Citation Nr: 21026236 Decision Date: 04/30/21 Archive Date: 04/30/21 DOCKET NO. 16-58 671 DATE: April 30, 2021 ORDER Entitlement to service connection for a lumbar spine disability is denied. Entitlement to service connection for shin splints is denied. FINDINGS OF FACT 1. The probative evidence of record does not establish that the Veteran’s lumbar spine disability is due to or the result of service, nor was it the result of or aggravated by the Veteran’s service-connected right knee disability. 2. The probative evidence of record does not establish that the shin splints are due to or the result of the Veteran’s period of service. CONCLUSIONS OF LAW 1. The criteria for service connection for a lumbar spine disability have not been met. 38 U.S.C. §§ 1110, 5107(b); 38 C.F.R. § 3.303, 3.307, 3.309, 3.310. 2. The criteria for service connection for shin splints have not been met. 38 U.S.C. §§ 1110, 5107(b); 38 C.F.R. § 3.303. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served active duty in the United States Marine Corps from February 1990 to May 1991. In January 2020, the Veteran testified before the undersigned Veterans Law Judge at a Video Conference hearing. A copy of the transcript has been associated with the claims file. In June 2020 and January 2021, the Board remanded the appeal for further development. Service Connection 1. Service connection for a lumbar spine disability The Veteran contends that his lumbar spine disability is due to his period of service, to include as secondary to his service-connected right knee disability. The question for the Board is whether the Veteran has a current disability that began during active duty service or is at least as likely as not related to an in-service injury, event, or disease or to a service-connected disability. The Board concludes that, while there is evidence of a current diagnosis of lumbar spondylosis, the preponderance of the evidence weighs against finding that the lumbar spine disability began during active duty service or is otherwise related to an active duty service injury, event, or disease or a service-connected disability. At the outset, the Board notes that the Veteran’s service treatment records are silent on complaint of or treatment for a lumbar spine disability. Turning to the evidence, in a February 2020 private opinion, the physician opined that the Veteran’s lumbar spine disability is secondary to his service-connected right knee disability. The physician explained that the Veteran’s knee disabilities caused him to have an altered gait. The physician stated that the results of an altered gait usually include a shortened stance phase and a surge during liftoff phase. The physician stated that this causes increased stress on the joints on the unaffected side including the midfoot, hip, and facet joint of the lumbar spine. The physician asserted that it is extremely unlikely that the Veteran’s right knee disability did not have any effect on the issues he experiences in his lower back. The Board notes that while the February 2020 private opinion offers a positive nexus, the reasons and bases do not align with the Veteran’s June 2015, March 2016, and May 2018 treatment records showing normal gait. As such, the Board finds the opinion to be inadequate for the purpose of adjudicating the claim. In an October 2020 VA examination, the examiner noted that the Veteran asserted that he injured his back from carrying heavy equipment during forced ruck marching. The examiner stated that it is less likely than not that the Veteran’s lumbar spine disability is aggravated beyond its natural progression by his service-connected right knee degenerative joint disease. The examiner explained that spondylosis is age-related change of the bones (vertebrae) and discs of the spine. The examiner stated that these changes are often called degenerative disc disease and osteoarthritis. The examiner further explained that osteoarthritis is considered a progressive disease and worsens over time. Therefore, there is no aggravation beyond its natural progression by the service connected right knee disability. In a February 2021 VA addendum opinion, the examiner stated that the Veteran’s lumbar spine disability is less likely than not due to or the result of his period of service. The examiner stated that the Veteran served from 1990 to 1993. The examiner explained that there is no documentation of any trauma, injuries or complaints for a lumbar spine disability during military service. The examiner concluded, therefore, that it is less likely than not that the Veteran’s lumbar spine disability is due to his period of service. The examiner also stated that it is less likely than not that the Veteran’s lumbar spine disability is proximately due to the Veteran’s service-connected right knee disability. The examiner explained that there is no medical literature review that supports that a lumbar spine disability can be a complication of the Veteran’s right knee disability. Therefore, the examiner concluded that the Veteran’s lumbar spine disability is not related to the Veteran’s right knee disability. After review of the record, the Board finds that the probative evidence of record does not establish