Citation Nr: 21031710 Decision Date: 05/24/21 Archive Date: 05/24/21 DOCKET NO. 10-43 717 DATE: May 24, 2021 ORDER Entitlement to service connection for cervical spondylosis, to include as secondary to service-connected lumbar spine spondylolisthesis is denied. FINDING OF FACT Cervical spondylosis did not originate in service or manifest to a compensable degree within one year of service discharge, is not otherwise etiologically related to service, and was not caused or aggravated by any service-connected disability. CONCLUSION OF LAW The criteria for entitlement to service connection for cervical spondylosis, to include as secondary to service-connected lumbar spine spondylolisthesis, have not been met. 38 U.S.C. §§ 1101, 1110, 5107(b); 38 C.F.R. §§ 3.303, 3.310. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran had active service from November 2010 to August 1991. A December 2014 Board decision remanded the issue on appeal for further development. That development has been accomplished, and the claim has now been returned to the Board for further action. Stegall v. West, 11 Vet. App. 268 (1998). Entitlement to service connection for cervical spondylosis, to include as secondary to service-connected lumbar spine spondylolisthesis, is denied. Service connection may be granted for disabilities resulting from disease or injury incurred in or aggravated by active duty. 38 U.S.C. §§ 1110, 1153; 38 C.F.R. § 3.303, 3.304, 3.306. In order for a disorder to be service connected, there must be: (1) medical evidence of a current disability; (2) medical, or in certain circumstances, lay evidence of in-service incurrence or aggravation of a disease or injury; and (3) medical evidence of a nexus between the claimed in-service disease or injury and the current disability. Hickson v. West, 12 Vet. App. 247, 253 (1999). Service connection may be established on a secondary basis for a disability which is proximately due to or the result of a service-connected disease or injury. 38 C.F.R. § 3.310 (a). Secondary service connection may also be established for a nonservice-connected disability which is aggravated by a service-connected disability. In such an instance, the veteran may be compensated for the degree of disability over and above the degree of disability existing prior to the aggravation. 38 C.F.R. § 3.310 (b); see Allen v. Brown, 7 Vet. App. 439, 448 (1995). In order to establish entitlement to service connection on this secondary basis, there must be (1) evidence of a current disability; (2) evidence of a service-connected disability; and (3) medical evidence establishing a nexus between the service-connected disability and the current disability. See Wallin v. West, 11 Vet. App. 509, 512 (1998). Certain chronic diseases, such as arthritis, are subject to presumptive service connection if manifest to a compensable degree within one year from separation from service even though there is no evidence of such disease during the period of service. This presumption is rebuttable by affirmative evidence to the contrary. 38 U.S.C. §§ 1112, 1113; 38 C.F.R. §§ 3.307 (a)(3), 3.309(a). Under 38 C.F.R. § 3.303 (b), an alternative method of establishing the second and third Shedden elements is through a demonstration of continuity of symptomatology if the disability claimed qualifies as a chronic disease listed in 38 C.F.R. § 3.309 (a). Spondylosis, or osteoarthritis, is a qualifying chronic disease. See Walker v. Shinseki, 708 F.3d 1331 (Fed. Cir. 2013). As a result, service connection via the demonstration of continuity of symptomatology is applicable to the issue of spondylosis in the present case. The Veteran asserts that his cervical spine disability was caused by his lumbar spine injury, and he essentially contends that service treatment records (STRs) which reflect treatment and diagnosis for a cervical spine disability are redacted because of his clearance level during active service. The Veteran has also asserted that his cervical spine disability was caused by an in-service 1972 mortar shell combat blast and was further aggravated by a 1985 hand grenade blast. See, e.g., April 2009 VA spinal cord injury admission evaluation note. STRs are silent for treatment or diagnosis of any cervical spine disability. Post-service, a December 2008 VA treatment record contained a diagnosis of cervical degenerative arthritis. No post-service treatment records contain any etiologic opinions. At an August 2013 VA examination, the Veteran reported that he began to experience neck pain in 1979, which he believed was affected by recoil from weapons. He did not get seen for it in the service. He denied any injuries to his neck after he retired from the Army, and then he worked as an electrician until 2008. In 2010, his neck worsened. The examiner opined that the Veteran's claimed neck disability is less likely than not proximately due to or the result of the Veteran's low back disability. As rationale, the examiner noted that there was no mention of any cervical pain in medical treatment notes until at least December 2008. Further, while STRs noted back injuries