. § 3.310(a). In short, establishing service connection on a direct basis requires evidence of (1) a current disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a nexus between the claimed in-service disease or injury and the present disease or injury. Caluza v. Brown, 7 Vet. App. 498, 506 (1995) aff'd, 78 F.3d 604 (Fed. Cir. 1996). Establishing service connection on a secondary basis requires evidence (1) that a current disability exists and (2) that the current disability was either (a) proximately caused by or (b) proximately aggravated by a service-connected disability. Allen v. Brown, 7 Vet. App. 439, 448 (1995). 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). The Veteran is service connected for intervertebral disc syndrome, degenerative arthritis, lumbosacral strain, degenerative disc disease, facet arthropathy, and L2-L5 laminectomy, bilateral lower extremity sciatic nerve paralysis with radiculopathy and neuropathy, and bilateral lower extremity radiculopathy. The Veteran's service treatment records (STRs) are silent for complaints of, treatment for, or diagnosis of any balance disorder. Throughout the Veteran's long active duty military career, no balance issues are noted, and he was regularly found physically qualified for flying duty. See, e.g., June 1966 Preflight, December 1972 Annual Flying, January 1975 Annual Flying, January 1981 Annual Flying, and December 1985 Retirement Reports of Medical Examination and Medical History. The Veteran underwent VA back and peripheral nerve examinations in June 2018 and August 2021. The examiners found that the Veteran's loss of balance resulted from his bilateral lower extremity neurological disorders. In particular, the June 2018 examiner noted that the Veteran has a moderate to severe peripheral polyneuropathy, and that his balance loss is likely secondary to the peripheral polyneuropathy. The June 2018 examiner also noted that the Veteran had muscle atrophy in both calves, had fallen several times due to balance problems, and had an abnormal gait due to balance problems and pain. The June 2018 examination report further shows that the Veteran used a cane constantly to help keep balance due to his lower extremity neurological issues. The June 2018 VA examiner found that the Veteran's balance disability resulted from his bilateral extremity radiculopathy or his intervertebral disc syndrome. The August 2021 VA examiner similarly found bilateral calf atrophy, and also found atrophy of disuse and instability of station, and noted an abnormal gait and that the Veteran is able to walk with a walker or a cane. Private medical treatment records from August 2018 note bilateral lower extremity weakness in the muscles below the knees, bilateral foot drop, significant atrophy and decreased bulk of all bilateral lower extremity muscles below the knees, and the Veteran's inability to shift weight and compensate for posture due to weakness with ankle dorsi and plantar flexion, related to significant bilateral extremity radiculopathies. The June 2018 and August 2021 VA examinations and associated opinions are shown to have been based on review of the Veteran's record, the Veteran's lay statements, and in-person examinations of the Veteran, and are accompanied by sufficient explanations as to the Veteran's loss of balance as a result of his service-connected disabilities. Thus, the Board places great probative weight on the June 2018 and August 2021 VA examinations and opinions. The Board also notes the VA examiners' findings are supported by the Veteran's private medical treatment records discussed above. In sum, resolving reasonable doubt in favor of the Veteran, the preponderance of the evidence is in favor of granting service connection. Entitlement to service connection for loss of balance is granted. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102; Gilbert, 1 Vet. App. at 53. C. CRAWFORD Veterans Law Judge Board of Veterans' Appeals Attorney for the Board S. Battaile 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.