Citation Nr: 25005168 Decision Date: 04/16/25 Archive Date: 04/16/25 DOCKET NO. 16-47 428 DATE: April 16, 2025 ORDER Entitlement to service connection, to include on a secondary basis, for bilateral cervical nerve root compression (pain on nape radiating to shoulder, with narrowing) is denied. FINDING OF FACT The Veteran's bilateral cervical nerve root compression did not originate in service or until years thereafter, is not otherwise etiologically related to service, and was not caused or aggravated by service-connected disability. CONCLUSION OF LAW The criteria for service connection for bilateral cervical nerve root compression (pain on nape radiating to shoulder, with narrowing), to include as secondary to a service-connected disability have not been met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from April 1964 to May 1984. This matter comes before the Board on appeal from an April 2016 rating decision. The issue was previously remanded in April 2018, August 2022, and November 2024 for VA examinations and opinions. Service Connection Service connection may be granted for a disability resulting from a disease or injury incurred in or aggravated by active service. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § § 3.303 (a). To establish a right to compensation for a present disability, a veteran must show: (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. Shedden v. Principi, 381 F.3d 1163 (Fed. Cir. 2004). Service connection is also available where the claimed disability was caused or aggravated by a service-connected disorder. See 38 C.F.R. § 3.310. In this context, "aggravation" refers to any incremental increase in disability, regardless of its permanence. The term "incremental increase in disability" means additional impairment of earning capacity in nonservice-connected disabilities resulting from service-connected conditions. Aggravation of a disability need not be permanent. The Veteran is seeking service connection for a cervical nerve root disorder that he asserts is either related to service or is secondary to a service-connected disability. The Veteran's service treatment records (STRs) are silent as to any complaints of neck or cervical pain or injury. VA treatment records document a diagnosis of cervical radiculopathy and note a diagnosis of bilateral cervical nerve root compression. A January 2016 cervical x-ray noted the Veteran had a straightened cervical spine with narrowing of the disc spaces, for which nerve root compression was possible. There was no demonstrable evidence of fracture/subluxation in the sections taken and the vertebral body heights and pedicles were maintained. A review of the record shows that the Veteran has been scheduled for a VA examination several times, however, the Veteran was either not able to be reached, was unavailable, or did not show up for the scheduled exam. The Veteran was most recently scheduled for a VA examination in December 2024 but failed to report for the appointment and has not provided good cause for his absence. The Board notes that every attempt has been made to verify that VA has the correct contact information for the Veteran, to include general record requests and review of the Veteran's Social Security profile and benefit data, which show the address the VA has on file. The Veteran simply is not cooperating with VA's efforts to obtain evidence crucial to his claim. Accordingly, the Board finds that further efforts to schedule the Veteran for a VA examination and obtain opinions will be futile. Based on the evidence of record, the Board finds that service connection for the claimed cervical nerve root compression is not warranted. The service treatment records, which cover a period of 20 years, are remarkably silent for any cervical complaints or abnormal findings. The first documentation of any cervical disorder is many years after discharge. There is no medical evidence suggesting a link between any current cervical disorder and service. The Board again points out that VA has made numerous attempts to examine the Veteran in connection with his claim, but that he has refused to cooperate. Information gathered at a VA examination would have been pertinent to the claim. This leaves the Veteran's own statements as the only evidence favorable to the claim. Even here, the evidence is wanting. The Veteran has not contended he experienced cervical symptoms in service. He has not contended he experienced cervical symptoms continuously since service, or within a year of discharge. The only contention advanced by the Veteran is that VA has already service-connected the requested disorder at 20 percent disabling. This is not true. The Board assumes he is instead referring to his left shoulder disorder, which carries that specific percentage rating, and which is somewhat in proximity to the cervical area. But that disorder affects a joint, namely the left shoulder, and does not involve the cervical spine. Turning to his implied suggestion that the left shoulder disorder is somehow related to the claimed cervical disorder, the Board finds that opining on such a relationship, whether through direct causation or aggravation, requires medical expertise, as it involves determining a relationship between two separate disease processes where the relationship is not readily perceptible. The Veteran in fact has not described, in terms of symptoms or processes, why he believes the two disorders are related. Thus, the Veteran is not competent to opine as to such a relationship. In short, there is no competent evidence linking the claimed cervical disorder to service or to service-connected disability. Accordingly, as the evidence is not in approximate balance but is persuasively against the claim for service connection for bilateral cervical nerve root compression, the benefit of the doubt doctrine enunciated in 38 U.S.C. § 5107 (b) is not applicable, as there is no approximate balance of evidence. Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021); Gilbert v. Derwinski, 1 Vet. App. 49, 53 (1990); Ortiz v. Principi, 274 F.3d 1361 (Fed. Cir. 2001). Thomas H. O'Shay Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Mitchell, Kimberly A. 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.