DEGENERATIVE ARTHRITIS OF THE SPINE (SPONDYLOSIS)

Summary

The veteran, who served from November 1986 to November 1989, appeals the denial of service connection for a neck disability, bilateral upper extremity radiculopathy, and headaches. The Board found that the Veteran's claims for spinal enthesopathy of the cervical region, spinal enthesopathy of the occipito atlanto axial region, change in gait, and scoliosis were best addressed as a single neck disability. The Veteran argued this neck disability was secondary to a service-connected back condition, but the Board found it directly related to service, citing in-service treatment for thoracic pain and a private physician's opinion linking neck disability to parachute jumps and whole-body vibration injuries. The Board granted service connection for the neck disability, applying the benefit of the doubt doctrine. The Board also found the Veteran's bilateral upper extremity radiculopathy and headaches to be secondary to the now service-connected neck disability, based on a VA examiner's opinion linking radiculopathy to cervical spine issues and a private examiner's opinion connecting headaches to cervical spine problems. Service connection for all claimed conditions was granted.

Rationale

Private physician opinion linked neck disability to in-service traumas (parachuting, vibration); Cited medical journals supporting link between parachute jumps and spinal compromise; No contrary medical opinion found

Full Decision Text

Citation Nr: A26021340
Decision Date: 03/10/26	Archive Date: 03/10/26

DOCKET NO. 210120-134978
DATE: March 10, 2026

ORDER

Entitlement to service connection for a neck disability, to include spinal enthesopathy of cervical region, spinal enthesopathy of occipito atlanto axial region, change in gait, and scoliosis, is granted.

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

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

Entitlement to service connection for headaches is granted.

FINDINGS OF FACT

1. The Veteran's claims for entitlement to service connection for spinal enthesopathy of cervical region, spinal enthesopathy of occipito atlanto axial region, change in gait, and scoliosis are best discussed together as a single neck disability with multiple diagnoses and manifestations.

2. The Veteran's neck disability, however diagnosed, is related to service.

3. The Veteran's bilateral upper extremity radiculopathy is related to his service-connected neck disability.

4. The Veteran's headaches are related to his service-connected neck disability.

CONCLUSIONS OF LAW

1. The criteria for service connection for a neck disability have been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309. 

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

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

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Veteran served on active duty from November 1986 to November 1989.

These matters come to the Board of Veterans' Appeals (Board) on appeal from an October 2020 Department of Veterans Affairs (VA) regional office (RO) rating decision.

In the January 2021 VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement), the Veteran elected the Hearing docket. A Board hearing was held in September 2024.

Therefore, the Board may only consider the evidence of record at the time of the October 2020 agency of original jurisdiction (AOJ) decision on appeal, as well as any evidence submitted by the Veteran at the hearing or within 90 days following the hearing. 38 C.F.R. § 20.302(a). If evidence was submitted either (1) during the period after the AOJ issued the decision on appeal and prior to the Board hearing, or (2) more than 90 days following the hearing, the Board did not consider it in its decision. 38 C.F.R. §§ 20.300, 20.302(a), 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. 

Service Connection

Service connection will be granted for a disability resulting from a disease or injury incurred in or aggravated by service. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303. Service connection may also be granted for a disease first diagnosed after discharge when all of the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303(d). Service connection requires competent evidence showing (1) a present disability; (2) an 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, 1167 (Fed. Cir. 2004).  

Service connection may also be awarded on secondary basis for a disability which is due to or aggravated by a service-connected disease or injury. 38 C.F.R. §
 discharge when all of the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303(d). Service connection requires competent evidence showing (1) a present disability; (2) an 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, 1167 (Fed. Cir. 2004).  

Service connection may also be awarded on secondary basis for a disability which is due to or aggravated by a service-connected disease or injury. 38 C.F.R. § 3.310. In order to prevail on the issue of secondary service connection, 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 service-connected disability and the current disability. Wallin v. West, 11 Vet. App. 509, 512 (1998).

1. Entitlement to service connection for spinal enthesopathy of cervical region

2. Entitlement to service connection for spinal enthesopathy of occipito atlanto axial region

3. Entitlement to service connection for change in gait

4. Entitlement to service connection for scoliosis 

Preliminarily, when a claimant makes a claim, he is seeking service connection for symptoms regardless of how those symptoms are diagnosed or labeled. Clemons v. Shinseki, 23 Vet. App. 1 (2009).

