Citation Nr: 22019869 Decision Date: 04/03/22 Archive Date: 04/03/22 DOCKET NO. 18-39 983 DATE: April 3, 2022 ORDER Service connection for cervical spine degenerative joint disease is granted. FINDINGS OF FACT 1. The Veteran has a present diagnosis of cervical spine degenerative joint disease (cervical spine arthritis). 2. The Veteran sustained a cervical spine injury during service. 3. Symptoms of cervical spine arthritis, namely pain, decreased range of motion, stiffness, and monthly flare-ups, started during service and have been continuous since service separation. CONCLUSION OF LAW Resolving reasonable doubt in the Veteran's favor, the criteria for chronic disease presumptive service connection for cervical spine arthritis have been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309. REASONS AND BASES FOR FINDINGS AND CONCLUSION The Veteran, who is the appellant, had active service from July 1968 to July 1971. The instant issue is on appeal from a September 2017 Department of Veterans Affairs (VA) Regional Office (RO) rating decision that denied service connection for a cervical spine disorder. The Veteran testified at a December 2021 Board of Veterans' Appeals (Board) hearing. A copy of the hearing transcript has been associated with the claims file. Service Connection for Cervical Spine Arthritis is Granted. The Veteran seeks service connection for a cervical spine disorder. See, e.g., June 2018 Notice of Disagreement. Direct Service Connection Service connection may be granted for a disability arising from disease or injury incurred in or aggravated by active service. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303(a). Service connection may be granted for any disease diagnosed after discharge when all the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303(d). Generally, service connection for a disability requires competent evidence of: (1) the existence of a current disability; (2) the existence of a disease or injury in service; and (3) a relationship or nexus between the current disability and any injury or disease during service. Chronic Disease Presumptive Service Connection The evidence shows a diagnosis of cervical spine degenerative joint disease (cervical spine arthritis), which is a "chronic disease" for purposes of presumptive service connection (38 C.F.R. § 3.309(a)); accordingly, the presumptive service connection provisions under 38 C.F.R. § 3.303(b) for service connection based on "chronic" symptoms in service and "continuous" symptoms since service are applicable. See Walker v. Shinseki, 708 F.3d 1331 (Fed. Cir. 2013). Under 38 C.F.R. § 3.303(b), service connection will be presumed where there are either chronic symptoms shown in service or continuity of symptomatology since service for diseases identified as chronic in 38 C.F.R. § 3.309(a); Walker, 703 F.3d at 1338-40 (holding that continuity of symptomatology is an evidentiary tool to aid in the evaluation of whether a chronic disease existed in service or an applicable presumptive period). With a chronic disease shown as such in-service, subsequent manifestations of the same chronic disease at any later date, however remote, are service connected, unless clearly attributable to intercurrent causes. For the showing of chronic disease in service, there is required a combination of manifestations sufficient to identify the disease entity, and sufficient observation to establish chronicity at the time. If a condition noted during service is not shown to be chronic, then generally a showing of continuity of symptoms after service is required for service connection. 38 C.F.R. § 3.303(b). Additionally, where a veteran served 90 days or more of active service, and chronic diseases become manifest to a degree of 10 percent or more within one year after the date of separation from such service, such disease shall be presumed to have been incurred in service, even though there is no evidence of such disease during the period of service. While the disease need not be diagnosed within the presumption period, it must be shown, by acceptable lay or medical evidence, that there were characteristic manifestations of the disease to the required degree during that time. 38 U.S.C. §§ 1101, 1112, 1137; 38 C.F.R. §§ 3.307, 3.309(a). The evidence shows a present diagnosis of cervical spine degenerative joint disease. See September 2017 VA Examination. The present disability requirement has been met. After a review of all the lay and medical evidence of record, the evidence is at least in relative equipoise on the question of whether there was an in-service cervical spine injury. The Veteran testified at the December 2021 Board hearing that he injured his neck (cervical spine) while performing tasks associated with his position as a ski team instructor. See December 2021 Hearing Transcript. A January 1970 Service Treatment Record documents a hyperflexion injury to the lower neck that occurred during skiing on January 18, 1970, that caused pain at the base of the neck and tenderness two days later. The Board resolves reasonable doubt on this question to find an in-service cervical spine injury. The evidence is at least in relative equipoise as to whether symptoms of cervical spine arthritis have been continuous since service separation, so as to support presumptive service connection for a "chronic" disease of arthritis pursuant to 38 C.F.R. § 3.303(b). The Veteran testified at the December 2021 Board hearing that, since the in-service cervical spine injury occurred, he continuously experienced symptoms, to include pain, decreased range of motion, stiffness, and monthly flare-ups. The Veteran also testified to consistent chiropractic treatment from his wife, who is a licensed chiropractor, and from other individuals. The Board resolves reasonable doubt on this question to find continuous post-service symptoms of cervical spine arthritis. Resolving reasonable doubt in favor of the Veteran, the Board finds that the criteria for chronic disease presumptive service connection (38 C.F.R. § 3.303(b)) for cervical spine arthritis have been met, as the evidence demonstrates an in-service cervical spine injury, continuous symptoms of cervical spine pain, decreased range of motion, stiffness, and monthly flare-ups, and a present diagnosis of cervical spine arthritis. (Continued on the next page) The Board is aware that there is a negative nexus opinion in this case. As service connection is being granted on a presumptive basis due to the chronic disease of cervical spine arthritis (38 C.F.R. § 3.303(b)), there is no need to discuss entitlement to service connection on a direct basis, as other theories of service connection and the need for a direct service connection opinion have been rendered moot, leaving no question of law or fact to decide regarding the issue of service connection for cervical spine arthritis. J. PARKER Veterans Law Judge Board of Veterans' Appeals Attorney for the Board A. Smith, 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.