Citation Nr: 21040346 Decision Date: 07/03/21 Archive Date: 07/03/21 DOCKET NO. 15-38 926A DATE: July 3, 2021 ORDER Entitlement to service connection for a cervical spine disorder is denied. FINDING OF FACT The preponderance of the evidence is against finding that a cervical spine disorder began during active service with continuous symptoms thereafter, onset to a compensable degree within one year of separation from active service, or is otherwise related to an in-service injury or disease, including a February 1985 fall. CONCLUSION OF LAW The criteria for service connection for a cervical spine disorder are not met. 38 U.S.C. §§ 1110, 1112, 1113, 1131, 1137, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran had active service from June 1980 to August 1980 and from August 1986 to August 1989. The record also establishes that he is service connected for disabilities arising from a February 1985 fall during a period of active duty for training (ACDUTRA) in Panama. Accordingly, that period of service has been converted to active service for purposes of disability compensation benefits administered by the Department of Veterans Affairs (VA). See 38 U.S.C. § 101(24)(B)-(C). The Veteran's claim was most recently before the Board of Veterans' Appeals (the Board) in May 2019. The Board remanded the matter because it determined that a September 2013 VA examination was inadequate. The Agency of Original Jurisdiction (AOJ) afforded the Veteran a new VA examination in November 2019. In an April 2020 supplemental statement of the case, the AOJ continued its denial of the Veteran's claim for service connection for a cervical spine disorder. The Veteran's appeal is once again before the Board. 1. Entitlement to Service Connection for a Cervical Spine Disorder The Veteran contends that he is entitled to service connection for a cervical spine disorder because it is etiologically related to a fall during a period of ACTDURA in February 1985. It is again noted that the February 1985 period of ACDUTRA was converted to active service because of his service-connected traumatic brain injury, forehead scar, and migraine headaches. The Veteran also reported in the November 2019 VA examination and in February 2017 VA treatment records that neck pain onset during active service and continued thereafter. Service connection may be granted for disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. § 3.303. The three-element test for service connection requires evidence of: (1) a current disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the current disability and the in-service disease or injury. Shedden v. Principi, 381 F.3d 1163, 1166 -67 (Fed. Cir. 2004). The Veteran has spondylosis of the cervical spine and a herniated disc at C5-C6. He underwent cervical discectomy, cervical arthrodesis with allograft, and instrumentation with ABC plate at C5-C6 in December 2012. Thus, the first requirement for a current disorder is met. With respect to the second element, the Veteran fell from a water tanker truck in February 1985 during a period of service with the Louisiana National Guard. Service personnel records document a slip and fall at a river crossing in Panama. The Veteran struck his head on the bottom of the river, suffering a scalp laceration. He was taken to the battalion medical aid station before being medically evacuated to Gorges Army Hospital, where he remained for 8 days. The fall in February 1985 satisfies the second requirement of an in-service event. Thus, the question for the Board is whether the Veteran's service spine disability is more likely than not due to the February 1985 fall. The Board concludes that the preponderance of the evidence shows that it is not. The record contains conflicting medical opinions regarding whether the Veteran's cervical spine disorder is at least as likely as not related to the February 1985 fall. In a March 2019 Neck (Cervical Spine) Conditions Disability Benefits Questionnaire, Dr. M.L.J. concludes that it is more likely than not that the Veteran's fall from a water tanker caused his cervical spine disorder. The Board affords this opinion very little probative weight, however. Dr. M.L.J. did not provide a rationale for his opinion or indicate that he had reviewed the Veteran's claims file. See Stefl v. Nicholson, 21 Vet. App. 120, 125 (2007) ("a mere conclusion by a medical doctor is insufficient to allow the Board to make an informed decision . . . ."). The opinion failed to reconcile/address the finding of a February 1985 X-ray, which was taken after the fall, showing that the Veteran's cervical spine were normal. There were also February 1985 statements from fellow servicemen pertaining to the nature and scope of the injury. These statements focused on the laceration without mentioning injuries to the neck or neck pain as a result of the fall. Indeed, considering the questionable history of the Veteran's report of injuring his neck in 1985 and experiencing chronic pain since that time, which is addressed below, an opinion based on that reported history is entitled to lesser probative value in the absence of rationale. The record also includes a November 2019 VA examination. The examiner concluded that the Veteran's cervical spine disorder was less likely than not proximately due to the Veteran's February 1985 fall. The Board finds the VA examiner's opinion highly probative because it is based on an accurate medical history and provides an explanation that contains clear conclusions and supporting data. Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 304 (2008). Specifically, the examiner developed the Veteran's medical history and noted his complaints that his neck has hurt since active service. However, the examiner noted that the Veteran entered active service in August 1986after the fallwithout complaints of neck pain and then separated from that period of active service in August 1989 without complaints of neck pain. The examiner also considered the length of the Veteran's stay in the hospital in February 1985. According to the examiner, that was a byproduct of available places for the Veteran stay rather than a reflection of the severity of the laceration following the fall. Finally, the examiner noted that the Veteran has osteoarthritis in lumber spine and both knees and reasoned that arthritis of the cervical spine is more likely related to his generalized osteoarthritis rather than the February 1985 fall. Finally, the Board notes that the Veteran may believe that his cervical spine disorder is due to the February 1985 fall. However, he is not competent to provide a nexus opinion regarding this issue, which is medically complex and requires knowledge of pathology and the interpretation of complicated diagnostic medical testing. The record does not show that the Veteran has the medical training or credentials to make such a determination. See Jandreau v. Nicholson, 492 F.3d 1372, 1377 n.4 (Fed. Cir. 2007); see also Kahana v. Shinseki, 24. Vet. App. 428 (2011). The Board also notes the Veteran's statements that his neck hurt since active service in the November 2019 VA examination. Continuity of symptomology can establish service connection for a recognized chronic disease such as osteoarthritis. 38 C.F.R. §§ 3.303(b), 3.309; Walker v. Shinseki, 708 F.3d 1331 (Fed. Cir. 2013). Here, however, the weight of the evidence of record does not show a continuity of symptomology for osteoarthritis of the cervical spine. As suggested in the November 2019 VA examination, the Board concludes that the Veteran's reports during the November 2019 VA examination and February 2017 VA treatment records are less probative than other evidence of record. See Miller v. Wilkie, 32 Vet. App. 249 (2020). As the examiner noted, the Veteran entered active service in August 1986 without complaints of neck pain and left that period of active service without complaints of neck pain in August 1989. The Board also notes that the February 1985 X-ray examination immediately after the fall showed a normal cervical spine. The reports associated with the line of duty determination conducted in February 1985 do not reference any neck pain associated with the fall. The Board finds the absence of complaints of neck pain proximate to the February 1985 fall to be more probative of the Veteran's reports that neck pain onset in February 1985 and continued thereafter. See Curry v. Brown, 7 Vet. App. 59, 68 (1994) (contemporaneous evidence has greater probative value than history as reported by the claimant). In light of the foregoing, the Veteran's claim for service connection for a cervical spine disorder must be denied. While a May 2021 statement from the Veteran's representative on his behalf asks that the benefit of the doubt doctrine be applied, it is inapposite here because the preponderance of the evidence is against the Veteran's claim. See 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102; Gilbert v. Derwinski, 1 Vet. App. 49, 53 (1990). MICHAEL A. HERMAN Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Douglas Humphrey, Associate 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.