DEGENERATIVE ARTHRITIS OF THE SPINE (SPONDYLOSIS)

MICHAEL MARTIN · 2026 · Case ID: A26001877

MIXED

Summary

The veteran, who served in the United States Army from April 1991 to May 1991 and March 1998 to May 1998, appeals the denial of service connection for several conditions and entitlement to TDIU. The Board granted service connection for a lumbar spine condition, finding that a congenital defect of lumbarization of S1 (L5 sacralization), though pre-existing, was aggravated by a superimposed in-service injury, leading to additional disability like degenerative disc disease (DDD). The Board found the VA's February 2025 medical opinion inadequate for failing to address the pre-existing condition's aggravation and the possibility of superimposed injury. Service connection for right and left lower extremity radiculopathy was also granted, found to be secondary to the service-connected lumbar spine condition, supported by private and VA medical opinions. Service connection for a depressive disorder due to another medical condition was granted, based on private medical opinion linking it to the physical limitations and pain from the service-connected lumbar spine and radiculopathy conditions, despite a VA examiner finding no direct service connection for the mental health condition. The Board remanded claims for cervical spine condition, right and left upper extremity radiculopathy, and TDIU due to the need for further development and clarification, particularly regarding the cervical spine opinion and the veteran's current employment status for TDIU.

Rationale

Pre-existing congenital defect aggravated by in-service injury; In-service injury in April 1998 with temporary physical profile; Post-service CT scan and MRI showed moderate central stenosis and disc bulging

Service Branch

ARMY

Special Benefit

TDIU

Docket No.

250708-561959

Full Decision Text

Citation Nr: A26001877
Decision Date: 01/08/26 Archive Date: 01/08/26

DOCKET NO. 250708-561959
DATE: January 8, 2026

ORDER

Entitlement to service connection for a lumbar spine condition is granted.

Entitlement to service connection for right lower extremity radiculopathy is granted.

Entitlement to service connection for left lower extremity radiculopathy is granted.

Entitlement to service connection for depressive disorder due to another medical condition with depressive features is granted.

REMANDED

Entitlement to service connection for a cervical spine condition (claimed as a neck condition) is remanded.

Entitlement to service connection for right upper extremity radiculopathy is remanded.

Entitlement to service connection for left upper extremity radiculopathy is remanded.

Entitlement to a total disability rating based on individual unemployability (TDIU) due to the service-connected disabilities is remanded.

FINDINGS OF FACT

1. The Veteran's congenital defect of lumbarization of S1 (L5 sacralization), which existed prior to his entry to active service, was subject to or aggravated by a superimposed in-service injury resulting in additional disability, to include but not limited to degenerative disc disease (DDD) of lumbar spine.

2. The Veteran's current right lower extremity radiculopathy is due to, caused by, resulted from, or aggravated by the service-connected lumbar spine condition.

3. The Veteran's current left lower extremity radiculopathy is due to, caused by, resulted from, or aggravated by the service-connected lumbar spine condition.

4. The Veteran does not have the diagnosis of posttraumatic stress disorder (PTSD). However, his current depressive disorder due to another medical condition with depressive features is due to, caused by, resulted from, or aggravated by the service-connected lumbar spine condition and bilateral lower extremity radiculopathy.

CONCLUSIONS OF LAW

1. The criteria for entitlement to service connection for a lumbar spine condition have been met. 38 U.S.C. §§ 1110, 1131, 1153, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.304, 3.306.

2. The criteria for entitlement to service connection for right lower extremity radiculopathy have been met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.310.

3. The criteria for entitlement to service connection for left lower extremity radiculopathy have been met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.310.

4. The criteria for entitlement to service connection for depressive disorder due to another medical condition with depressive features have been met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.304, 3.310, 4.125.

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Veteran served on active duty in the United States Army from April 1991 to May 1991 and March 1998 to May 1998, with additional reserve service in the Army National Guard.

These matters come before the Board of Veterans' Appeals (Board) on appeal from the August 2024 and March 2025 rating decisions of the Department of Veterans Affairs (VA) Regional Office (RO).

In the August 2024 rating decision, the RO denied service connection for PTSD and any other mental health condition, after finding that new and relevant evidence had been received to readjudicate this claim that was previously denied in the June 2024 rating decision. The Veteran timely appealed the August 2024 rating decision to the Board.

In the March 2025 rating decision, the RO denied service connection for a cervical spine condition, a lumbar spine condition, and bilateral upper and lower extremities radiculopathy, after finding that new and relevant evidence had been received to readjudicate these claims that were previously denied in the June 2024 rating decision. Also, the RO denied entitlement to a TDIU. The Veteran timely appealed the March 2025 rating decision to the Board.

