Citation Nr: 21010048 Decision Date: 02/23/21 Archive Date: 02/23/21 DOCKET NO. 14-05 835 DATE: February 23, 2021 ORDER Service connection for a cervical spine disability is denied. FINDING OF FACT The Veteran’s current cervical spine disability did not onset in service or within a year of his separation from service and is not causally related to his service nor caused or aggravated by his service-connected lumbar spine disability. CONCLUSION OF LAW The criteria for service connection for a cervical spine disability have not been met. 38 U.S.C. §§ 1110, 1131, 5103A, 5107; 38 C.F.R. §§ 3.159, 3.303, 3.304, 3.307, 3.309, 3.310. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served honorably in the U.S. Army from January 1980 to November 1992. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from an August 2001 rating decision issued by a Department of Veterans Affairs (VA) Agency of Original Jurisdiction (AOJ). The Veteran testified before the undersigned at a hearing held in October 2015; a transcript of that hearing is of record. In May 2016 and April 2020, the Board remanded this appeal for further development. The Board is satisfied there was substantial compliance with its remand orders. See Dyment v. West, 13 Vet. App. 141, 146-47 (1999); Stegall v. West, 11 Vet. App. 268, 271 (1998). 1. Entitlement to service connection for a cervical spine disability The Veteran contends that his current cervical spine disability is causally related to his active military service, to include as secondary to his service-connected low back disability. Service connection may be granted for disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. § 3.303. The three-element test for service connection requires evidence of: (1) a current disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the current disability and the in-service disease or injury. Shedden v. Principi, 381 F.3d 1163, 1166 -67 (Fed. Cir. 2004). Service connection may also be granted on a presumptive basis for certain chronic diseases, including arthritis, if shown to be manifest to a degree of 10 percent or more within one year following a veteran’s separation from active service. 38 U.S.C. §§ 1101, 1112, 1113; 38 C.F.R. §§ 3.307, 3.309. Additionally, service connection may be granted, on a secondary basis, for a disability which is proximately due to or the result of an established service-connected disorder. 38 C.F.R. § 3.310. Here, the record reflects that the Veteran separated from active service in November 1992. Service treatment records reflect complaints related to his low back, but none related to his cervical spine. Post-service treatment records continue to show treatment related to his lumbosacral spine in the years immediately following service. An October 1996 private medical report discussing the Veteran’s low back pain notes the Veteran’s cervical spine and upper limbs to be clinically normal with normal movements, motor power, sensation, and reflexes. There are no complaints related to the cervical spine or cervical findings until a March 2000 magnetic resonance imaging (MRI) scan that showed localized spondylotic changes at C5-6 with osteophytosis. In a March 2000 letter, the Veteran’s private treating doctor noted the new presentation of progressive degenerative disc disease in the Veteran’s cervical spine. At his October 2015 Board hearing, the Veteran testified that during service he was more focused on his low back pain, which was a sharp cutting pain, but that he did have a tension, muscle spasm type pain in his neck during service. He stated that he did lifting in service but did not recall a specific injury to his cervical spine. A VA etiology opinion was obtained in September 2020. The medical professional who reviewed the Veteran’s file opined that it is less likely than not that the Veteran’s cervical spine disability was incurred in or related to his service. The reviewer explained that degenerative disc disease and degenerative joint disease are degenerative changes that occur over time and can be related to age, genetics, obesity, gender or previous trauma. The examiner noted that the evidence does not reflect that the Veteran had a neck diagnosis or trauma in service. The VA reviewer further opined that it is less likely than not that the Veteran’s cervical spine disability was caused by his service-connected lumbar spine degenerative disc disease. The reviewer explained that development of cervical osteoarthritis is not aggravated or caused by osteoarthritis of the lumbar or thoracic spine. The Veteran submitted a copy of an internet inquiry in which a person stated that a physician told a patient that her lumbar degenerative disc disease is not related to her thoracic and cervical spine conditions. A doctor’s response states that degenerative disc disease cannot spread but some people have weak discs everywhere that are prone to degenerating with time. The Board concludes that, while the Veteran has a current diagnosis of cervical spine degenerative disc disease, the preponderance of the evidence weighs against finding that the Veteran’s cervical spine degenerative disc disease began during service or is otherwise related to an in-service injury, event, or disease or was caused or aggravated by his service-connected degenerative disc disease, lumbar spine status post compression fracture T12. Private treatment records show the Veteran was not diagnosed with cervical spine arthritis until March 2000, more than seven years after his separation from service. While the Veteran is competent to report having experienced neck pain in service, he is not competent to provide a diagnosis in this case or determine that any symptoms he experienced in service were manifestations of his later diagnosed cervical degenerative disc disease. The issue is medically complex, as it requires interpretation of complicated diagnostic medical testing. Jandreau v. Nicholson, 492 F.3d 1372, 1377, 1377 n.4 (Fed. Cir. 2007). Further, the September 2020 VA reviewer opined that it is less likely than not that the Veteran’s cervical spine disability was incurred in service. The Board finds a preponderance of the evidence is against finding that the Veteran’s cervical spine arthritis onset in or within a year of his separation from service. The Board further finds that a preponderance of the evidence is against finding that his current cervical spine disability is causally related to his service. The Board acknowledges the Veteran’s own opinion that there is a relationship but finds that as a lay person he does not have the education, training, or experience, to competently opine as to the etiology of cervical spine degenerative arthritis. The issue is medically complex, as it requires knowledge of anatomical relationships and interpretation of complicated diagnostic medical testing. Therefore, it is outside the competence of the Veteran in this case. See 38 C.F.R. § 3.159(a)(1); Kahana v. Shinseki, 24 Vet. App. 428, 438 (2011). Consequently, the Board gives more probative weight to the opinion of the September 2020 VA reviewer. The September 2020 VA reviewer opined that the Veteran’s cervical spine disability is not at least as likely as not related to an in-service injury, event, or disease. The examiner’s opinion is probative, because it is based on an accurate medical history and provides an explanation that contains clear conclusions and supporting data. Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 304 (2008). Finally, the Board finds that a preponderance of the evidence is against finding that the Veteran’s cervical spine disability was caused or aggravated by his service-connected lumbar spine disability. The Board acknowledges the Veteran’s own etiology opinion but finds, as discussed above, it is outside of the competence of the Veteran in this case. The Board again gives more probative weight to the opinion of the September 2020 VA reviewer, who opined that the Veteran’s cervical spine disability was not caused or aggravated by his service-connected lumbar spine disability. Based on the forgoing, the Board finds that a preponderance of the evidence is against service connection for a cervical spine disability, the benefit of the doubt doctrine does not apply, and the claim must be denied. H. SEESEL Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board A. Christensen 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.