during service, no mention was made of neck pain as would be customary if such pain was present. The examiner opined that as no neck pain was ever noted to be associated with any of the noted lumbar injuries in service, it could be presumed that neck pain was not associated with the in-service injuries. The examiner also opined that degenerative disease of the spine is directly related to local strain or trauma and is not a systemic condition that necessarily spreads through the spine. Finally, the examiner stated that as there were no neck symptoms reported by the Veteran for nearly 15 years post-service, and as radiologic imaging of the neck showed worsening of the condition in less than 18 months, it is likely that the neck condition is a separate condition unrelated to a lumbar disability and due instead to a cumulative strain or undisclosed injury. In an October 2015 VA addendum opinion, the examiner opined that it was less likely than not that the Veteran's claimed cervical spine disability was aggravated beyond its natural progression by his lumbar spine disability because there was no entry in his medical treatment records which reflected any acute worsening of the lumbar spine in correlation to the cervical spine. The examiner further noted that the lumbar spine is geographically remote from the cervical spine and there was no evidence of degenerative joint disease between the two spinal regions. The examiner concluded that the cervical spine disease was aggravated only by the natural progression of local changes which cause strain to the cervical joints. Based upon the evidence of record, the Board finds that the Veteran's cervical spine disability is not related to service or his service-connected lumbar spine spondylolisthesis. First, the most competent and probative evidence of record indicates that the Veteran's cervical spine disability did not manifest during active service, nor did any cervical spinal arthritis manifest within a year of discharge. STRs are silent for specific treatment or diagnoses of a cervical spine disability. Further, there is no indication that the Veteran's STRs are incomplete, as the Veteran contends. The Veteran's STRs span the entire length of his service, and include detailed histories and notes of multiple injuries and treatments. A March 2015 administrative decision conceded the Veteran's service from May 1982 to August 1983 was in intelligence as a non-commissioned officer, and that the Veteran may have had duties that were of a sensitive nature. However, a September 1982 medical examination and hematology report, a June 1982 orthopedic report, and July 1982 bilateral knee x-ray report with physical profile board proceedings are associated with the Veteran's STRs records as well as several other detailed medical treatment records surrounding the period of service in question. Additionally, post-service medical treatment records do not establish diagnoses or treatment of cervical spine arthritis within one year of service discharge. Indeed, there is no evidence of treatment for a cervical spine condition until 2008, approximately 17 years after discharge from service. Finally, there is no medical nexus opinion in favor of service connection. The Board acknowledges the Veteran's lay statements of record, but he has not been shown to possess expert knowledge which would enable him to render a nexus opinion. Jandreau v. Nicholson, 492 F.3d 1372, 1376-77 (Fed. Cir. 2007). Consequently, the preponderance of the objective evidence of record fails to establish that the Veteran's cervical spine disability is related to service. As there is no probative evidence of record establishing an in-service injury or disease, an opinion on the question of direct service connection is not necessary. See McLendon v. Nicholson, 20 Vet. App. 79 (2006). Second, the preponderance of the objective medical evidence of record also fails to establish the Veteran's cervical spine disability is related to his service-connected lumbar spine disability. The Board finds the opinions of the August 2013 and October 2015 VA examiners to be probative and persuasive. The examiners are shown to have reviewed of the evidence of record, including the contentions of the Veteran, and the evidence as to the Veteran's history was adequately considered. See Dalton v. Nicholson, 21 Vet. App. 23 (2007). Further, the Veteran has not been shown to possess the training, credentials, or other expertise to render an opinion that is of comparable probative value to the VA examiner's opinions. See Jandreau at 1377 n.4. (Continued on the next page) For the reasons stated above, the Board concludes that the preponderance of evidence is against granting service connection for cervical spine spondylosis on any theory of entitlement raised by the Veteran or the record. Thus, there is no reasonable doubt to be resolved in the Veteran's favor, and the claim must be denied. 38 U.S.C. § 5107; 38 C.F.R. § 3.102. Roya Bahrami Acting Veterans Law Judge Board of Veterans' Appeals Attorney for the Board N. Peden 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.