In the July 8, 2025 VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement), the Veteran elected the Evidence Submission docket. Therefore, the Board may only consider the evidence of record regarding the claim for entitlement to service connection for PTSD and any other mental health condition at the time of the August 2024 RO decision on appeal, and regarding the claims for entitlement to service connection for a cervical spine condition, a lumbar spine condition, and bilateral upper and lower extremities radiculopathy; and entitlement to a TDIU at the time of the March 2025 RO decision on appeal, as well as any evidence submitted by the Veteran or representative with, or within 90 days from receipt of, the VA Form 10182. 38 C.F.R. § 20.303. If evidence was submitted either (1) during the period after the RO issued the decisions on appeal and prior to the date the Board received the VA Form 10182, or (2) more than 90 days following the date the Board received the VA Form 10182, the Board did not consider it in its decision. 38 C.F.R. §§ 20.300, 20.303, 20.801.

If the Veteran would like VA to consider any evidence that was submitted that the Board could not consider, the Veteran may file a supplemental claim (VA Form 20-0995) and submit or identify this evidence. 38 C.F.R. § 3.2501. If the evidence is new and relevant, VA will issue another decision on the claims, considering the new evidence in addition to the evidence previously considered. Id. Specific instructions for filing a supplemental claim are included with this decision.

However, because the Board is remanding the claims for entitlement to a TDIU, and entitlement to service connection for a cervical spine condition and bilateral upper extremity radiculopathy, any evidence the Board could not consider will be considered by the RO in the adjudication of these claims. 38 C.F.R. § 3.103(c)(2)(ii).

SERVICE CONNECTION

Generally, 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. 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).

Service connection may also be granted for a disability that is due to, caused by, or resulted from, or aggravated by, service-connected disease or injury. 38 C.F.R. § 3.310. Secondary service connection requires: (1) a service-connected disability; (2) a nonservice-connected disability; and (3) evidence that the nonservice-connected disability is either (a) due to, caused by, or the result of the service-connected disability or (b) aggravated (increased in severity) by the service-connected disability. Id.

If a veteran has a current, chronic disability listed in 38 C.F.R. § 3.309(a), a nexus can be presumed if there is evidence of chronic disease manifested as such during active service; or chronic disease manifested to a compensable degree within a specified period after active service (usually 1 year); or if there is competent, credible, and persuasive evidence of continuity of symptomatology since active service. See Walker v. Shinseki, 708 F.3d 1331, 1338 (Fed. Cir. 2013); 38 C.F.R. §§ 3.303(b), 3.307(a)(3), 3.309(a).

When there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, the benefit of the doubt should be given to the claimant. 38 U.S.C. § 5107; 38 C.F.R. § 3.102. When, after careful consideration of all procurable and assembled
1 year); or if there is competent, credible, and persuasive evidence of continuity of symptomatology since active service. See Walker v. Shinseki, 708 F.3d 1331, 1338 (Fed. Cir. 2013); 38 C.F.R. §§ 3.303(b), 3.307(a)(3), 3.309(a).

When there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, the benefit of the doubt should be given to the claimant. 38 U.S.C. § 5107; 38 C.F.R. § 3.102. When, after careful consideration of all procurable and assembled data, a reasonable doubt arises regarding service origin, the degree of disability, or any other point, such doubt should be resolved in favor of the claimant. 38 C.F.R. § 3.102.

1. Entitlement to service connection for a lumbar spine condition is granted.

The Veteran claims that he has a lumbar spine condition that is directly related to his active military service. In an October 1998 correspondence, the Veteran stated that the Army made his lower back worse. In an October 1998 application form for compensation, the Veteran claimed that he had a back injury during active service in April 1998. The Veteran also stated that he knew that he had a back problem prior to service but did not know how bad until being in basic training. He claimed that his basic military training made his back condition worse, and his back has not been the same ever since. In a November 1998 statement in support of claim, the Veteran stated that in March 1998 during basic training, he began having really bad back pain that shot down his left hip and left leg. He also stated that he knew that he had a back problem before he went into the Army, but the basic training made it worse.

However, in an April 2024 correspondence, the Veteran stated that both of his parents wrote a letter in 1999 and his family doctor wrote letter in early 2000's to help him with his claim. He stated that VA overlooked his father's statement asserting that while the Veteran was with them, his father had never paid for any back injury and his doctor wrote that he had never treated the Veteran for any back injury. The Veteran claimed that his doctor stated regardless of anything there is no way that the Veteran went into the military with this back condition, because he would not have made it through the medical examination or would not have been able to do things as like the "duck walk" for example. The Veteran claimed that VA purposely overlooked things that would prove that he was injured while in basic training. The Veteran claimed that instead VA tried to prove that when the Veteran was 14 years old, he strained his back injury while playing volleyball and that this was what created a pre-existing back injury. The Veteran claimed that the back injury during service was different than any pre-existing back condition.

A veteran is considered to have been in sound condition when examined, accepted and enrolled for service, except as to defects, infirmities, or disorders noted at entrance into service, or where clear and unmistakable (obvious or manifest) evidence demonstrates that an injury or disease existed prior thereto and was not aggravated by such service. 38 C.F.R. § 3.304(b). Only such conditions as are recorded in examination reports are to be considered as noted. Id.

