Citation Nr: 21014840 Decision Date: 03/15/21 Archive Date: 03/15/21 DOCKET NO. 17-10 879 DATE: March 15, 2021 ORDER Service connection for a back disability is granted. FINDING OF FACT Resolving all reasonable doubt in his favor, the Veteran’s back disability is related to his active service. CONCLUSION OF LAW The criteria for service connection for back disability have been met. 38 U.S.C. §§ 1110, 5103, 5103A, 5107; 38 C.F.R. §§ 3.102, 3.159, 3.303, 3.307, 3.309. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from December 2010 to December 2014. He testified at a videoconference hearing before the undersigned in December 2019. This matter was before the Board in December 2019 when it was remanded for additional development. Service Connection Service connection may be established for disability resulting from disease or injury incurred in or aggravated by service. 38 U.S.C. § 1110; 38 C.F.R. § 3.303. Service connection may be granted on a presumptive basis for certain chronic diseases, including arthritis, if the disability was manifested to a compensable degree within one year of separation from service. 38 U.S.C. §§ 1110, 1112(a)(1), 1113, 1131; 38 C.F.R. §§ 3.307(a)(3), 3.309(a). Generally, to establish service connection, the evidence must show (1) the existence of a present disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship (nexus) between the current disability and the in-service disease or injury (or in-service aggravation). Holton v. Shinseki, 557 F.3d 1362, 1355 (Fed. Cir. 2009); Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004). For presumptive chronic diseases, to include sensorineural hearing loss, an alternative method of establishing the second and third elements is through a demonstration of continuity of symptomatology. See 38 C.F.R. § 3.303(b); Walker v. Shinseki, 708 F.3d 1331 (Fed. Cir. 2013). When there is an approximate balance of positive and negative evidence regarding the merits of an issue material to the determination of the matter, the benefit of the doubt in resolving each such issue shall be given to the claimant. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102. When all of the evidence is assembled, VA is responsible for determining whether the evidence supports the claim or is in relative equipoise, with the appellant prevailing in either event, or whether a fair preponderance of the evidence is against the claim, in which case the claim is denied. Gilbert v. Derwinski, 1 Vet. App. 49, 55 (1990). The Veteran seeks service connection for a back disability related to service. He contends that the heavy packs, flak jacket, Kevlar and ballistic plates he wore for many months caused his back disability. See April 2016 Notice of Disagreement. He contends that his current back disability first manifested during his period of active service and has continued and progressed since that time. See December 2019 hearing transcript; April 2020 VA Back Conditions Disability Benefits Questionnaire (DBQ). The evidence of record shows the Veteran has a current diagnosis of a back disability. VA outpatient treatment records and an April 2020 VA Back Conditions DBQ note findings of inflammatory arthritis with radiculopathy which caused sacroiliitis. Thus, the current disability requirement is met. After having carefully reviewed the record, weighing the evidence both in support of and against the claim, and resolving reasonable doubt in favor of the Veteran, the Board finds that the evidence is in relative equipoise as to whether the Veteran has a back disability related to his military service. In this regard, the Veteran’s service treatment records dated from 2010 to 2014 show various complaints of upper and lower back pain and spasm from July 2014 to October 2014. X-ray studies in September 2014 were negative; however, July 2014 labs showed HLA-B27, the genetic marker for ankylosing spondylitis/immune system diseases such as reactive inflammatory arthritis. The record also establishes that the Veteran has credibly and consistently maintained that he has had back pain since service. See Charles v. Principi, 16 Vet. App. 370 (2002). There is no evidence to refute these statements. In fact, the Veteran submitted the instant claim in December 2014, just weeks after his separation from service, and was seen as early as April 2015 for complaints of back pain. It was not until March 2016 that he was afforded MRI studies, which showed bilateral sacroiliitis. The Board acknowledges that in April 2020, a VA examiner opined that the Veteran did not have a back disability related to service. The VA examiner’s conclusion is a medical conclusion that the Board cannot ignore or disregard (see Willis v. Derwinski, 1 Vet. App. 66 (1991)); however, the Board is free to assess medical evidence and is not compelled to accept a medical opinion. See Wilson v. Derwinski, 2 Vet. App. 614 (1992). The Board notes that the 2020 VA examiner did not consider the consistent lay statements of ongoing chronic back pain in providing the opinion. (Continued on the next page)   Resolving all doubt in the Veteran’s favor, service connection for back disability is granted. See 38 C.F.R. § 3.102; Gilbert, supra. A. ISHIZAWAR Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Fletcher, Kathleen 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.