Citation Nr: 21012645 Decision Date: 03/04/21 Archive Date: 03/04/21 DOCKET NO. 17-21 801 DATE: March 4, 2021 ORDER Service connection for headaches is denied. Service connection for a back condition is denied. Service connection for a neck condition is denied. Service connection for a left shoulder condition is denied. FINDINGS OF FACT 1. The Veteran’s headaches are not otherwise etiologically related to an in-service injury or disease. 2. The Veteran’s back condition, neck condition, and/or left shoulder condition were not shown as chronic in service and did not manifest to a compensable degree within the applicable presumptive period; continuity of symptomatology is not established; and the disabilities are not otherwise etiologically related to an in-service injury or disease. CONCLUSIONS OF LAW 1. The criteria for service connection for headaches have not been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303. 2. The criteria for service connection for a back condition have not been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309. 3. The criteria for service connection for a neck condition have not been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309. 4. The criteria for service connection for a left shoulder condition have not been met. 38 U.S.C. §§ 1110, 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 from March 1972 to April 1975. This matter comes before the Board of Veterans’ Appeals (Board) from June 2015 and May 2017 rating decisions of a Department of Veterans Affairs (VA) Regional Office (RO). In October 2019, the Veteran testified before the undersigned Veterans Law Judge at a Travel Board hearing regarding service connection for his claimed headaches, low back, and neck conditions. A transcript is of record. This matter was previously before the Board in August 2020 but was remanded for further development. The Board finds that there has been substantial compliance with the Board’s prior remand directives. Stegall v. West, 11 Vet. App. 268, 271 (1998). Service Connection 1. Service connection for headaches is denied. 2. Service connection for a back condition is denied. 3. Service connection for a neck condition is denied. 4. Service connection for a left shoulder condition is denied. The Veteran seeks service connection for headaches, a back condition, a neck condition, and a left shoulder condition. The Veteran contends his disabilities are due to slipping and falling on his back in service while recovering a tank. Alternatively, he contends his disabilities are due to the general physical rigors of his service and military occupational specialty as a recovery specialist. See October 2019 Board hearing transcript. For the reasons that follow, the Board finds entitlement to service connection is not warranted. 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). Certain chronic diseases will be presumed related to service, absent an intercurrent cause, if they were shown as chronic in service; or, if they manifested to a compensable degree within a presumptive period following separation from service; or, if they were noted in service (or within an applicable presumptive period) with continuity of symptomatology since service that is attributable to the chronic disease. 38 U.S.C. §§ 1101, 1112, 1113, 1137; 38 C.F.R. §§ 3.303, 3.307, 3.309. Walker v. Shinseki, 708 F.3d 1331, 1338 (Fed. Cir. 2013). VA examination reports dated in October 2020 reflect current diagnoses of degenerative arthritis of the cervical and lumbar spine, left glenohumeral joint osteoarthritis, and cervicogenic headaches. Arthritis is an enumerated condition under 38 C.F.R. § 3.309(a); Walker, 708 F.3d 1331. However, the Board finds that the disabilities were not shown as chronic in service, did not manifest to a compensable degree within a presumptive period, and were not noted in service with attributable continuity of symptomatology. The Veteran’s disabilities did not onset in service and are not otherwise related to service. The Veteran’s service treatment records indicate treatment for a tension headache in March 1975, muscle pain of neck and arm in September 1974, and an unspecified muscle pull in June 1972. The Veteran’s January 1972 enlistment and January 1975 separation reports of medical examination reflect normal clinical evaluations of the head, upper extremities, spine and other musculoskeletal system, and neurologic system. The Veteran denied a history of swollen or painful joints; frequent or severe headache; arthritis, rheumatism, or bursitis; bone, joint, or other deformity; painful or trick shoulder or elbow; and recurrent back pain on his January 1972 enlistment report of medical history. The Veteran reports symptoms since the claimed in-service fall. His post-service treatment records reflect diagnoses of migraine headaches, chronic neck and low back pain, lumbar spondylosis, degenerative disease in the cervical spine, sciatic neuralgia, and left shoulder pain. An August 2014 cervical spine radiology report reflects degenerative disease in the cervical spine with significant right C3 to C4 neural foraminal stenosis. A September 2015 correspondence from the Veteran’s physician notes treatment for chronic neck pain and back pain. The correspondence further notes that an August 2014 back x-ray shows degenerative changes in the lumbar spine. The Veteran’s VA treatment records show disorder of the lumbar spine, headache, and chronic low back pain as active problems. See, e.g., February 2017 VA treatment record. A May 2017 VA treatment record notes a history of back pain since the military with no known traumatic injury. During his October 2019 Board hearing, the Veteran reported falling on his back and left side in