service connection for a lumbar spine disability, to include as secondary to service-connected right knee disability. The February 2021 VA opinion indicated that the Veteran’s lumbar spine disability was not related to his period of service such that service connection on a direct basis would be warranted. Moreover, the October 2020 and February 2021 VA opinions indicate that the Veteran’s lumbar spine disability is not related to, the result of, or aggravated by the Veteran’s service-connected right knee disability. The Board finds these medical opinions to be probative in nature, as they are based on an adequate rationale, medical literature, and review of relevant medical history and lay statements. As such, service connection for a lumbar spine disability is not warranted. The Board has also considered presumptive service connection under 38 C.F.R. § 3.309(a) for arthritis and service connection based on a continuity of symptomatology under 38 C.F.R. § 3.303(b); however, the probative evidence does not indicate that the disability manifested within a year of separation of service or that it occurred continuously since discharge from service. Therefore, presumptive service connection and service connection based on continuity of symptomatology are not warranted. While the Veteran believes that his lumbar spine disability is related to his period of service, to include as due to service-connected right knee disability, the Veteran is not competent to provide an etiology opinion on a lumbar spine disability, as this is a complex medical matter. The Board reiterates that the preponderance of the probative evidence weighs against findings that his lumbar spine disability is due to or the result of his active duty service or to a service-connected right knee disability. 2. Service connection for shin splints The Veteran contends that his bilateral shin splints are due to his period of service. The question for the Board is whether the Veteran has a current disability that began during service or is at least as likely as not related to an in-service injury, event, or disease. The Board concludes that, while the Veteran has diagnoses of bilateral shin splints, the preponderance of the evidence weighs against finding that the Veteran’s diagnosis of shin splints began during service or is otherwise related to an in-service injury, event, or disease. Turning to the evidence, the Board notes that the Veteran’s service treatment records are silent on complaint of or treatment for shin splints. However, at a January 2020 Board hearing, the Veteran reported that marching on hard surfaces and carrying excess weight resulted in his shin splints. The Board finds this description consistent with the Veteran’s service. In June 2020 and January 2021 Board decisions respectively, the Board previously found the August 2017 and the October 2020 VA examinations to be inadequate for the purpose of adjudicating the claim. Therefore, no further analysis of these examinations is necessary. In a February 2021 VA addendum opinion, the examiner stated that the Veteran’s shin splints were less likely than not due to or the result of his period of service. The examiner noted that the Veteran served from 1990 to 1993. The examiner explained that there is no documentation of any trauma, injuries or complaints during military service of shin splints. The examiner noted that the Veteran’s reports of marching and carrying excess weight in relationship to his current shin splints were considered, but there are no treatment records to support the claim. The examiner concluded, therefore, that it is less likely than not that the Veteran’s shin splints are due to his period of service. After review of the record, the Board finds that the evidence weighs against finding for service connection for shin splints. The medical evidence indicates that the Veteran’s shin splints were less likely than not due to his period of active duty service. The Board finds the medical opinion to be probative in nature, as it is based on an adequate rationale and review of relevant medical history and lay statements. As there is no probative evidence to the contrary, a nexus has not been established. Therefore, service connection for shin splints is not warranted. The Board has considered the Veteran’s contention that his period of service resulted in his current diagnosis of bilateral shin splints. Although lay persons are competent to provide opinions on some medical issues, as to the specific issue in this case, determining the etiology of his shin splints falls outside the realm of common knowledge of a lay person. See Kahana v. Shinseki, 24 Vet. App. 428, 435 (2011). In this regard, while the Veteran can competently report his symptoms, any opinion regarding whether the Veteran’s current shin splints are related to his service requires medical expertise that the Veteran has not demonstrated. See Jandreau v. Nicholson, 492 F. 3d 1372, 1376 (2007). As such, the Board assigns no probative weight to the Veteran’s assertions that his shin splints are related to his military service. JENNIFER HWA Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board C. Ford 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.