The presumption of soundness applies only when a disease or injury not noted upon entry to service manifests in service, and a question arises as to whether it preexisted service. Gilbert v. Shinseki, 26 Vet. App. 48, 55 (2012), aff'd 749 F.3d 1370 (Fed. Cir. 2014).

In Wagner v. Principi, 370 F.3d 1089, 1096 (2004), the United States Court of Appeals for the Federal Circuit held if a preexisting disorder is noted upon entry into service, the veteran cannot bring a claim for service connection for that disorder, but the veteran may bring a claim for service-connected aggravation of that disorder. In that case, 38 U.S.C. § 1153 applies and the burden falls on the veteran to establish an increase in disability during service. 38 U.S.C. § 1153. If the presumption of aggravation attaches, the burden shifts to the government to show by clear and unmistakable evidence that there has been no increase in the severity of the preexisting condition or that any increase was the result of natural progression. Id; 38 C.F.R. § 3.306(b).

Clear and unmistakable evidence is defined as obvious or manifest. See 38 C.F.R. § 3.306
service connection for that disorder, but the veteran may bring a claim for service-connected aggravation of that disorder. In that case, 38 U.S.C. § 1153 applies and the burden falls on the veteran to establish an increase in disability during service. 38 U.S.C. § 1153. If the presumption of aggravation attaches, the burden shifts to the government to show by clear and unmistakable evidence that there has been no increase in the severity of the preexisting condition or that any increase was the result of natural progression. Id; 38 C.F.R. § 3.306(b).

Clear and unmistakable evidence is defined as obvious or manifest. See 38 C.F.R. § 3.306(b). Clear and unmistakable evidence means that the evidence "cannot be misinterpreted and misunderstood, i.e., it is undebatable." Quirin v. Shinseki, 22 Vet. App. 390, 396 (2009). Temporary or intermittent flare-ups during service of a pre-existing injury or disease are not sufficient to be considered "aggravation in service" unless the underlying condition, as contrasted to symptoms, is worsened. Hunt v. Derwinski, 1 Vet. App. 292, 297 (1991).

Regarding a congenital condition, the Board notes that VA distinguishes between congenital or developmental defects, for which service connection is precluded by regulation, and congenital or hereditary diseases, for which service connection may be granted, if initially manifested in or aggravated by service. See VAOPGCPREC 82-90, VAOPGCPREC 67-90. A defect differs from a disease in that a defect is "more or less stationary in nature," while a disease is "capable of improving or deteriorating." See VAOPGCPREC 82-90.

In this regard, the presumption of soundness does not apply to congenital defects because such defects "are not diseases or injuries." 38 U.S.C. §§ 1110, 1111; 38 C.F.R. § 3.303(c); Quirin v. Shinseki, 22 Vet. App. 390, 397 (2009); Terry v. Principi, 340 F.3d 1378, 1385-86 (Fed. Cir. 2003) (holding that the presumption of soundness does not apply to congenital defects); Winn v. Brown, 8 Vet. App. 510, 516 (1996) (holding that a non-disease or non-injury entity such as a congenital defect is "not the type of disease- or injury-related defect to which the presumption of soundness can apply"). However, a congenital defect can still be subject to superimposed disease or injury. VAOPGCPREC 82-90. If such superimposed disease or injury does occur, service connection may be warranted for the resulting disability. Id.

The Board notes that the March 1991 and the December 1997 enlistment examination reports did not note any lower back condition or disability. Therefore, the Board finds that a preexisting disorder of lower back was not noted upon entry into service, hence, presumption of soundness attaches and the issue of entitlement to service connection for a lower back condition on direct basis can be addressed and adjudicated in the Veteran's case.

Nonetheless, the Board notes that service treatment records noted lower back condition and a question arises as to whether it preexisted service. A May 1991 service treatment record noted that the Veteran had chronic lower back pain since 1983. Similarly, in an April 1998 service treatment record, the clinician noted chronic midline lower back pain. Therefore, the question is also before the Board whether clear and unmistakable (obvious or manifest) evidence demonstrates that a lower back condition existed prior to the Veteran's entry into active service, which clearly and unmistakably not aggravated by the Veteran's active service.

Furthermore, an April 1998 in-service radiologist's report noted that X-ray of the Veteran's lumbar spine was negative except lumbarization of S1. In this regard, the Board notes that in a July 2024 VA medical opinion for radiculopathy, the examiner stated that the Veteran's L5 sacralization was congenital and first discovered at the age of 13. Thus, the question is also before the Board as to whether the Veteran's congenital defect of lumbarization of S1 (L5 sacralization) was subject to superimposed disease or injury during active service resulting in an additional disability for which service connection is warranted.

For the following reasons, the Board finds that the Veteran's pre-existing congenital defect of lumbarization of S1 (L5 sacralization) was subject
lumbar spine was negative except lumbarization of S1. In this regard, the Board notes that in a July 2024 VA medical opinion for radiculopathy, the examiner stated that the Veteran's L5 sacralization was congenital and first discovered at the age of 13. Thus, the question is also before the Board as to whether the Veteran's congenital defect of lumbarization of S1 (L5 sacralization) was subject to superimposed disease or injury during active service resulting in an additional disability for which service connection is warranted.

