Citation Nr: 21014346 Decision Date: 03/11/21 Archive Date: 03/11/21 DOCKET NO. 15-34 538 DATE: March 11, 2021 ORDER Service connection for a neck disorder, to include as secondary to service-connected degenerative arthritis of the thoracolumbar spine, is denied. FINDING OF FACT The Veteran’s degenerative disc and joint diseases of the cervical spine are not secondary to service-connected degenerative arthritis of the thoracolumbar spine and are not otherwise related to an in-service injury or event; continuity of symptomatology has not been established. CONCLUSION OF LAW The criteria for entitlement to service connection for a neck disorder, to include as secondary to service-connected degenerative arthritis of the thoracolumbar spine, have not been met. 38 U.S.C. §§ 1110, 1112, 1113, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309, 3.310.   REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from June 1963 to January 1968. This matter is before the Board of Veterans’ Appeals (Board) on appeal from an August 2014 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO). This matter was previously remanded by the Board in April 2018 and July 2019 for further development, which have since been completed. Entitlement to service connection for a neck disorder, to include as secondary to service-connected degenerative arthritis of the thoracolumbar spine. The Veteran asserts there is a connection between his in-service July 1964 motor vehicle accident and his neck disorder. He indicates he injured his lower and upper back in the in-service event. See April 2014 VA Form 21-4138, Statement in Support of Claim. Alternatively, the record has raised entitlement on a secondary basis, where his neck disorder is secondary to his service-connected degenerative arthritis of the thoracolumbar spine disability. 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, 1131; 38 C.F.R. § 3.303(a). Generally, in order 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). Certain chronic diseases will be presumed related to service if they were shown as chronic (reliably diagnosed) 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, with continuity of symptomatology since service that is attributable to the chronic disease. 38 U.S.C. §§ 1101, 1112, 1113, 1137; Walker v. Shinseki, 708 F.3d 1331, 1338 (Fed. Cir. 2013); Fountain v. McDonald, 27 Vet. App. 258 (2015); 38 C.F.R. §§ 3.303, 3.307, 3.309. Secondary service connection may be granted for a disability that is proximately due to or the result of a service-connected disability and includes the concept of aggravation of a nonservice-connected disability by a service-connected disability. 38 C.F.R. § 3.310(a); Allen v. Brown, 7 Vet. App. 439 (1995). The Veteran has current diagnoses of degenerative disc disease and degenerative joint disease of the cervical spine (neck disorder). See April 2019 VA examination report. The question for the Board is whether the Veteran’s neck disorder began during service or is at least as likely as not related to an in-service injury, event, or disease; or has a current disability that is proximately due to or the result of, or is aggravated beyond its natural progress by his service-connected degenerative arthritis of the thoracolumbar spine disability. Based on the evidence, the Board concludes that the preponderance of the evidence weighs against finding that the Veteran’s neck disorder began during service, or is otherwise related to an in-service injury, event, or disease. The Board further concludes that the neck disorder is not secondary to his service-connected degenerative arthritis of the thoracolumbar spine disability. Indeed, the Veteran’s service treatment records show that in July 1964, he was involved in a motor vehicle accident that left him hospitalized for approximately one week, while stationed in Germany. He was found with sprained left acromioclavicular joint and contusion of the right shoulder. The treatment report right after the motor vehicle accident and his remaining service treatment records were negative for neck-related injuries. He marked “no” to “bone, joint, or other deformity” on his November 1967 separation Report of Medical History. The November 1967 separation physical examination report showed normal spine and other musculoskeletal systems and upper extremities. Two months after separation from service, the Veteran underwent a general VA examination in March 1968. He did not report neck troubles, and on examination, the examiner found no abnormalities, no atrophies, dystrophies, nor any deformities were noted of the upper extremities. No edema of any joint was present. Private treatment records in 1988 reflect that historically, the Veteran had a machine fall on him in 1974 and again, around 1978, when he fell down some stairs with a portable vacuum on his back that led to thoracic and lumbar spine injuries. Dr. G.G. found that he had “severe degenerative arthritis of the spine from that.” In May 1993, he was seen by Dr. F. for complaints of pain in the cervical area. Dr. F. diagnosed him with cervical arthritis. X-Ray imaging revealed mild degenerative disk disease at C3-4 and moderately severe disk disease at C6-7. The Veteran was seen in July 2012 by Dr. L.K. for reports of lower back and neck pain. He reported that two winters ago, he slipped and fell on the ice and developed a whiplash injury. His neck also hurts, and he pointed to the cervical-thoracic junction as where the pain was the worst experienced. In November 2012, he was seen by Dr. T.K., a neurologist, for complaints of nerve problems in his lower extremities. At that visit, he stated that he had whiplash 40 years ago, with some head trauma. At a January 2016 visit to a private health clinic, he reported that he had a bad car accident in Germany and then when working at a log company, a piece of equipment dropped a log and it landed on his upper back. The clinician, T.F. assessed him with chronic back/neck pain. At a