Citation Nr: 21011667 Decision Date: 03/02/21 Archive Date: 03/02/21 DOCKET NO. 15-44 776 DATE: March 2, 2021 ORDER Service connection for a cervical spine disability, to include as secondary to service-connected lumbosacral disc disease and/or left elbow epicondylitis, is denied. Service connection for a right shoulder disability, to include as secondary to service-connected lumbosacral disc disease and/or left elbow epicondylitis, is denied. FINDINGS OF FACT 1. The preponderance of the evidence is against finding that a cervical strain disability began during active service or developed secondary to or was aggravated by a service-connected disability. 2. The preponderance of the evidence is against finding that a right shoulder strain began during active service or developed secondary to or was aggravated by a service-connected disability. CONCLUSIONS OF LAW 1. The criteria for service connection for a cervical spine disability, to include as secondary to service-connected lumbosacral disc disease and/or left elbow epicondylitis, have not been met. 38 U.S.C. §§ 1110, 1112, 1113, 1131, 1137, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.310. 2. The criteria for service connection for a right shoulder disability, to include as secondary to service-connected lumbosacral disc disease and/or left elbow epicondylitis, have not been met. 38 U.S.C. §§ 1110, 1112, 1113, 1131, 1137, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.310. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran honorably served on active duty in the United States Army from July 1962 to December 1962 and from July 1982 to April 1998. He testified before the undersigned Veterans Law Judge in February 2019 in support of his claims. The Veteran has a combined disability rating of 40 percent, with special monthly compensation. He is service-connected for, among other things, lumbosacral disc disease, left lateral epicondylitis of the left elbow, right knee osteoarthritis, and erectile dysfunction. Service Connection Service connection requires evidence of three elements: (1) a current disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship or nexus between the current disability and the disease or injury incurred or aggravated during active service. Shedden v. Principi, 381 F.3d 1163, 1166-67 (Fed. Cir. 2004). Service connection for certain chronic diseases, including degenerative joint disease, will be presumed if the diseases manifest to a compensable degree within one year following active military service. Service connection may also be granted on a secondary basis for a disability that is proximately due to a service-connected condition. 38C.F.R. §3.310(a). Service connection is also possible when a service-connected disability has aggravated a claimed condition, but compensation is only payable for the degree of additional disability attributable to the aggravation. Allen v. Brown, 7 Vet. App. 439 (1995). 1. Service connection for a cervical spine disability, to include as secondary to service-connected disabilities. The Veteran has a post-service diagnosis of a cervical strain. A review of the Veteran’s service treatment records fails to reveal a specific injury to the Veteran’s neck/cervical spine or treatment for symptomatology related to the neck/cervical spine. However, the Veteran credibly testified that he suffered from two falls during service, in addition to having two-or-three automobile accidents in-service. The Veteran’s 1992 service medical records document the Veteran as having two similar falls, the first in October 1991 and the second in April 1992; and his having physical therapy in relation to multiple problems with musculoskeletal pains in his wrist, back, and elbow. Given the Veteran’s credible testimony and supportive service records, VA concedes that the Veteran had in-service injuries that could be related to his development of his post-service cervical strain disability. The Veteran’s alternate theory of entitlement to service connection is that his cervical spine disability manifested as a result of his service-connected back disability - and as such, it should be service-connected on a secondary basis. As the Veteran has a current cervical spine diagnosis, and the argument can credibly be made that this diagnosis is related to either an in-service injury or developed secondary to an already service-connected disability, the outcome of the Veteran’s claim hinges on whether the medical nexus evidence of record supports or refutes the Veteran’s theories. Unfortunately, the Board finds that the overall medical evidence is not favorable to the Veteran’s claim; and the appeal must therefore be denied. Medical nexus evidence in the claims file consists of a November 2020 Cervical Spine Conditions Disability Benefits Questionnaire (DBQ). This examination report, provided by J.C., D.O., reflects that Dr. J.C. reviewed the Veteran’s claims file, service records, and post-service medical records and conducted a physical examination. He also