For the following reasons, the Board finds that the Veteran's pre-existing congenital defect of lumbarization of S1 (L5 sacralization) was subject to or aggravated by a superimposed in-service injury resulting in additional disability, to include but not limited to degenerative disc disease (DDD) of lumbar spine.

Initially, regarding the existence of a current lower back condition, the Board notes that in the February 2025 VA examination report for lower back (thoracolumbar spine) conditions, the examiner noted the diagnosis of lumbar spine DDD status post L5-S1 decompression. Also, in the February 2025 VA examination report for scars/disfigurement, the examiner noted the diagnosis of lumbar spine scar. Furthermore, in an August 2017 private treatment record, the clinician noted that the Veteran has mid back pain and DDD of thoracic and lumbar spine.

Regarding the in-service lower back condition, the Board notes that a May 1991 service treatment record noted that the Veteran had chronic lower back pain since 1983. However, a December 1994 lumbar spine X-ray was normal. The Board notes that this X-ray report was after the Veteran's first period of active service but prior to the second period of active service. As noted above, in the December 1997 enlistment examination report for the Veteran's second period of active service, the examiner did not note any back problem.

However, in an April 9, 1998 service treatment record, the clinician noted chronic midline lower back pain. In the April 9, 1998 in-service X-ray report, the clinician noted the reason for order was "soldier says he has h/o bony vertebral abnormality...now with sx of L4-L4 intermitted radiculopathy" and the radiologist noted "negative except lumbarization of S1." In an April 21, 1998 service treatment record, the clinician noted that the Veteran had a lower back injury, therefore, the Veteran was placed on temporary physical profile until May 5, 1998. Thus, the Board finds that the Veteran had additional injury during service and also had new symptoms of lower back condition at L4 level with radiculopathy, which shows in-service superimposed injury and/or additional lower back disability and/or aggravation of a pre-existing condition.

In an October 1998 correspondence, the Veteran stated that Army made his lower back worse, and within two weeks of training in March 1998, his back started hurting.

In the October 1998 application form for compensation, the Veteran stated that before he went into the Army he knew that he had a back problem, but he did not know how bad until being in basic training, and he was put on profile but the drill sergeant made him break his profile because of that his back had never been the same since then.

In a September 1999 private medical opinion, the examiner noted that the Veteran was a patient in their clinic. The examiner noted that the Veteran had degenerative back disease. The examiner stated that the Veteran injured his back in the service. He had persistent symptoms with mechanical type back pain, but lately had had some radicular pain. The examiner concluded that the Veteran's back pain was service related.

In a September 1999 CT scan report of the Veteran's lumbar spine, the clinician noted moderate central stenosis at L4-5 secondary to central disk bulging. The clinician also noted that there was mild stenosis at L5-S1 as well while appears congenital in nature and is accentuated by broad-based disk bulging at that level as well.

In a February 2000 MRI report of the Veteran's lumbar spine, the clinician noted L5-S1 disc displacement as a broad-based and slightly eccentrically placed protrusion.

In a March 2000 statement, the Veteran's parents stated under oath that the Veteran did not have back problems prior to his entry to active service. They stated that the Veteran had insurance under his parents until the age of 20 or 21, but he was never treated for back problems.

In a February 2001 private medical opinion, the examiner noted that the MRI of lumbar spine was not normal. The examiner
-S1 as well while appears congenital in nature and is accentuated by broad-based disk bulging at that level as well.

In a February 2000 MRI report of the Veteran's lumbar spine, the clinician noted L5-S1 disc displacement as a broad-based and slightly eccentrically placed protrusion.

In a February 2001 private medical opinion, the examiner noted that the MRI of lumbar spine was not normal. The examiner noted the Veteran's statement that there was no back or leg injury prior to his military service. The examiner concluded that given the Veteran's age of 27 at the time and the fact that he did not have back symptoms prior to the in-service injury, it would be reasonable to conclude that the spine injury was a result of the military injury.

In a May 2003 X-ray report of the Veteran's lumbar spine, the clinician noted moderate narrowing of the lumbar spine from L1-2 down to L5-S1, and left sacralization of L5.

In a May 2003 VA medical opinion, the examiner stated that it was possible, given the Veteran's documented history that if he did have an injury to his back any time prior to his entrance into military service, which resulted in herniated disk, that he could have ended up becoming symptomatic from a disk herniation over time. It is certainly possible that the time in the military basic training could expedite the symptoms that he may or may not have gone on to develop otherwise. The examiner stated that it seemed that the Veteran's disability certainly had gotten much worse since the time he entered the military back in 1998, from the time he was seen and evaluated before that. The examiner also stated that if the Veteran had a chronic back condition prior to entering the military service, it is likely that his military experience is the cause and also exacerbated his chronic back condition.

In a February 2008 private treatment record, the clinician noted lower back pain. The clinician noted that the Veteran injured himself in April 1998 while in the Army. He sustained a severe lumbosacral sprain and an acute disc herniation.

