Citation Nr: 21021076 Decision Date: 04/09/21 Archive Date: 04/09/21 DOCKET NO. 18-47 616 DATE: April 9, 2021 ORDER Service connection for a low back disorder is denied. Service connection for left lower extremity (LLE) sciatica is denied. Service connection for right lower extremity (RLE) sciatica is denied. FINDINGS OF FACT 1. The Veteran served on active duty from November 1976 to May 1979; he has been 100 percent disabled based on unemployability since July 2015 and 100 percent disabled for all service connected disabilities since January 2021. 2. A low back disorder was not noted in service; a current back disorder, diagnosed as degenerative arthritis of the spine, was not chronic in service, not continuous since service, not shown to a compensable degree within one year of service, is not casually or etiologically related to service, and has not been medically associated with a service-connected disability. 3. Bilateral lower extremity sciatica was not shown in service and was not caused or aggravated by a service-connected disability CONCLUSIONS OF LAW 1. A low back disorder was not incurred in service. 38 U.S.C. §§ 1131, 5103, 5103A, 5107 (2012); 38 C.F.R. §§ 3.102, 3.159, 3.303, 3.309 (2020). 2. LLE sciatica was not incurred in service and is not secondary to a service-connected disability. 38 U.S.C. §§ 1101, 1112, 1131, 5107(b) (2012); 38 C.F.R. §§ 3.102, 3.303(a), 3.307, 3.309, 19.2 (2020). 3. RLE sciatica was not incurred in service and is not secondary to a service-connected disability. 38 U.S.C. §§ 1101, 1112, 1131, 5107(b) (2012); 38 C.F.R. §§ 3.102, 3.303(a), 3.307, 3.309, 19.2 (2020). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS In March 2020, the Veteran testified before the undersigned Veterans Law Judge. A copy of the transcript has been associated with the claims file. In July 2020, the Board remanded the appeal for additional development. The case has now been returned to the Board for further appellate action. Service connection may be granted on a direct basis as a result of disease or injury incurred in service based on nexus using a three-element test: (1) the existence of a present disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the present disability and the disease or injury incurred in or aggravated by service. See 38 C.F.R. §§ 3.303(a), (d); Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009). Service connection may be granted on a presumptive basis for diseases listed in 38 C.F.R. § 3.309 under the following circumstances: (1) where a chronic disease or injury is shown in service and subsequent manifestations of the same disease or injury are shown at a later date unless clearly attributable to an intercurrent cause; or (2) where there is continuity of symptomatology since service; or (3) by showing that the disorder manifested itself to a degree of 10 percent or more within one year from the date of separation from service. See 38 C.F.R. § 3.307. Service connection may be granted on a secondary basis for a disability which is aggravated by, proximately due to, or the result of a service-connected disease or injury under 38 C.F.R. § 3.310. Allen v. Brown, 7 Vet. App. 439 (1995). In order to establish service connection on a secondary basis, there must be (1) evidence of a current disability; (2) evidence of a service-connected disability; and (3) medical evidence establishing a link between the service-connected disability and the current disability. See Wallin v. West, 11 Vet. App. 509, 512 (1998). Low Back Disorder The Veteran asserts that his low back disability began in-service while he was on submarine duty which required a lot of crouching, crawling in small confined spaces with twisting, turning, and prolonged sitting watching sonar screens. Turning to the evidence, the first element of service connection of a current disability is met. Specifically, the Veteran was diagnosed with degenerative arthritis of the lumbar spine with bilateral lower extremity radiculopathy in a December 2020 VA examination. As to an in-service incurrence, service treatment records (STRs) are absent of complaints, diagnoses, or treatment for a back disorder. At the time of service separation, the clinical evaluation of his spine was normal. Therefore, the medical evidence does not support the second element of direct service connection. To the extent that the Veteran asserts a nexus between service and his low back disorder, in a February 2020 letter, a private physician noted that the Veteran experienced back pain associated with lower limb radicular, neuropathic pain and a January 2017 MRI showed degenerative disc disease (DDD) of the lumbar spine. The clinician stated that “it is my understanding that [the Veteran’s] back and leg pain symptoms began while in the military” and the pathology noted on his lumbar MRI was consistent with a history of repetitive ballistic movements, jumping, repetitive bending, carrying or wearing heavy equipment such as a backpack. However, the clinician did not provide a rationale for his opinion, discuss normal findings at the time of separation, or address the period of time between discharge and onset of symptoms. In addition, the clinician appeared to base his opinion only on the history as provided by the Veteran, which is not supported by the contemporaneous medical evidence of record. As such, this opinion is afforded less probative value. In a July 2020 VA medical opinion, the examiner opined that the Veteran’s low back disorder was less likely than not incurred in or caused by service. The examiner explained that there was no evidence in the Veteran’s STRs that he injured his back during service. The examiner indicated that the Veteran reported symptoms of back pain with bilateral radicular symptoms since appropriately 1992, approximately 15 years after service. In a December 2020 VA Disability Benefit Questionnaire (DBQ), the Veteran reported that his low back pain began in 1977 which he attributed to submarine duty requiring lots of crouching, crawling in small confined spaces with twisting, turning, and prolonged sitting watching sonar screens. The examiner diagnosed degenerative arthritis of the spine and noted X-rays showing arthritis of the lumbar spine. The examiner, after review of all of