Citation Nr: 21026392 Decision Date: 05/03/21 Archive Date: 05/03/21 DOCKET NO. 16-21 725 DATE: May 3, 2021 ORDER Service connection for a head injury is denied. Service connection for headaches is denied. Service connection for a cervical spine disorder is denied. FINDINGS OF FACT 1. The Veteran had active duty from September 1974 to September 1978. 2. The Veteran reported incurring a head injury in service; however, residuals of a head injury are not currently shown. 3. The Veteran reported headaches in service; however, symptoms were not shown to be chronic; a current diagnosis of headaches is not causally or etiologically related to service. 4. A cervical spine disorder, diagnosed as degenerative disc disease (DDD), degenerative joint disease (DJD), cervical spine pain, spondylosis, and cervical radiculopathy, was not shown in service, symptoms were not shown to be chronic, not continuous since service, not shown to a compensable degree within one year of service, and is not casually or etiologically related to service. CONCLUSIONS OF LAW 1. A head injury was not incurred in service. 38 U.S.C. §§ 1110, 1131, 5103(a), 5103A, 5107 (2012); 38 C.F.R. §§ 3.159, 3.303 (2020). 2. Headaches were not incurred in service. 38 U.S.C. §§ 1110, 1131, 5103(a), 5103A, 5107 (2012); 38 C.F.R. §§ 3.159, 3.303 (2020). 3. A cervical spine disorder was not incurred in service and is not presumed to have been incurred in service. 38 U.S.C. §§ 1110, 1131, 5103(a), 5103A, 5107 (2012); 38 C.F.R. §§ 3.159, 3.303, 3.307, 3.309 (2020). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran testified before the undersigned Veterans Law Judge in January 2019. A copy of the transcript has been associated with the claims file. In July 2019, the Board denied the claims. The Veteran appealed to the Veterans' Claims Court. In July 2020, the Court Clerk vacated the Board's decision in a Joint Motion for Remand (JMR) and remanded the claim for additional development. In December 2020, the Board remanded the claims consistent with the reasons and bases listed in the JMR. These actions stem the basis for the current appeals. 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 Head Injury At the January 2019 hearing, the Veteran testified that he began experiencing headaches in service after hitting his head on a pipe. He explained that while he sought treatment for his headaches in service, he did not report that he hit his head. Further, he reported undergoing an MRI in April 2018 to assess residuals of the head injury. Service treatment records (STRs) reflect that the Veteran incurred headaches in service. However, they do not show that he experienced headaches due to a head injury. Further, clinical records reflect that while he did undergo an MRI in April 2018, it was for a cervical spine disorder. Moreover, while he reported hitting his head on a pipe, clinical records are absent of any diagnosis, complaint, or treatment for a head injury, other than headaches which will be addressed below. As the Veteran was not diagnosed with or did not report symptoms of a head injury, the first element of service connection, a current diagnosis, is not shown, and the medical evidence does not support the claim of service connection. Headaches As an initial matter, the Veteran contends that headaches were due to a head injury. However, as he is not currently service connected for a head injury, secondary service connection is not for application. Therefore, service connection for headaches will only be addressed on a direct basis. As to a current disorder, at the hearing, the Veteran testified he began receiving treatment for headaches in 1978. Further, while he complained of headaches in 2008, a CT scan was negative. Nevertheless, he was diagnosed with cervicogenic headaches in 2013. Therefore, the first element of service connection is met. As to an in-service incurrence, in a July 1977 STR, the Veteran complained of recurrent moderate to severe throbbing headaches originating behind the eye and occurring two to three times daily. Further in a December 1997 he reported a history of migraine headaches. However, he did not report headaches at separation. Nevertheless, as he sought treatment for headaches in service, the second element of service connection is met. As to nexus, in a December 2013 VA examination, the Veteran complained of migraine headaches in service. Upon examination, the examiner opined that headaches were less likely than not incurred in service. The examiner reasoned that the Veterans presented with symptoms of throbbing unilateral headache radiating to neck and shoulder lasting three months, together with reported MRI findings of cervical pathology and pain resolving with cervical injections is compatible with cervicogenic headache. However, the headaches documented in service were described as "occurring two to three times a day, "always located behind left eye and . . . throbbing." The examiner explained that the headaches in service were more likely than not cluster headaches, as they occurred in a clusters two to three times a day, whereas the present headaches were constant over several months and compatible with cervicogenic headaches. A reasonable reading of the medical opinion is that the headaches in service were different than the current headaches and they were not related. There is no contradictory opinion. Therefore, the medical evidence does not support the claim of service connection. Cervical Spine Disorder As an initial matter, the Veteran contends that cervical spine pain was due to a head injury. However, as he is not currently service connected for a head injury, secondary service connection is not for application. Nevertheless, as DJD and spondylosis are chronic disorders under 38 C.F.R. § 3.309, both direct and presumptive service connection will be addressed. Turning first to direct service connection, in a September 2013 clinical record, the Veteran reported neck pain beginning in 2002. Further he was diagnosed with DDD in 2008, neck pain and DJD in 2009, cervical spondylosis in 2010, and cervical radiculopathy in 2012. Therefore, a current disorder is shown, and the first element of direct service connection is met. As to an in-service incurrence, STRs are absent of complaints, diagnoses, or treatment for a cervical spine disorder. Specifically, the Veteran sought treatment for headaches, a left knee disorder, and a swollen finger, but did not report cervical spine pain. Further, the neck was normal at separation. Therefore, the second element of direct service connection is not shown, and the medical evidence does not support the claim for direct service connection. Turning to presumptive service connection, the Veteran was discharged from service in 1978 but was not diagnosed with DJD until 2009. As he was discharged in 1978 and symptoms of DJD were not identified until 2009, over 30 years later, the medical evidence does not support service connection on a chronic in service or 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. Specifically, the Veteran separated from service in 1978 and stated that he did not have neck pain until 2002. Therefore, this evidence does not support presumptive service connection on a "manifest within one-year from separation" basis, and the medical evidence does not support presumptive service connection is not supported by the medical evidence. The Board has considered the Veteran's lay statements and testimony that these disorders began in service. While he is competent to report symptoms because this requires only personal knowledge as it came to him through his senses, he is not competent to offer etiologies of these disorders. 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 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 (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 D. Ragofsky, Attorney Advisor 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.