In a December 2009 private treatment record, the clinician noted that the Veteran had chronic back pain. In the August 2017 private treatment record, the clinician noted DDD of thoracic and lumbar spine. In a July 2019 private treatment record, the clinician noted the Veteran's lower back pain.

The Board notes that in a July 2024 VA medical opinion on the Veteran's claimed right lower extremity radiculopathy, the examiner stated that the Veteran has claimed right lower extremity radiculopathy due to history of bony vertebral abnormality as being directly related to military service. The examiner stated that based on review of the available evidence, it is less likely than not that the claimed condition is due the sacralization, as this is a congenital abnormality that is known to cause back pain that worsens over time if left untreated and is not associated with nerve damage. However, the examiner stated that it was documented multiple times in the Veteran c-file that his L5 sacralization was congenital and first discovered at the age of 13, due to complaints of low back pain. The examiner also stated that medical records support the possible etiology regarding the Veteran's lumbar spine to be related to injury during military service.

The RO obtained a VA medical opinion in February 2025, in which the examiner stated that the Veteran's lumbar spine DDD status post L5-S1 decompression with bilateral sciatic radiculopathy was less likely than not caused by or related to the extreme physical exertion with stresses and strain to back and lower extremities caused by weight bearing, carrying of load, prolonged standing, pulling and bending associated with tasks performed during military service. As a supporting rationale, the examiner stated that review of service treatment records show that the Veteran had pre-existing lower back condition of vertebral disorder since age 13 and 27 years duration when seen in 1998. Additionally, imaging from September 1999 of CT scan of lumbar spine showed stenosis of lumbar spine to be congenital in nature.

The Board finds the February 2025 VA medical opinion inadequate because if the Veteran had a pre-existing lower back condition, the examiner should have opined as to whether the Veteran's lower back condition clearly and unmistakably (i.e., it is undebatable) pre-existed active service, and whether the Veteran's lower back condition was clearly and unmistakably (i.e., it is undebatable) not aggravated during active duty service. The examiner utilized the incorrect evidentiary standard of "as likely as not" rather than "clear and unmistakable." Furthermore, the examiner did not address the Veteran's parents' statement from March 2000 asserting that the Veteran did not have any back problems prior to active service. Also, the examiner did not address a May 2003 VA medical opinion, in which the examiner stated that the Veteran's back condition is not directly related to service, but the service may have been expedited it by his injury in the military. Finally, the examiner did not address as to whether the Veteran's congenital back condition was subject to a superimposed injury during service resulting in additional disability, such as DDD of lumbar spine.

The Board notes that the Veteran submitted a May 2025 private medical opinion, in which the examiner did not address any of the Veteran's lumbar spine condition that pre-existed his active service, but the examiner stated that the Veteran's lower back condition is directly related to his active service. As a supporting rationale, the examiner stated that veterans are vulnerable to get lower back conditions due to strenuous activities during service. The examiner also noted that the Veteran had in-service lower back pain in April and May 1998.

Thus, based on the above noted evidence of record and after resolving reasonable doubt in favor of the Veteran, the Board finds that the Veteran's congenital defect of lumbarization of S1 (L5 sacralization), which existed prior to his entry to active service, was subject to or aggravated by a superimposed in-service injury resulting in additional disability, to include but not limited to DDD of lumbar spine.

The evidence of record clearly noted that the Veteran had an in-service injury in April 1998, and he was placed on temporary physical profile. The Veteran's additional symptoms of a lumbar spine condition at L4 level with radiculopathy was noted. The April 1998 in-service X-ray report noted only lumbarization of S1. However, the September 1999 post-service CT scan report noted additional findings of moderate central stenosis at L4-5 secondary to central disk bulging. Similarly, besides noting left sacralization of L5, the May 2003 X-ray report also noted additional finding of moderate narrowing of the lumbar spine from L1-2 down to L5-S1.

As noted above, in the May 2003 VA medical opinion, the examiner stated that if the Veteran had a chronic back condition prior to entering the military service, it is likely that his military experience is the cause and also exacerbated his chronic back condition.

Finally, in the July 2024 VA medical opinion on the Veteran's claimed right lower extremity radiculopathy, the examiner stated that it was documented multiple times in the Veteran c-file that his L5 sacralization was congenital and first discovered at the age of 13, due to complaints of lower back pain. However, the examiner stated that medical records support the possible etiology regarding the Veteran's lumbar spine to be related to injury during military service.

Accordingly, the Board finds that the Veteran's congenital defect of lumbarization of S1 (L5 sacralization), which existed prior to his entry to active service, was subject to or aggravated by a superimposed in-service injury resulting in additional disability, to include but not limited to DDD of lumbar spine.

Consequently, entitlement to service connection for a lumbar spine condition is granted.