obtained a medical history from the Veteran. After considering all the evidence, Dr. J.C. subsequently opined that it was less likely than not that the Veteran’s cervical strain was incurred in or caused by an in-service injury or disease, nor was it caused by the two falls in service or his automobile accidents. He also opined that the Veteran’s cervical strain was not proximately due to or the result of, or aggravated by, his service-connected disabilities. In providing rationales, Dr. J.C. stated that the Veteran reported that his neck pain began after a fall in 1992. Per a medical record in April 1992, he injured his left wrist and left elbow. However, he did not tell a doctor about his neck problems until 4 years later, in 1996. Despite the Veteran’s long tenure in service, Dr. J.C. found that there were no significant medical records pertaining to the neck while in service. Regarding the issue of aggravation, Dr. J.C. opined that the Veteran’s service-connected lumbosacral disc disease, right knee osteoarthritis, left elbow epicondylitis and erectile dysfunction did not anatomically worsen the Veteran’s cervical strain. In this regard, the Veteran’s cervical strain by its anatomical position was less likely than not to be aggravated by his service-connected disabilities. The Board finds Dr. J.C.’s medical opinion to be credible, persuasive, and unrebutted in that it is the only medical evidence that provides a clear etiology of the Veteran’s cervical strain with a supporting rationale. The Board assigns significant weight given its consideration of all the evidence of record, to include post-service medical records dated from 2009 to 2020 that do not reference treatment for any cervical spine disability. Based on the foregoing, the Board finds that the preponderance of the evidence is against the Veteran’s cervical spine claim, and the appeal must be denied. 2. Service connection for a right shoulder disability, to include as secondary to service-connected lumbosacral disc disease and/or left elbow epicondylitis, The Veteran has been diagnosed with a right shoulder strain. His service treatment records do not reflect any complaints of or treatment for the right shoulder. In fact, a December 1997 retirement report of medical examination in his service file reveals that a clinical examination of the Veteran’s upper extremities at that time was found to be normal. In a corresponding report of medical history, the Veteran described his health as excellent and denied having shoulder trouble. Regardless, as set forth above, credible evidence exists indicating that the Veteran was involved in two falls while in service, one in which he broke his wrist, in addition to several automobile accidents in service. Arguably, the Veteran injured his right shoulder during one of these events. Turning to the medical nexus evidence in this case, the Veteran was afforded a shoulder and arm conditions medical examination in November 2020. At that time, Dr. J.C. reviewed the Veteran’s claims file, service records, and post-service medical records and conducted a physical examination. He also obtained a medical history from the Veteran. After considering all the evidence, Dr. J.C. diagnosed the Veteran with a right shoulder strain and opined that it was less likely than not that the Veteran’s right shoulder strain was incurred in or caused by an in-service injury, event, or illness, nor was it caused by his documented falls in service or his automobile accidents. In addition, Dr. J.C. opined that the right shoulder strain was not proximately due to or the result of, or aggravated by, his service-connected disabilities. The doctor’s rationale was that while the Veteran reported that he had right shoulder pain since a fall (in service) in 1992, he did not tell a doctor about his right shoulder until after service in 2007. Although an April 1992 service record documented that the Veteran injured his left wrist and left elbow, the record does not mention any injury to the right shoulder. The Veteran also reported that there were no medical records concerning his right shoulder while in service. Furthermore, Dr. J.C. found that the Veteran’s service-connected disabilities did not anatomically worsen his shoulder condition; and that the right shoulder, by its anatomical position, was less likely to be aggravated by any of his service-connected disabilities. For the same reasons set forth above, the Board finds Dr. J.C.’s medical opinion to be credible, persuasive, and unrebutted in that it is the only medical evidence that provides a clear etiology of the Veteran’s right shoulder strain with a supporting rationale. Given its considerable weight assigned by the Board in the evaluation of the Veteran’s right shoulder claim, the preponderance of the evidence is against the Veteran’s right shoulder claim, and the appeal must be denied. H.M. WALKER Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Talpins, Patricia 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.