Citation Nr: A26034412 Decision Date: 04/14/26 Archive Date: 04/14/26 DOCKET NO. 210322-148320 DATE: April 14, 2026 ORDER Entitlement to service connection for a neck/cervical spine disability, to include cervical spine arthritis and degenerative disc disease (DDD), is granted. FINDING OF FACT Resolving reasonable doubt in the Veteran's favor, his neck/cervical spine disability is at least as likely as not related to active duty service. CONCLUSION OF LAW The criteria for service connection for a neck/cervical spine disability, to include cervical spine arthritis and DDD, are met. 38 U.S.C. §§ 1110, 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 November 2002 to February 2006. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a January 2021 rating decision by a Department of Veterans Affairs (VA) Regional Office (RO). By way of brief procedural history, in July 2020, the Veteran submitted a VA Form 20-0996, Decision Review Request: Higher-Level Review (HLR), and requested review of the April 2020 rating decision which denied service connection for a neck condition. In November 2020, the higher-level reviewer found a difference of opinion and transferred the claim to the supplemental claim decision review option for additional development. Subsequently, in January 2021, the AOJ issued the supplemental claim decision on appeal which continued to deny the claim. In the March 2021 VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement), the Veteran elected the Hearing docket. A Board hearing was held in October 2024. Therefore, the Board may only consider the evidence of record at the time of the January 2021 supplemental claim decision on appeal, as well as any evidence submitted by the Veteran or his representative at the hearing or within 90 days following the hearing. 38 C.F.R. §?20.302. Service connection - Applicable Law and Regulations 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; 38 C.F.R. § 3.303(a). 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). Additionally, certain chronic diseases, to include arthritis, will be presumed related to service, absent an intercurrent cause, if they were shown as chronic in service; or, if they manifested to a compensable degree within a presumptive period following separation from service; or, if they were noted in service (or within an applicable presumptive period) with continuity of symptomatology since service that is attributable to the chronic disease. 38 U.S.C. §§ 1101, 1112, 1113, 1137; 38 C.F.R. §§ 3.303, 3.307, 3.309. Walker v. Shinseki, 708 F.3d 1331, 1338 (Fed. Cir. 2013). Entitlement to service connection for a neck/cervical spine disability The Veteran contends that his currently diagnosed neck/cervical spine disabilities had their onset during active duty service. Specifically, he asserts that he has experienced neck pain and related bilateral upper extremity pain/numbness since his deployment to Iraq when he was involved in an IED explosion. In other words, he claims that his bilateral upper extremity/hand symptoms in-service were early manifestations of his neck disability. He has also variously asserted that his neck condition is the result of wearing heavy, full combat gear while serving in Iraq. See January 2020 Statement In Support of Claim; March 2021 Correspondence; and February 2020 VA Examination Report. As an initial matter, a February 2020 VA examination report reflects that the Veteran has been diagnosed with a current neck disability, namely, cervical spine arthritis and degenerative disc disease with bilateral upper extremity radiculopathy. As such, the first element of a service connection claim has been met here. With respect to in-service incurrence, although there are no complaints, treatment, or diagnoses related to the neck or cervical spine; however, service treatment records (STRs) dated in July 2005 reflect that the Veteran complained of bilateral hand pain and numbness which started while serving in Iraq. He also reported chronic bilateral hand pain and numbness on separation examination in September 2005. Again, he asserts that these upper extremity symptoms were associated with his cervical spine disability. Concerning the claimed IED explosion, neither STRs nor service personnel records (SPRs) document this incident. However, SPRs document that the Veteran served in Iraq from January 2004 to January 2005 (a designated imminent danger pay area). Moreover, in his March 2007 PTSD stressor statement, the Veteran reported being attacked by rockets, mortars and IEDs while serving in Iraq. A March 2008 rating decision granted PTSD based on the Veteran's accounts of combat service in Iraq which it found to be consistent with his job duties and assignments. In light of the foregoing, the Board also concedes that the Veteran was likely exposed to various IED explosions, rockets, and mortars while serving in Iraq and that his duties involved carrying heavy equipment/gear in combat situations. This is consistent with the facts and circumstances of his service. See 38 U.S.C. § 1154(b). Based on the foregoing, the Board finds that the second element of a service connection claim, i.e., in-service incurrence of a disease or injury, has also been met here. Thus, the remaining question for consideration here is whether the Veteran's currently diagnosed neck/cervical spine disability is related to service. On this question there are probative opinions in favor of and against the claim. The evidence in favor of the claim includes a February 2020 VA opinion in which the examiner opined that the cervical spine disability was at least as likely as not incurred in or caused by the in-service injury, event, or illness. The rationale was as follows: "This Veteran has DJD, DDD, and bilateral upper extremity radiculopathy. This Veteran should not have these conditions at such a young age. The cervical spine is at a high risk for injury because of limited muscle support that exists in the cervical area of the spine. This combat veteran's testimony was given greater probative value that his neck condition had its onset was while in the military. The medical literature supports that neck pain is a common problem in combat veterans with a plurality of the Veteran's being unable to identify the exact precipitating event. The literature also supports that wearing body armor and related equipment results in increased weight on the axial spine causing altered body mechanics leading to a chronic neck strain. The literature supports this can cause lingering pain and susceptibility to injury that persists even after the armor and equipment is no longer being worn." The February 2020 VA examiner reviewed military medical records, the Veteran's statements as to onset, and rendered a cogent opinion that was supported by medical evidence and sufficient rationale. Her medical opinion is entitled to significant probative weight. See Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 304 (2008) (a medical opinion's factually accurate, fully articulated, sound reasoning for the conclusion contributes to its probative value). The evidence against the claim includes a January 2021 VA opinion in which the examiner opined that the cervical spine disability was less likely than not incurred in or caused by the claimed in-service injury, event, or illness. The examiner reasoned the following: "All available medical records were reviewed. STRs are negative for any injury to or treatment of the neck during active duty service. Separation exam dated 9/23/05 is also negative for a neck condition. A nexus is not established." This VA opinion is afforded less probative weight as it contains no meaningful discussion of the Veteran's statements as to onset or his in-service duties and is largely based on the absence of in-service treatment for a neck condition. In addition to the highly probative February 2020 VA medical nexus opinion, the Board has considered the Veteran's lay testimony and statements. In this regard, he has consistently asserted that he first experienced neck pain and other related symptoms during active duty service and while serving in Iraq. See January 2020 Statement In Support of Claim; March 2021 Correspondence; and February 2020 VA Examination Report. He has also reported continued neck/upper extremity symptomology since that time. The Board finds such statements to be both competent and credible in light of the Veteran's confirmed service in Iraq; the occupational duties associated with such service; the STRs; and his treatment for neck pain relatively proximate to service (see VA treatment records dated September 2009) and near continuously thereafter. In summary, the Board finds that the most probative evidence of record weighs in favor of a finding that the Veteran's currently diagnosed neck/cervical spine disability is related to service. Accordingly, entitlement to service connection for a neck/cervical spine disability is warranted, and the claim is granted. [SIGNATURE ON NEXT PAGE] JONATHAN B. KRAMER Veterans Law Judge Board of Veterans' Appeals Attorney for the Board H. Hoeft, 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.