Citation Nr: 21011779 Decision Date: 03/02/21 Archive Date: 03/02/21 DOCKET NO. 16-22 826 DATE: March 2, 2021 ORDER Entitlement to service connection for a low back condition is denied. FINDING OF FACT The Veteran’s low back condition was not incurred during active service, was not caused by active service, and did not manifest to a compensable degree within one year of separation from active duty. CONCLUSION OF LAW The criteria for entitlement to service connection for a low back condition have not been met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.303, 3.304, 3.307, 3.309. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from October 1963 to February 1967. The Board of Veterans’ Appeals (Board) remanded the matter for further development in September 2018. 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). Alternately, service connection may be established under 38 C.F.R. § 3.303(b) by (a) evidence of (i) the existence of a chronic disease in service or during an applicable presumption period under 38 C.F.R. § 3.307 and (ii) present manifestations of the same chronic disease, or (b) when a chronic disease is not present during service, evidence of continuity of symptomatology. Certain chronic diseases, including degenerative arthritis, may be service connected if manifested to a degree of 10 percent disabling or more within one year after separation from service. 38 U.S.C. §§ 1101, 1112, 1113; 38 C.F.R. §§ 3.307, 3.309. The Veteran’s entrance examination in September 1963 and the separation examination in January 1967 were negative for a conditions or complaints of the back. April 2016 VA treatment notes provided a diagnosis for multilevel degenerative disease of the lumbosacral spine. The Veteran was provided with a VA examination in October 2019. The Veteran reported he was lying down on the top rack of a 3-tiered bunk bed on his ship in 1965 when the ship rocked, and he fell down on his back. The sharp pain in his lower back subsequently resolved the next day. He would have back pain flare-ups through the years and he believes he had x-rays in 1969. He did not seek medical evaluation for his low back since 1969. The Veteran was diagnosed with lumbar degenerative disc disease (DDD). The examiner determined the DDD was not caused by the in-service fall as described by the Veteran. The fall occurred 54 years prior to the examination. The Veteran was released from active service 52 years prior to examination, and the Veteran had been relatively asymptomatic in multiple recent years. The Veteran did not have any severe symptoms which warranted medical evaluation at the time of the in-service fall. The exit examination showed a normal spine, and the Veteran did not report any back pain or symptoms. Therefore, it was less likely than not that the current lumbar spinal condition was related to active duty service. The VA examiner’s opinion was based upon a complete review of the Veteran’s claims file, and the examiner provided a negative opinion and adequate rationale to support the findings. The Board notes that there is no probative evidence in the record relating the Veteran’s current back condition to active duty. Certain chronic diseases will be presumed related to service if they were noted as chronic in service; or, if they manifested to a compensable degree within a presumptive period following separation from service; or, if continuity of the same symptomatology has existed since service, with no intervening cause. 38 U.S.C. §§ 1101, 1112, 1113, 1137; Walker v. Shinseki, 708 F.3d 1331 (Fed. Cir. 2012). The Board concludes that, while the Veteran has DDD of the lumbar spine, it was not chronic in service or had continued since service. The Veteran reported receiving treatment for his back pain in 1969, 2 years after separation from active service; but then did not receive treatment after 1969 for many years. The Board has every reason to believe the Veteran was offering a truthful account of his experiences to his clinicians in an attempt to receive appropriate medical care. However, arthritis did not manifest to a compensable degree within a presumptive period. There is no evidence in the record which shows diagnosed degenerative changes by February 1968, within a year of separation from active service. The earliest evidence of degenerative changes is located in April 2016 VA treatment records. This is approximately 48 years after separation from active service. The evidence supports finding that the Veteran’s back condition was diagnosed over one year after his separation from active service, outside of the applicable presumptive period. While the Veteran is competent to report having experienced symptoms of back pain since service, he does not possess the training or credentials necessary to provide a competent diagnosis in this case or to determine that these symptoms were manifestations of arthritis, which is diagnosed with radiographic evidence. The issue is medically complex, as it requires interpretation of complicated medical diagnostic imaging. Jandreau v. Nicholson, 492 F.3d 1372, 1377 n.4 (Fed. Cir. 2007). The Board gives more probative weight to competent medical evidence, which establishes that these symptoms are not related to the reported fall in active duty service. Accordingly, the preponderance of the evidence is against the claim, and the claim for service connection for a low back condition must be denied. 38 U.S.C. § 5107(b). A. C. MACKENZIE Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board B. N. Quarles, 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.