2. Entitlement to service connection for right lower extremity radiculopathy is granted.

3. Entitlement to service connection for left lower extremity radiculopathy is granted.

The Veteran claims service connection for bilateral lower extremity radiculopathy as directly related to active service or secondary to lumbar spine disability. Regarding the current diagnosis of bilateral lower extremity radiculopathy, the Board notes that in the February 2025 VA examination report for peripheral nerves conditions, the examiner noted the diagnosis of bilateral sciatic radiculopathy of the Veteran's lower extrem
in additional disability, to include but not limited to DDD of lumbar spine.

Consequently, entitlement to service connection for a lumbar spine condition is granted.

2. Entitlement to service connection for right lower extremity radiculopathy is granted.

3. Entitlement to service connection for left lower extremity radiculopathy is granted.

The Board notes that the Veteran submitted a May 2025 private medical opinion, in which the examiner stated that the Veteran's back pain during service has progressively worsened and gradually evolved with radiculopathy of bilateral lower extremity, resulting in numbness, tingling, and radiating pain. The examiner stated that the Veteran has DDD of the lumbar spine. The examiner explained that lumbar radiculopathy is radicular pain associated with back pain and is a very common medical complaint. The definition of acute lumbosacral radiculopathy is a diffuse disease process that affects more than one underlying nerve root, causing pain, loss of sensation, and motor function depending on the severity of symptoms. Back pain radiating into the foot, with a positive straight leg raising test. Muscle strength is often preserved in the case of radiculopathy because muscles often receive innervation from multiple roots. Thus, muscle strength is often only affected by severe cases of radiculopathy. Lumbar radiculopathy, sometimes called sciatica, refers to the pain caused by compression or irritation of one, or several of the nerves in the lumbar spine. These nerves start in the lower back and travel downward through the buttocks, along the leg and into the feet. They are important as they send signals to your muscles and provide the nervous system's connection to the skin and muscles of the thighs, calves, and feet. It can also cause sensations of burning, numbness, tingling, or pins and needles in the legs and feet.

Similarly, in a July 2024 VA medical opinion for radiculopathy, the examiner stated that the Veteran's radiculopathy likely resulted from damage to the lumbar spine, and medical records support the possible etiology regarding the Veteran's lumbar spine to be related to injury during military service.

The Board is granting service connection for the Veteran's lumbar spine disability in the current decision, and the above noted evidence of record shows that that the Veteran's current bilateral lower extremity radiculopathy is due to, caused by, resulted from, or aggravated by the service-connected lumbar spine condition.

Accordingly, entitlement to service connection for right and left lower extremity radiculopathy as secondary to the service-connected lumbar spine condition is warranted.

4. Entitlement to service connection for depressive disorder due to another medical condition with depressive features is granted.

In the July 2024 supplemental claim form, the Veteran claimed service connection for PTSD or any other mental disorder.

Service connection for PTSD requires (1) medical evidence diagnosing the condition in accordance with 38 C.F.R. § 4.125(a); (2) a link, established by medical evidence, between current symptoms and an in-service stressor; and (3) credible supporting evidence that the claimed in-service stressor occurred. 38 C.F.R. § 3.304(f).

For cases certified to the Board on or after August 4, 2014, the diagnosis of PTSD must be in accordance with the American Psychiatric Association's Diagnostic and Statistical Manual for Mental Disorders, Fifth Edition (DSM-5), otherwise DSM-IV is applicable. See 38 C.F.R. § 4.125(a); 79 Fed. Reg. 45,093, 45,094 (Aug. 4, 2014); 80 Fed. Reg. 14,308 (Mar. 19, 2015). This case was certified to the Board after August 4, 2014; therefore, DSM-5 is applicable.

The Veteran was afforded a VA examination for the claimed PTSD in February 2025. In the February 2025 VA examination report for PTSD, the examiner noted that the Veteran does not have the diagnosis of PTSD that conforms to DSM-5 criteria. However, the examiner noted the diagnosis of unspecified depressive disorder with anxious distress. Also, in a June 2025 private psychological examination report, the examiner noted the diagnosis of depressive disorder due to another medical condition with depressive features under DSM-5 criteria. However, the examiner did not note the diagnosis of PTSD.

Thus, the Board
(Mar. 19, 2015). This case was certified to the Board after August 4, 2014; therefore, DSM-5 is applicable.

Thus, the Board finds that the Veteran does not have diagnosis of PTSD under DSM-5 criteria; but he has the diagnosis of unspecified depressive disorder with anxious distress, and depressive disorder due to another medical condition with depressive features.

In the June 2025 private medical opinion, the examiner stated that the Veteran's mental health difficulties are at least as likely as not (with a likelihood that is at least approximately balanced or nearly equal, if not higher) related to the physical conditions, to include back and neck pain, including radiculopathy. After noting the Veteran's family, marital, social, educational, occupational, and mental health history, the examiner explained that the Veteran has been experiencing a persistent degree of emotional distress following the onset of the physical conditions. His pain and discomfort has led to significant and intrusive anxious and depressive thoughts and feelings, which adversely impact multiple facets of his life, including social, occupational, and family environments. Additionally, he experiences cognitive consequences to his mood symptoms. Furthermore, the examiner stated that there is no evidence of pre-existing mental health difficulties prior to the Veteran's time in the military and subsequent injury. Therefore, it is then at least as likely as not that the Veteran's depressive disorder is related to his experience of limitations from his injuries and continued reported pain. These limitations have resulted in a number of social and occupational difficulties, including the loss of several employment opportunities due to being unable to physically perform the required tasks.

