Citation Nr: 22018367 Decision Date: 03/29/22 Archive Date: 03/29/22 DOCKET NO. 17-56 431 DATE: March 29, 2022 ORDER Entitlement to service connection for restless leg syndrome, as secondary to service-connected back and psychiatric disorder disabilities, is granted. FINDING OF FACT The probative evidence of record supports finding the Veteran's restless leg syndrome is caused by his service-connected back disability and his service-connected psychiatric disorder. CONCLUSION OF LAW The criteria for service connection for a restless leg syndrome as secondary to service-connected back and psychiatric disorder, are met. 38 U.S.C. §§ 1131, 5103, 5103A, 5107; 38 C.F.R. §§ 3.102, 3.159, 3.310. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from December 1984 to December 1987. This matter comes before the Board of Veteran's Appeals (Board) from an August 2016 rating decision issued by the Department of Veterans Affairs (VA) Regional Office (RO). This matter was previously before the Board in April 2019 when the claim was remanded for development. The Board finds the April 2019 remand directives have been substantially complied with, and the matter is again before the Board. Stegall v. West, 11 Vet. App. 268, 271 (1998). Entitlement to service connection for restless leg syndrome The Veteran seeks service connection for restless leg syndrome, as secondary to his service-connected back disability. See notice of disagreement (NOD) of August 2016 and VA Form 9 of October 2017. As the Veteran has consistently asserted his condition as secondary to his service-connected disability, the Board finds the appeal has been limited to that theory of entitlement. Service connection may be established on a secondary basis for a disability which is shown to be proximately due to or the result of a service-connected disease or injury. 38 C.F.R. § 3.310; Allen v. Brown, 7 Vet. App. 439 (1995). In other words, service connection on a secondary basis, may be granted for a disability found to be proximately due to, or the result of, a service-connected disease or injury. To prevail on the issue of secondary service causation, the record must show (1) evidence of a current disability, (2) evidence of a service-connected disability, and (3) medical nexus evidence establishing a connection between the current disability and the service-connected disability. See Wallin v. West, 11 Vet. App. 509, 512 (1998); Reiber v. Brown, 7 Vet. App. 513, 516-17 (1995). Evidence of record The Veteran's medical records have been associated with the claims file. These records show the Veteran was prescribed medication for "restless legs" and reported episodes of restless legs which complicated his pain and sleeping difficulties. See medical records for November 2014, October 2015, and August 2017. Additionally, various medical opinions addressing the Veteran's restless leg syndrome have been associated with the claims file following the Board's remand. In pertinent part to the matter of service connection on a secondary basis for restless leg syndrome, an examiner found the Veteran's claimed condition, is at least as likely as not proximately due to or the result of the Veteran's service-connected degenerative disc disease (DDD) with radiculopathy (back disability). In favor of this conclusion, the examiner noted research findings indicating that individuals with a back disability such as the Veteran's, have an increased risk for developing restless leg syndrome, and also noted that the Veteran's restless leg syndrome was first documented in 2014, years after his back disability diagnosis. The examiner also clarified the Veteran's restless leg syndrome is caused by and not aggravated by his back disability. See medical opinion for secondary service connection and aggravation, of January 2020. In September 2020, another medical opinion was associated with the claims file finding the Veteran's restless leg syndrome is at least as likely as not caused by his back disability. This medical opinion noted research findings in favor of the opinion and also clarified the condition is caused by and not aggravated by the Veteran's back disability. See medical opinion for secondary service connection and aggravation of September 2020. A third medical opinion addressing the likely etiology of the Veteran's restless leg syndrome found the condition is at least as likely as not proximately due to or the result of the Veteran's service connection psychiatric disorder. In favor of this opinion, the examiner noted that research has shown the use of antidepressants increased patients' risk for developing restless leg syndrome and that the Veteran's condition developed after his psychiatric disorder. See medical opinion for secondary service connection of September 2020. The Board finds these medical opinions are adequate and highly probative as to the question of whether the Veteran's restless leg syndrome warrants service connection on a secondary basis. Analysis Here, the Veteran's medical records show treatment for complaints of restless legs. As such, the current disability requirement has been met. Additionally, probative medical opinions associated with the claims file in January 2020 and September 2020 have determined the Veteran's restless leg syndrome is caused by his service-connected back disability and his service-connected psychiatric disorder. As such, the second and third requirements for service connection on a secondary basis are also met, as the Veteran's claimed condition has been associated by medical evidence to his service-connected disabilities. 38 C.F.R. § 3.310; Allen v. Brown, 7 Vet. App. 439 (1995). Accordingly, based on the above and absent any probative evidence contradicting the probative opinions of record, the Board finds that the evidence of record supports finding the Veteran's restless leg syndrome is caused by his service-connected back and psychiatric disabilities and as such, service connection for the condition is warranted on a secondary basis. KRISTI L. GUNN Veterans Law Judge Board of Veterans' Appeals Attorney for the Board B. Gonzalez-Maldonado 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.