DEGENERATIVE ARTHRITIS OF THE SPINE (SPONDYLOSIS)

Summary

The Veteran, an Army veteran who served from August 1987 to August 1991, appeals the denial of service connection for a cervical spine disorder with associated radiculopathy. The Veteran claims this condition is secondary to his already service-connected lumbar spine disability. The Board reviewed evidence including a November 2019 VA examination which confirmed the cervical spine diagnosis. The primary issue was establishing a nexus between the cervical spine condition and the service-connected lumbar spine disability. The Veteran's claim was supported by a November 2019 VA examiner's opinion, which found it at least as likely as not that the lumbar degenerative disc disease was secondary to the existing lumbar condition, citing anatomical relationships and medical literature. The Board found this opinion highly probative. Conflicting opinions from January 2020 and August 2020 VA examiners, which found no relationship or inconclusive evidence, were deemed less probative due to conclusory reasoning and failure to address aggravation. The Board found the November 2019 opinion sufficient, resolving doubt in the Veteran's favor and concluding the evidence was in equipoise. Service connection for the cervical spine disorder, to include as secondary to the lumbar spine disability, was granted.

Rationale

November 2019 VA exam found it at least as likely as not that lumbar degenerative disc disease is secondary to existing lumbar condition.; Examiner cited anatomical relationships and medical literature supporting the link.; Conflicting January 2020 and August 2020 VA opinions were deemed less probative due to conclusory reasoning and failure to address aggravation.

Full Decision Text

Citation Nr: A26024677
Decision Date: 03/18/26	Archive Date: 03/18/26

DOCKET NO. 210527-162689
DATE: March 18, 2026

ORDER

Service connection for degenerative arthritis of the cervical spine with cervical radiculopathy, to include as secondary to the lumbar spine disability, is granted.

FINDING OF FACT

Resolving all reasonable doubt in the Veteran's favor, the weight of the competent evidence of record is at least in approximate balance that his cervical spine disability is secondary to his service-connected lumbar spine disability.

CONCLUSION OF LAW

The criteria for service connection for degenerative arthritis of the cervical spine with cervical radiculopathy have been met. 38 U.S.C. §§ 1101, 1131, 5107; 38 C.F.R. §§ 3.303, 3.307, 3.309, 3.310.

REASONS AND BASES FOR FINDING AND CONCLUSION

The Veteran served on active duty in the United States Army from August 1987 to August 1991. 

This matter comes before the Board of Veterans' Appeals (Board) on appeal from an August 2020 rating decision issued by a Department of Veterans Affairs (VA) regional office, the agency of original jurisdiction (AOJ).

As background, a January 2020 rating decision originally denied service connection for a cervical spine disorder. In March 2020, the Appellant submitted a VA Form 20-0996, Decision Review Request: Higher-Level Review, and requested review of the January 2020 rating decision. In July 2020, the higher-level review identified a duty to assist error and additional development was directed. Thereafter, in August 2020, the AOJ issued the rating decision on appeal.  

In the May 2021 VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement), the Veteran elected the Hearing Docket. In November 2024, the Appellant testified before the undersigned Veterans Law Judge at a virtual hearing. A transcript of the hearing has been associated with the file.

Therefore, the Board may only consider the evidence of record at the time of the August 2020 AOJ decision on appeal, as well as any evidence submitted by the Appellant at the November 2024 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.

Entitlement to service connection for a cervical spine disorder. 

The Veteran contends that his current cervical spine disorder, to include associated radiculopathy, is caused or aggravated by his service-connected lumbar spine disability. Accordingly, he claims entitlement to service connection for such disorder.

Under the laws administered by VA, service connection may be granted for a disability resulting from disease or injury incurred in or aggravated by active service. See 38 U.S.C. § 1131; 38 C.F.R. § 3.303(a). Service connection may also be granted for any disease diagnosed after discharge from service when all the evidence, including that pertinent to service, establishes that the disease was incurred during service. 38 C.F.R. § 3.303(d).

Generally, the evidence 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. 38 C.F.R. §§ 3.303 (a); Shedden v. Principi, 381 F.3d 1163, 1166-67 (Fed. Cir. 2004).

Service connection may be established under the provisions of 38 C.F.R. §§ 3.303(b) when the evidence, regardless of its date, shows that a veteran had a chronic condition in service, such as arthritis, or during the applicable presumptive period. In addition, certain chronic diseases may be presumed to have been incurred or aggravated during service if they become disabling to a compensable degree within one year of separation from active duty. 38 U.S.C. §§ 1101, 1112; 38 C.F.R. §§ 3.307, 3.309.