Here, the Veteran's spinal enthesopathy of cervical region, spinal enthesopathy of occipito atlanto axial region, change in gait, and scoliosis can be best clustered together and discussed as a single neck disability.  See id., 23 Vet. App. at 5 (indicating that a claim should be construed based on the "reasonable expectations" of the claimant and the evidence developed in processing that claim).  This is because, as discussed below, even if they may be "distinct conditions" they result in "similar symptoms" to include pain and limited range of motion of the neck.  The Board also notes that 38 C.F.R. § 4.71a, General Rating Formula for Diseases and Injuries of the Spine, considers both an "abnormal gait" and "scoliosis" as part of an accurate rating for the neck.  For this reason, and for ease of discussion, they will be discussed as one.

The Veteran has primarily argued that his neck disability is secondary to his service-connected back.  However, while not specifically contended, the Board has a duty to address the reasonably raised theory that his neck disability is directly related to service.  Robinson v. Peake, 21 Vet. App. 545 (2008).  In doing so, it finds that service connection is warranted and that discussion of other theories of causation are not warranted

The eligible evidence shows that the Veteran is diagnosed with a neck disability.  For example, the pre-decisional August 2020 VA examiner diagnosed him with a cervical strain, degenerative arthritis of the spine, and spinal stenosis. Eligible post-hearing medical records also show a diagnosis of spinal enthesopathy of occipito atlanto axial region and spinal enthesopathy of cervical region, with "problems turning neck" and abnormal gait.  The first Shedden element is thus met.

The Veteran is also in receipt of a parachute badge and was seen in service for "R thoracic pain."  The second Shedden element is therefore met and the remaining determination is whether they are linked.

The August 2020 VA examiner failed to provide a direct etiological opinion regarding the Veteran's claimed neck disability and service.  It is thus not afforded any probative weight.

In an October 2024 medical opinion, the private physician opined that the Veteran's neck disability to include spinal enthesopathy of cervical region, spinal enthesopathy of occipito atlanto axial region, change in gait, and scoliosis are directly related to "in-service traumas attributive to both his parachuting and whole-body vibration injuries."  The examiner cited numerous medical journals in support of this opinion that "parachute jumps have been shown to significantly compromise the spine."

Based on the above, the Board finds entitlement to service connection for a neck disability warranted.  The private medical opinion sufficiently links the Veteran's neck disability to his in-service parachute jumps and treatment for "R thoracic pain" given medical evidence and likelihood that "parachute jumps have been shown to significantly compromise the spine."   Nieves-Rodriguez v. Peake, 22 Vet. App
opathy of occipito atlanto axial region, change in gait, and scoliosis are directly related to "in-service traumas attributive to both his parachuting and whole-body vibration injuries."  The examiner cited numerous medical journals in support of this opinion that "parachute jumps have been shown to significantly compromise the spine."

Based on the above, the Board finds entitlement to service connection for a neck disability warranted.  The private medical opinion sufficiently links the Veteran's neck disability to his in-service parachute jumps and treatment for "R thoracic pain" given medical evidence and likelihood that "parachute jumps have been shown to significantly compromise the spine."   Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 302 (2008).   Indeed, there is no medical opinion to the contrary and the Board is not allowed to ignore or disregard the medical conclusions of a physician and is not permitted to substitute its own judgment on a medical matter. Colvin v. Derwinski, 1 Vet. App. 171 (1991).

While the Board could remand to correct a pre-decisional duty to assist error in failing to obtain a VA direct examination, it cannot remand claims for potential negative evidence.  Mariano v. Principi, 17 Vet. App. 305 (2003).  The claim is granted based upon application of the benefit of the doubt doctrine.  Lynch v. McDonough, 21 F.4th 776, 781 (Fed. Cir. 2021).  The nature and extent of the disability is not before the Board at this time.

