Citation Nr: 21032556 Decision Date: 05/27/21 Archive Date: 05/27/21 DOCKET NO. 17-01 257 DATE: May 27, 2021 ORDER Entitlement to service connection for degenerative arthritis of the right elbow is granted. Entitlement to service connection for degenerative arthritis of the left elbow is granted. Entitlement to service connection for degenerative arthritis of the thoracolumbar spine is granted. FINDINGS OF FACT 1. The Agency of Original Jurisdiction (AOJ) granted service connection for degenerative joint disease of both knees (arthritis). The AOJ coded the disorder as DC 5003. 2. The Veteran has degenerative arthritis of the right elbow. 3. Degenerative arthritis of the right elbow is a subsequent manifestation of the already service connected arthritis. 4. The Veteran has degenerative arthritis of the left elbow. 5. Degenerative arthritis of the left elbow is a subsequent manifestation of the already service connected arthritis. 6. The Veteran has degenerative arthritis of the thoracolumbar spine. 7. Degenerative arthritis of the thoracolumbar spine is a subsequent manifestation of the already service connected arthritis. 8. Clear intercurrent cause for the arthritis is not established in the file. CONCLUSIONS OF LAW 1. Degenerative arthritis of the right elbow was incurred in service. 38 U.S.C. § 1131; 38 C.F.R. § 3.303. 2. Degenerative arthritis of the left elbow was incurred in service. 38 U.S.C. § 1131; 38 C.F.R. § 3.303. 3. Degenerative arthritis of the thoracolumbar spine was incurred in service. 38 U.S.C. § 1131; 38 C.F.R. § 3.303. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from October 1979 to September 1983. These matters come before the Board of Veterans' Appeals (Board) on appeal from an August 2013 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO). The Veteran presented testimony before the undersigned Veterans Law Judge during a Travel Board hearing in October 2019. A transcript of the hearing is associated with the electronic claims file. During the October 2019 Board hearing, the VLJ clarified the issues on appeal; clarified the concept of service connection claims; identified potential evidentiary defects; clarified the type of evidence that would support the Veteran's claim; and enquired as to the existence of potential outstanding records. Thus, the actions of the VLJ supplement the VCAA and comply with any related duties owed during a hearing set forth in 38 C.F.R. § 3.103. In January 2020, the Board reopened the Veteran's previously denied claims of arthritis of the back, right elbow lateral epicondylitis and degenerative joint disease, and left elbow arthritis and remanded the reopened claims of service connection for a right elbow disability, left elbow disability, and thoracolumbar spine disability for evidentiary development. The Veteran's claims folder has returned to the Board for further appellate consideration. Service connection for right elbow, left elbow, and thoracolumbar spine disabilities "[T]he term osteoarthritis is a synonym of the terms degenerative arthritis and degenerative joint disease." Greyzck v. West, 12 Vet. App. 288, 291 (1999). In February 2021, supported by imaging studies, a VA examiner found the Veteran has degenerative arthritis of the right elbow, left elbow, and thoracolumbar spine. See February 2021 VA examination reports. The examiner opined the Veteran's degenerative arthritis of the right elbow, left elbow, and thoracolumbar spine are due to the normal aging process and genetic predisposition. However, the examiner did not provide a rationale as to how the Veteran's current degenerative arthritis of the thoracolumbar spine is due to genetic predisposition and aging. Also, although the examiner noted both of the Veteran's elbows demonstrated symmetric findings and the current elbow disabilities were therefore due to genetic predisposition and aging, the examiner did not address evidence of a possible earlier onset of arthritis. In this regard, the Board notes the Veteran's report to the examiner of longstanding elbow and back pain as well as medical records noting chronic pain of the elbows at least as early as September 1999 as well as treatment for back pain in June 1999. Moreover, the examiner did not address whether the Veteran's reports of longstanding chronic pain were early manifestations of his later confirmed arthritis. Therefore, the Board gives little probative weight the examiner's opinion regarding the aging process and genetic predisposition. In a May 1984 decision, the AOJ granted service connection for degenerative joint disease of both knees. No words of limitation were used, therefore, 38 C.F.R. § 4.71a, Diagnostic Code 5003 (degenerative arthritis) applies. In fact, the AOJ has consistently coded the disorder as 5003. By law, arthritis is a chronic disease. 38 U.S.C. § 1101. By regulation, subsequent manifestations of the same disease process are service connected unless clearly due to intercurrent cause. 38 C.F.R. § 3.303. As noted above, the Board has found little value in the VA examiner's opinion regarding the aging process and genetic predisposition. Therefore, the Board finds the examiner's opinion insufficient to establish an intercurrent cause. Since intercurrent cause is not shown, service connection for degenerative arthritis of the right elbow, left elbow, and thoracolumbar spine, as part of the already service connected generalized arthritic process, is granted. Furthermore, genetic predisposition tends to support the conclusion that all arthritis is related. As far as aging, we are unaware of aging, standing alone, causes arthritis. The use of diagnostic codes has legal implications. Diagnostic Code 5003 contemplates a generalized process and by law and regulation is a chronic disease. We accept that the AOJ intended what was accomplished in the May 1984 rating decision and several subsequent rating decisions. Here, intercurrent cause is not established and the grant of service connection is expanded to include the other joints in this case. H. N. SCHWARTZ Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Arif Syed, Counsel 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.