the evidence and examination of the Veteran, opined that the Veteran’s low back disorder was less likely than not incurred in or caused by service. The examiner explained that there was no evidence in the Veteran’s STRs that he injured his back during service. The examiner noted that the Veteran did not appear to develop back pain until 2006, well after his separation from service. In a subsequent January 2021 VA medical opinion, the examiner opined that the Veteran’s low back disorder was less likely than not incurred in or caused by service. The examiner explained that, after review of all of the evidence and examination of the Veteran, there was no evidence in the Veteran’s STRs that he injured his back during service. The examiner noted that the Veteran did not appear to develop back pain until 2000, approximately 21 years after service. The examiner indicated that the Veteran’s excess weight put added stress on his joints, putting him at risk for developing arthritis. Further, the examiner noted that if the Veteran’s current back conditions were due to an injury in service, it would have been expected that he would have developed post-traumatic arthritis, in which symptoms present within two to five years after the injury (not 21 years), and evidence of cartilage degeneration within five years. The Board affords the VA examiners’ opinions more probative value than the opinion offered by the Veteran’s private physician in February 2020 because the VA examiners offered more thorough rationales that are consistent with the medical evidence, considered the STRs, and addressed the period of time between discharge and onset of symptoms. As such, the medical evidence does not support direct service connection. Turning to presumptive service connection, the Veteran has been diagnosed with degenerative arthritis of the spine. a disease associated with presumptive service connection under 38 C.F.R. § 3.309. Therefore, the presumptive service connection provisions for service connection based on “chronic” symptoms in service and “continuous” symptoms since service are applicable. The available STRs do not show any complaints of or treatment for degenerative arthritis of the lumbar spine in service. Of note, the separation examination reflected a normal clinical evaluation of the spine. As such, a chronic lumbar spine disorder was not shown in service. Next, the medical evidence does not support presumptive service connection based on continuity of symptomatology since service. The April 1979 separation examination reflected that clinical evaluation of his back was normal. The record next indicates the Veteran sought treatment in 2006 for low back pain. The December 2006 private treatment records documented MRI findings of the lumbar spine showing multilevel spondylosis, moderate neural foraminal stenosis at numerous levels without gross central stenosis nor marked nerve root deviation Thus, the first recorded reference to degenerative changes was noted in December 2006, approximately 27 years after discharge. As such, the medical evidence does not support service connection on a “continuity of symptomatology” basis. Further, the disorder did not manifest itself to a degree of 10 percent or more within one year from the date of separation of service. The Veteran separated from service in 1979 but did not note symptoms until 2006 at the earliest. This evidence does not support presumptive service connection on a “manifest within one-year from separation” basis. Therefore, presumptive service connection on any basis is not supported by the medical evidence. Bilateral Lower Extremity Sciatica The Veteran has bilateral lower extremity sciatica which he asserts is a result of active duty. Alternatively, he suggested it was secondary to a low back disability. In this regard, the medical evidence reflects a current diagnosis of bilateral lower extremity radiculopathy as reported in the December 2020 VA examination report. Thus, a current diagnosis has been shown and the first element of service connection is met. As to an in-service incurrence, the STRs do not show complaints of, treatment for, or a diagnosis of bilateral sciatica during service. Thus, the second element of direct service connection, an in-service incurrence, has not been shown and the medical evidence does not support service connection on a direct basis. Rather, the Veteran’s main assertion is that bilateral lower extremity sciatica is related to a low back disorder. However, service connection for a low back disorder has been denied in this decision. As such, the medical evidence does not support service connection for a bilateral lower extremity sciatica as secondary to a service connected disability. All associated private and VA medical records have also been reviewed. While they contain treatment for bilateral radiculopathy, there is no indication that any examiner or treatment provider has related his disorders to service, or any incident thereof. The Board has considered the Veteran’s lay statements that his disorders were caused by service. He is competent to report symptoms because this requires only personal knowledge as it comes to him through his senses. However, he is not competent to offer an opinion as to the etiology of his disorders due to the medical complexity of the matters involved. Such competent evidence has been provided by the service records, clinical evidence, and examinations obtained and associated with the claims file. Here, the Board attaches greater probative weight to the clinical findings than to his statements. In light of the above, the preponderance of the evidence is against the claims for service connection and there is no doubt to be otherwise resolved. As such, the appeals are denied. Finally, the Veteran has not raised any other issues, nor have any other issues been reasonably raised by the record, for the Board’s consideration. See Doucette v. Shulkin, 28 Vet. App. 366, 369-370 (2017) (confirming that the Board is not required to address issues unless they are specifically raised by the claimant or reasonably raised by the evidence of record). L. HOWELL Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board T. Grzeczkowicz 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.