service, which started his headaches and back, neck, and shoulder pain. The Veteran indicated that he self-treated and received treatment years later. See generally October 2019 Board hearing transcript. The Board remanded the appeal in August 2020 to obtain VA examinations and nexus opinions. The Veteran underwent a VA neck conditions examination in September 2020. The examiner diagnosed degenerative disc disease and degenerative arthritis of the spine. During the examination, the Veteran reported neck and left shoulder pain after a fall off a vehicle in 1973. During his September 2020 VA shoulder and arm examination, the Veteran was diagnosed with left glenohumeral joint osteoarthritis. The Veteran reported pain after a fall of a vehicle in 1973. The Veteran’s September 2020 VA headaches examination reflects a diagnosis of cervicogenic headaches. During the examination, the Veteran reported he gets headaches that start in the rear of his neck and travel up to the back of his head. The Veteran reported onset as 1973. His September 2020 VA back examination reflects a diagnosis of degenerative arthritis of the spine and degenerative disc disease. He reported onset as 1973. In September 2020, the VA examiner opined that the Veteran’s back condition, neck condition, left shoulder condition, and headache condition were less likely than not incurred in or caused by service, including manifesting within one year after discharge from service or noted during service with continuity of the same symptomatology since service. Regarding his back, neck, and shoulder conditions, the examiner noted the Veteran’s January 1975 separation examination shows he denied such conditions, and no documents show complaints of these conditions within one year of separation. The examiner indicated the Veteran’s most recent lumbar spine, cervical spine, and left shoulder x-rays show mild degenerative arthritis; therefore, it is unlikely his arthritis could have been incurred before April 1975 as the condition would be more severe. Regarding the Veteran’s cervicogenic headaches, the examiner acknowledged the Veteran’s service treatment records indicate treatment for a tension headache in March 1975; however, the examiner indicated tension headaches are normal in the general population and the fact that the Veteran had this diagnosis is not indicative of a chronic illness. The examiner indicated cervicogenic headache is caused by the Veteran’s cervical spine degenerative disc disease and arthritis, neither of which is likely to have been the result of active service. Therefore, it is unlikely his currently diagnosed cervicogenic headache is incurred during active service. After a review of the evidentiary record, the Board finds the preponderance of the evidence weighs against finding that the Veteran’s headaches, back condition, neck condition, and left shoulder condition onset in service or are otherwise related to service. To the extent arthritis is an enumerated conditions under 38 C.F.R. § 3.309(a), the evidence of record weighs against finding that such was shown as chronic in service, manifested to a compensable degree within a presumptive period, or was noted in service with attributable continuity of symptomatology. As indicated above, the Veteran’s service treatment records do not reflect a diagnosis of arthritis. The Board also finds no competent evidence of a diagnosis of arthritis within a year of service discharge. Rather, the first evidence of this condition was not until decades after discharge. While the Veteran is competent to report having experienced symptoms of back, neck, and shoulder pain since service, he is not competent to determine whether arthritis was present and manifested to a compensable degree either in service, or within the presumptive period following discharge. He has not demonstrated the necessary medical expertise (e.g. medical training or credentials) to do so. The issue is medically complex, as it requires knowledge of interpretation of complicated diagnostic medical testing. Jandreau v. Nicholson, 492 F.3d 1372, 1377, 1377 n.4 (Fed. Cir. 2007). Therefore, it is outside of his competence. See Kahana v. Shinseki, 24. Vet. App. 428 (2011). Moreover, the Board finds the lay reports of symptoms in service and continuity of symptoms since service are not credible. The Veteran’s reports of continuity of symptoms are inconsistent with his contemporaneous treatment records, which show a normal clinical evaluation at separation from service. There is no competent evidence of record indicating that the Veteran’s headache, back, neck, and/or left shoulder conditions are otherwise related to service. The September 2020 VA opinions are probative as they were based on the examiner’s consideration of the entirety of the Veteran’s medical history and supported with cogent rationale. See Hernandez-Toyens v. West, 11 Vet. App. 379, 382 (1998). The opinions were provided by a medical professional who possessed the necessary education, training, and expertise to provide the requested opinions. Consequently, the Board gives more probative weight to the competent medical evidence. In reaching the above conclusions, the Board has considered the applicability of the benefit of the doubt doctrine; however, as the preponderance of the evidence is against the claim, the doctrine is not applicable. Accordingly, service connection for headaches, back condition, neck condition, and left shoulder condition is not warranted. See 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102; Gilbert v. Derwinski, 1 Vet. App. 49, 55-57 (1990). D. JOHNSON Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board M.Aoughsten, 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.