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
 be established under the provisions of 38 C.F.R. §§ 3.303(b) when the evidence, regardless of its date, shows that a veteran had a chronic condition in service, such as arthritis, or during the applicable presumptive period. In addition, certain chronic diseases may be presumed to have been incurred or aggravated during service if they become disabling to a compensable degree within one year of separation from active duty. 38 U.S.C. §§ 1101, 1112; 38 C.F.R. §§ 3.307, 3.309.

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 chronicity is not established, then a showing of continuity of symptomatology after discharge is required to support the claim. 38 C.F.R. § 3.303 (b). However, the regulatory provisions pertaining to chronicity and continuity of symptomatology are constrained by 38 C.F.R. § 3.309 (a), and, thus, such provisions are only available to establish service connection for the specific chronic diseases listed in 38 C.F.R. §§ 3.309 (a). See Walker v. Shinseki, 708 F.3d 1331 (Fed. Cir. 2013).

In addition, service connection may also be established on a secondary basis for a disability which is proximately due to, or aggravated by, a service-connected disability. 38 C.F.R. § 3.310 (a).

As an initial matter, the Board notes that the Veteran underwent a November 2019 VA examination that confirmed a diagnosis of degenerative arthritis of the cervical spine with cervical radiculopathy. As such, the first criteria for a grant of service connection has been satisfied. The remaining question is whether it is at least as likely as not that the disability is proximately attributable to the Veteran's service-connected lumbar spine condition as he contends. Upon consideration of the record, the Board finds that the evidence is at least in equipoise as to whether the Veteran's diagnosed low back condition is secondary to his low back condition.

In support of his claim, the Veteran has argued that the November 2019 positive nexus opinion should control. In this regard, after this thorough review of the record and physical examination of the Veteran, a VA examiner opined that it was at least as likely as not that the Veteran's lumbar spine degenerative disc disease is secondary to the lumbar spine condition for which he is already service connected. As a rationale, the examiner discussed at length the specific anatomy at issue, to include the impact of the Veteran's lumbar stenosis, facet arthropathy, and bulging disc on the entirety of his spine health. Additionally, the examiner cited primary source medical studies confirming the nature of this anatomical relationship between lumbar spine disorders and the development of related cervical spine problems.  

The Board finds this opinion to be highly probative of the question of whether the cervical spine condition is secondary to the lumbar spine condition, in light of the thorough review of the claims file and reference to medical literature in support of conclusions reached. Sklar v. Brown, 5 Vet. App. 140 (1993).

The Board acknowledges that a different VA examiner issued a negative nexus opinion in January 2020, finding that the evidence was inconclusive with regard to a relationship between the Veteran's service-connected low back condition and his claimed neck condition. Furthermore, in August 2020, another VA examiner considered the discrepancy between the November 2019 and January 2020 nexus opinions and similarly found that a low back condition could not cause or aggravate a neck condition without a significant and prolonged gait disturbance or a fall and injury. 

Nonetheless, where there are conflicting medical opinions in the claims file, the Board must independently assess the opinions and make a determination as to relative weight to assign to each opinion. Madden v. Gober, 125 F.3d 1477 (Fed. Cir. 1997). Here, the January 2020 and August 2020 examiners offered only a conclusory rationale for the finding that the low back condition did not aggravate the neck condition, and they completely neglected to discuss whether the Veteran's cervical spine condition worsened over time, which is an integral component of the aggravation prong of the secondary service connection analysis. For these reasons, the Board finds the determinations of the January 2020 and August 2020 examiners to be less than probative. See Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 303 (2008).

Under these circumstances, the Board finds that the November 2019 evaluation is sufficient to substantiate the Veteran's claim seeking service connection on a secondary basis.
2020 examiners offered only a conclusory rationale for the finding that the low back condition did not aggravate the neck condition, and they completely neglected to discuss whether the Veteran's cervical spine condition worsened over time, which is an integral component of the aggravation prong of the secondary service connection analysis. For these reasons, the Board finds the determinations of the January 2020 and August 2020 examiners to be less than probative. See Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 303 (2008).

Under these circumstances, the Board finds that the November 2019 evaluation is sufficient to substantiate the Veteran's claim seeking service connection on a secondary basis. Resolving all doubt in favor of the Veteran, the Board concludes that the evidence is at least in equipoise as to the question of whether his diagnosed cervical spine condition is directly caused by the service-connected low back condition. Consequently, service connection is warranted. Allen, supra.

 

 

Marcus N. Fulton

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	Breckenridge, Meredith 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.