The Board notes that in a February 2025 VA medical opinion, the examiner stated that the Veteran's mental health condition is not directly related to his active service. However, the examiner noted that the Veteran's physical health issues and his mental health issues are interrelated and overlap with regard to their effect on social and occupational functioning.

In the current decision, the Board is granting service connection for a lumbar spine condition, including bilateral lower extremity radiculopathy, and the above noted evidence of record shows that the Veteran's current depressive disorder due to another medical condition with depressive features is due to, caused by, resulted from, or aggravated by the service-connected lumbar spine condition and bilateral lower extremity radiculopathy.

Accordingly, entitlement to service connection for depressive disorder due to another medical condition with depressive features is warranted.

REASONS FOR REMAND

1. Entitlement to service connection for a cervical spine condition (claimed as a neck condition) is remanded.

In the April 2024 supplemental claim form, the Veteran claimed service connection for a cervical spine condition as directly related to active service or as secondary to a lumbar spine disability.

The RO afforded the Veteran an examination for the claimed cervical spine disability in February 2025. In the February 2025 VA examination report for neck (cervical spine) conditions, the examiner noted the diagnosis of cervical spine DDD with date of diagnosis as 2017. In the accompanying February 2025 VA medical opinion, the examiner stated that the Veteran's cervical spine DDD with right upper radicular nerve radiculopathy is not caused by or related to the extreme physical exertion with stresses and strain to neck and upper extremities caused by weight bearing, carrying of load, prolonged standing, pulling and bending associated with tasks performed during military service. The examiner stated that extensive evaluation of the Veteran's treatment records are mute for any neck complaints or upper extremity radicular symptoms, injuries, or visits during service. The Veteran was diagnosed with post service cervical spine DDD, which is likely due to age related changes and his right upper radicular nerve radiculopathy is due to post service cervical spine nerve root compression.

The Board finds the February 2025 VA medical opinion inadequate because the examiner provided a conclusory supporting rationale without sufficient explanation and supporting data. See Stefl v. Nicholson, 21 Vet. App. 120, 124 (2007) (a medical opinion "must support its conclusion with an analysis that the Board can consider and weigh against contrary opinions"). Also, the examiner solely relied on the service treatment records, and did not address any possible delayed onset of cervical spine DDD. Furthermore, the examiner stated that the Veteran's cervical spine DDD is due to age related changes. However,
is likely due to age related changes and his right upper radicular nerve radiculopathy is due to post service cervical spine nerve root compression.

The Board finds the February 2025 VA medical opinion inadequate because the examiner provided a conclusory supporting rationale without sufficient explanation and supporting data. See Stefl v. Nicholson, 21 Vet. App. 120, 124 (2007) (a medical opinion "must support its conclusion with an analysis that the Board can consider and weigh against contrary opinions"). Also, the examiner solely relied on the service treatment records, and did not address any possible delayed onset of cervical spine DDD. Furthermore, the examiner stated that the Veteran's cervical spine DDD is due to age related changes. However, the Board notes that in the February 2025 examination report, the examiner noted the date of diagnosis of cervical spine DDD as 2017, when the Veteran was only 47 years of age.

Accordingly, the Board finds that failure to obtain an adequate medical opinion on the Veteran's diagnosed cervical spine condition is a pre-decisional duty to assist error that warrants a remand to correct this error by obtaining a new medical opinion. The Board notes that the RO did not obtain a medical opinion on secondary service connection for the claimed cervical spine condition as secondary to a lumbar spine condition. However, failure to obtain such an opinion is not a pre-decisional duty to assist error because the Veteran was not service connected for a lumbar spine condition at the time of rating decision on appeal.

The Board also notes that the Veteran submitted a May 2025 private medical opinion, in which the examiner stated that the Veteran's cervical spine condition is directly related to his active service. As a supporting rationale, the examiner generally stated that veterans are vulnerable to get cervical spine conditions due to strenuous activities during service. Also, the examiner stated that the Veteran had complaints of a cervical spine condition during active service, but the examiner did not address which specific evidence of record shows that the Veteran had cervical spine condition during active service.

Accordingly, the Board finds that a remand is warranted to obtain a new medical opinion on the Veteran's diagnosed cervical spine condition that addresses the above noted concerns.

2. Entitlement to service connection for right upper extremity radiculopathy is remanded.

3. Entitlement to service connection for left upper extremity radiculopathy is remanded.

The Veteran has claimed service connection for bilateral upper extremity radiculopathy as secondary to the cervical spine condition. Also, in the May 2025 private medical opinion, the examiner stated that the Veteran has bilateral upper extremity radiculopathy, which is secondary to the cervical spine disability. Furthermore, in the February 2025 VA medical opinion, the examiner stated that the Veteran's right upper radicular nerve radiculopathy is due the cervical spine nerve root compression.