March 2019 visit with Dr. T.K., the neurologist recorded that the Veteran reported having whiplash in a car accident in 1980 and has had “popping” and pain in his neck ever since. The Veteran was afforded a VA examination in April 2019. He was diagnosed with degenerative joint disease (DJD) and degenerative disc disease (DDD) of the cervical spine. The Veteran reported a history of having neck pain with decreased and painful range of motion. More recent X-Ray imaging showed mild joint space narrowing at C3-C4, C5-C6, and C6-C7. The examiner opined that the cervical spine condition was less likely due to service, as there was no physical evidence that this condition was related to service. The examiner further opined that the Veteran’s cervical spine disability was ‘not related to’ his service-connected degenerative arthritis of the thoracolumbar spine disability. Pursuant to the July 2019 Board remand, a VA medical opinion was requested in November 2019. After reviewing the claims file and the Veteran’s medical history, the examiner opined that his cervical spine DJD and DDD was not due to service. The rationale was that there was no documentation in his medical record of any neck injury while serving on active duty, and there was no evidence of any follow-up care for a cervical condition until 1993, which was 25 years after discharge from service. There were no changes from 1993 to 2004 to 2012 in his radiological findings. The examiner explained there was no evidence that the Veteran’s neck disorder was related to any injury that occurred while service on active duty—the X-Ray findings and MRI results in the record showed the Veteran essentially has had no change in his cervical spine condition over the course of the years. The examiner also found that the Veteran’s neck disorder was not aggravated by his service-connected degenerative arthritis of the thoracolumbar spine disability. The examiner explained that in the time period from 1968 until 2019, the Veteran had been exposed to multiple traumatic episodes, such as the 1974 event when a machine fell on him, and again in 1978, when he fell down some stairs with a portable vacuum on his back. Considering looking at a time of 41 years, with no significant progression of cervical disease, other than normally expected progression due to aging, the examiner found that it was less likely than not the Veteran’s service-connected degenerative arthritis of the thoracolumbar spine disability aggravated his neck condition. VA treatment records reflect ongoing treatment for cervical spine or neck pain, and that his neck pain had been ongoing for at least 30 years, but there was no medical opinion addressing etiology. Given the competent medical evidence, service connection for a neck disorder, to include as due to service-connected thoracolumbar spine disability, is not warranted. The service treatment records do not show a cervical spine injury or chronic neck disorder was found during service, or at discharge, as there was no record of such on his November 1967 separation examination. The current competent medical evidence also does not support a finding that a current neck disorder is related to service, including the 1964 motor vehicle accident the Veteran was involved in. When considered together, the Board finds the 2019 VA medical nexus opinions to be probative because they are based on in-person examinations and evaluation of the Veteran’s medical records. The opinions were also supported by adequate rationale that allows the Board to understand the basis for the conclusions and make a fully informed decision in this appeal. To the extent that the Veteran asserts that his current neck disorder is etiologically related to service, his statements are not competent because he does not possess the requisite medical training or expertise to make such a determination. Jandreau v. Nicholson, 492 F.3d 1372, 1377 (Fed. Cir. 2007). The Board gives more probative weight to competent medical evidence, which establishes that these symptoms are instead attributable to multiple, post-service intercurrent events, such as the 1974 event when a machine fell on him, the 1978 event of falling down the stairs, and the 1980 post-service motor vehicle and 2010 falling-on-the-ice accidents that resulted in whiplash. Therefore, service connection is not warranted on a direct basis. Service connection is also not warranted on the basis of chronicity and continuity of symptomatology or on a presumptive basis. As noted earlier, the Veteran was not diagnosed with a chronic neck disorder during service, and as such, chronicity and continuity is not established. Moreover, the March 1968, which took place two months after discharge from service, was normal for his upper extremities. Further, the evidence shows that the Veteran was not diagnosed with a neck disorder until 1993, which is decades after his separation from service. As a result, there is no competent evidence that a neck disorder began during service or manifested to a degree of 10 percent or more within a year of separation from the period of active service. See 38 C.F.R. §§ 3.303, 3.307, 3.309. Finally, service connection is also not warranted on a secondary basis, as the probative evidence of record has not established that the Veteran’s neck disorder was proximately caused by or aggravated by his service-connected degenerative arthritis of the thoracolumbar spine disability. The Board finds the November 2019 VA medical opinion most probative in this regard; there is no medical evidence to the contrary. In sum, the competent and persuasive evidence is against finding for service connection for a neck disorder, to include as due to service-connected degenerative arthritis of the thoracolumbar spine disability. There is no doubt to be resolved; service connection is not warranted. D. JOHNSON Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board M. Tang, 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.