5. Entitlement to service connection for left upper extremity radiculopathy

6. Entitlement to service connection for right upper extremity radiculopathy

The Veteran has primarily argued that his bilateral upper radiculopathy is secondary to his service-connected back.  However, while not specifically contended, the Board has a duty to address the reasonably raised theory that these disabilities are secondary to his now service-connected neck disability.  Robinson v. Peake, 21 Vet. App. 545 (2008).  In doing so, it finds that service connection is warranted and that discussion of other theories of causation are not warranted.

The October 2020 rating decision favorably found that the Veteran was diagnosed with bilateral upper extremity radiculopathy. This finding is binding on the Board.  38 C.F.R. § 3.104(c). Furthermore, as part of this Board decision, the Veteran has been awarded service connection for a neck disability, however diagnosed.  The first two Wallin elements are thus met, and the remaining determination is whether they are related.

After reviewing the claims file, the Board finds that the Veteran's bilateral upper extremity is caused by his now service-connected neck disability.  The August 2020 VA examiner diagnosed the Veteran with bilateral cervical radiculopathy and opined that this would be caused by "nerve root impingement in the cervical spine."  Given that the latter is related to service, the former is deemed to be caused by the same.  

Furthermore, pursuant to the General Formula for Rating Disabilities of the Spine Note 1 provides that associated objective neurologic abnormalities are evaluated separately under an appropriate diagnostic code. See 38 C.F.R. § 4.71a (General Formula, Note 1).  Given that the Veteran's neck disability is now service-connected, the associated bilateral upper radiculopathy is also related to service.  38 C.F.R. § 3.310.  

The claim is granted based upon application of the benefit of the doubt doctrine.  Lynch v. McDonough, 21 F.4th 776, 781 (Fed. Cir. 2021).  The nature and extent of the disabilities are not before the Board at this time.

7. Entitlement to service connection for headaches

The Veteran has primarily argued that his headaches are secondary to his service-connected back.  However, while not specifically contended, the Board has a duty to address the reasonably raised theory that this disability is secondary to his now service-connected neck and bilateral upper radiculopathy disabilities.  Robinson v. Peake, 21 Vet. App. 545 (2008).  In doing so, it finds that service connection is warranted and that discussion of other theories of causation are not warranted.

The October 2020 rating decision favorably found that the Veteran was diagnosed with headaches. This finding is binding on the Board.  38 C.F.R. § 3.104(c). Furthermore, as part of this Board decision, the Veteran has been awarded service connection for a neck disability, however diagnosed, and bilateral upper extremity radiculopathy.  The first two Wallin elements are thus met, and the
 this disability is secondary to his now service-connected neck and bilateral upper radiculopathy disabilities.  Robinson v. Peake, 21 Vet. App. 545 (2008).  In doing so, it finds that service connection is warranted and that discussion of other theories of causation are not warranted.

The October 2020 rating decision favorably found that the Veteran was diagnosed with headaches. This finding is binding on the Board.  38 C.F.R. § 3.104(c). Furthermore, as part of this Board decision, the Veteran has been awarded service connection for a neck disability, however diagnosed, and bilateral upper extremity radiculopathy.  The first two Wallin elements are thus met, and the remaining determination is whether they are related.

The only medical opinion regarding whether the Veteran's headaches are related to his service-connected neck and bilateral upper radiculopathy disabilities was comprised by the October 2024 private examiner.  Therein, the private examiner opined that the Veteran's headaches are related to his cervical spine issues.  The examiner reasoned that his headaches "can be triggered by certain movements or awkward position of the head," and that "pain signals can radiate outward along the branching peripheral nerves, and even up the spinal cord toward the head.  Thus, causing headache and neuropathic pain."  

After reviewing the claims file, the Board finds that the Veteran's headaches are caused by his now service-connected neck and bilateral upper extremity radiculopathy disabilities.  The private examiner reasonably linked the Veteran's headaches to his service-connected disabilities given that the cervical "pain signals can radiate outward...and even up the spinal cord toward the head...causing headache."  Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 302 (2008).   Indeed, there is no medical opinion to the contrary and the Board is not allowed to ignore or disregard the medical conclusions of a physician and is not permitted to substitute its own judgment on a medical matter. Colvin v. Derwinski, 1 Vet. App. 171 (1991).

The claim is granted based on application of the benefit of the doubt doctrine.  Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021).  The nature and extent of the disability is not before the Board at this time. 

 

M. C. WILSON

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	Finelli, Christopher

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.