Citation Nr: 22010409 Decision Date: 02/23/22 Archive Date: 02/23/22 DOCKET NO. 08-10 077A DATE: February 23, 2022 ORDER Service connection for cervical spine ankylosing spondylitis, degenerative arthritis and spinal stenosis, as secondary to service-connected lumbar spine disability, is granted. FINDING OF FACT The Veteran's cervical spine ankylosing spondylitis, degenerative arthritis, and spinal stenosis was caused by his service-connected lumbar spine disability. CONCLUSION OF LAW The criteria for service connection for cervical spine ankylosing spondylitis, degenerative arthritis, and spinal stenosis, as secondary to service-connected lumbar spine disability, are met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.310. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from September 1964 to June 1974. This matter comes to the Board on appeal from a June 2008 rating decision. The Veteran presented testimony at Board hearings in May 2011 and May 2016. As noted in previous Board decisions, the Veteran's case will be addressed by a panel of three Veterans Law Judges. This case was last before the Board in December 2020, at which time the Board, as relevant, remanded the claims of entitlement to service connection for a lumbar spine disability, a cervical spine disability, and a left shoulder disability for additional development. In March 2021 and December 2021 rating decisions, the RO granted service connection for a lumbar spine disability and a left shoulder disability, respectively. As these decisions represent a full grant of benefits sought on appeal, such issues are no longer before the Board. The remaining claim now returns for further appellate review. Service connection for a cervical spine disability, including as secondary to a service-connected lumbar spine disability and/or left knee disability. Legal Criteria Service connection may be granted for a disability resulting from a disease or injury incurred in or aggravated by active service. See 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303. A veteran seeking compensation under these provisions must establish three elements: "(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 or aggravated during service." Saunders v. Wilkie, 886 F.3d 1356, 1361 (Fed. Cir. 2018) (quoting Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004)). Service connection may also be granted for a disability that is proximately due to, or aggravated by, service-connected disease or injury. See 38 C.F.R. § 3.310. Analysis As noted in the Introduction, in a March 2021 rating decision, the RO granted service connection for a lumbar spine disability, characterized as degenerative arthritis of the spine, with ankylosing spondylitis, spinal stenosis, and degenerative disc disease. In December 2020, the Board remanded the Veteran's claim, in part, to obtain a medical opinion regarding whether his cervical spine disability was caused by his lumbar spine disability. In accordance with the Board's December 2020 remand directives, the Veteran was afforded a VA cervical spine disabilities examination and medical opinion in February 2021. The February 2021 VA examiner, on its face, appeared to provide a negative secondary nexus opinion, indicating that the Veteran's cervical spine disability is less likely than not proximately due to or the result of his service-connected lumbar spine disability. However, in the rationale section, the VA examiner indicated that ankylosing spondylitis, for which the Veteran is now service-connected, "can and is likely a contributing factor to his current neck symptoms as this causes fusion of the spine which would alter the normal biomechanical forces and movement of the spine leading to abnormal wear and tear of the neck and inflammatory changes." In consideration of this evidence, the Board finds it to be at least in equipoise as to whether the Veteran's current cervical spine disability is proximately due to his service-connected lumbar spine disability (ankylosing spondylitis). Accordingly, when resolving reasonably doubt in favor of the Veteran, the Board finds that his cervical spine disability was caused by his service-connected lumbar spine disability. See 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102. Therefore, service connection is warranted for cervical spine ankylosing spondylitis, degenerative arthritis, and spinal stenosis, on a secondary basis. Eric S. Leboff Veterans Law Judge Board of Veterans' Appeals A. JAEGER Veterans Law Judge Board of Veterans' Appeals RYAN T. KESSEL Veterans Law Judge Board of Veterans' Appeals Attorney for the Board R. Glenn, 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.