In the current decision, the Board is remanding the claim for entitlement to service connection for a cervical spine condition for additional development. The adjudication of this issue by the RO would impact the issues of service connection for bilateral upper extremity radiculopathy. Thus, these issues are inextricably intertwined with the remanded issue of service connection for a cervical spine disability. See Harris v. Derwinski, 1 Vet. App. 180, 183 (1991) (the adjudication of claims that are inextricably intertwined is based upon the recognition that claims related to each other should not be subject to piecemeal decision-making or appellate litigation).

Therefore, the adjudication of the issues of entitlement to service connection for bilateral upper extremity radiculopathy must be deferred and remanded pending the proposed development in the other remanded issue.

4. Entitlement to a TDIU is remanded.

The Board is remanding the claims of service connection for a cervical spine condition and bilateral upper extremity radiculopathy for additional development. The adjudication of these issues by the RO would impact the claim for entitlement to a TDIU. Thus, this issue is inextricably intertwined with the remanded issues. Therefore, the adjudication of the issue of entitlement to a TDIU must be deferred and remanded pending the proposed development in the other remanded issues.

Furthermore, the Board notes that in a July 2024 TDIU application form, the Veteran claimed a TDIU due to mental health condition, and noted his disability affected his full-time employment in 2010. However, the Veteran did not indicate when he last worked full-time because he also indicated that in 2021 he earned the most income, while working as commercial driver. The Veteran also indicated that he worked 40 hours a week until April 2024.

Additionally, the Board notes that in the February 2025 VA examination report for PTSD, the clinician noted that the Veteran had been a truck driver
entitlement to a TDIU must be deferred and remanded pending the proposed development in the other remanded issues.

Additionally, the Board notes that in the February 2025 VA examination report for PTSD, the clinician noted that the Veteran had been a truck driver off and on for years, and he had been working for the current employer for the past 6 months. The Veteran reported that prior to this job he worked for different trucking companies but stated that he had left positions as he "physically" could not do the job.

Accordingly, the Board finds that there is discrepancy about the Veteran's current status of work. Failure to obtain a clarification from the Veteran regarding status of his current work and whether any special accomodation was arranged by his employers to enable him to work is a pre-decisional duty to assist error that warrants a remand to obtain this information from the Veteran.

The matters are REMANDED for the following action:

1. Request the Veteran to complete an updated TDIU application form. The Veteran should provide information regarding his employment, earnings, and educational history; and whether any special accomodation has been arranged by his employers to enable him to work.

The RO is advised that a fully completed VA Form 21-8940, TDIU application form, is not compulsory; however, it provides the required information for further development and adjudication of the TDIU claim. However, the Veteran can provide the above requested information in any form.

2. Obtain a new medical opinion on the Veteran's diagnosed cervical spine condition, including DDD of cervical spine. The claims file should be available to the examiner for review.

After reviewing the claims file and copy of this remand, the examiner should provide an opinion as to whether the Veteran's currently diagnosed cervical spine condition is at least as likely as not (likelihood is at least approximately balanced or nearly equal, if not higher) began during his active military service or manifested to a compensable degree within one year of active service or directly related to an in-service disease, event, or injury.

In providing the above requested opinion, besides reviewing the claims file in general, the examiner should specifically review and address the evidence of record associated with the claims file with entries dated:

(i) 02/10/2025, titled "C&P Exam" that contains the February 2025 VA examination report for neck (cervical spine) conditions, in which the examiner noted the diagnosis of cervical spine DDD with date of diagnosis as 2017;

(ii) 02/10/2025, titled "C&P Exam" that contains the February 2025 VA medical opinion, in which the examiner stated that the Veteran's cervical spine condition is not related to active service and stated that it is due to age related changes. However, in the February 2025 examination report, the examiner noted the date of diagnosis of cervical spine DDD as 2017, when the Veteran was only 47 years of age;

(iii) 07/08/2025, titled "Medical Treatment Record - Non-Government Facility" that contains the May 2025 private medical opinion, in which the examiner stated that the Veteran's cervical spine condition is directly related to his active service. The examiner stated that the Veteran's cervical spine condition is related to strenuous activities during active service, and that current medical literature supports that degeneration occurs anywhere from 2 to over 20 years post trauma. Also, the examiner stated that the Veteran had complaints of a cervical spine condition during active service, but the examiner did not address which specific evidence of record shows that the Veteran had cervical spine condition during active service.

Clear supporting rationales must be provided for the opinions rendered. If the examiner determines that it is not possible to provide an opinion without resorting to speculation, then the examiner must provide an explanation of why that is so and state whether the need to speculate is due to a deficiency in the state of general medical knowledge (no one could respond given medical science and the known facts), a deficiency in the record (additional facts are required), or a deficiency in the examiner's knowledge (the examiner does not have the required knowledge or training).

MICHAEL MARTIN

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board Nadeem Tariq, Counsel

The Board's decision in this case is binding only with respect to the instant matter decided. This

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