Case 25012190

KELLI A. KORDICH · 2025 · Case ID: 25012190

DENIED

Summary

The veteran, who served in the U.S. Army from June 2004 to February 2006 and again from June 2009 to August 2010, with additional National Guard service, appealed the denial of service connection for chronic pain syndrome and a neck disability. The veteran contended that her chronic pain syndrome began in 2009 during service in Afghanistan and was related to service, but the Board found no objective evidence or diagnosis of chronic pain syndrome in the record, and that any pain complaints could be attributed to specific underlying disabilities. The Board also denied service connection for a neck disability, noting the absence of any neck complaints or diagnoses in service treatment records. Post-service records showed a diagnosis of cervical spondylosis with radiculopathy in 2016, six years after active duty. Multiple VA examinations were conducted for both claims. For chronic pain syndrome, the Board found the evidence weighed against the claim, as no diagnosis was supported. For the neck disability, the Board found that while the veteran reported neck pain and was diagnosed with cervical spondylosis, the evidence did not establish a nexus to service or aggravation by service-connected conditions, with multiple examiners opining the condition was less likely than not related to service or caused by aging and wear and tear. The Board concluded that the evidence persuasively weighed against granting service connection for either claimed condition.

Rationale

No objective evidence or diagnosis of chronic pain syndrome.; Pain complaints attributed to specific underlying disabilities.; VA examiners opined the condition was not warranted and not related to service.

Service Branch

ARMY

Special Benefit

NO SPECIAL BENEFIT

Docket No.

19-00 248A

Full Decision Text

Citation Nr: 25012190
Decision Date: 09/26/25 Archive Date: 09/26/25

DOCKET NO. 19-00 248A
DATE: September 26, 2025

ORDER

Entitlement to service connection for chronic pain syndrome is denied.

Entitlement to service connection for a cervical spine (neck) disability is denied.

FINDINGS OF FACT

1. The persuasive evidence of record weighs against finding that the Veteran has a diagnosis of chronic pain syndrome at this time.

2. The persuasive evidence of record weighs against finding that the Veteran's currently diagnosed neck disability was manifest during service and the Veteran's currently diagnosed neck disability is not otherwise etiologically related to her active service or to any service-connected disability.

CONCLUSIONS OF LAW

1. The criteria to establish entitlement to service connection for chronic pain syndrome are not met. 38 U.S.C. §§ 1110, 1116A, 5107; 38 C.F.R. §§ 3.159, 3.303, 3.304.

2. The criteria to entitlement to service connection for a neck disability are not met. 38 U.S.C. §§ 1131, 5103, 5103A, 5107; 38 C.F.R. §§ 3.102, 3.159, 3.303, 3.304, 3.307, 3.309, 3.310.

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Veteran served on active duty in the United States Army from June 2004 to February 2006, and from June 2009 to August 2010. Further, the record reflects she had additional service in the National Guard.

These matters are on appeal from an August 2016 rating decision.

The Veteran provided testimony at a hearing before a Veterans Law Judge (VLJ) of the Board in April 2021. However, the VLJ who presided over that hearing is no longer with the Board. As the VLJ who presided at a hearing in the Legacy appeal system must participate in the decision on the claim, 38 U.S.C. § 7107(c); 38 C.F.R. § 20.604 (formerly 20.707), the Veteran was offered the opportunity for another hearing. She subsequently provided testimony at a hearing before the undersigned in July 2022. Transcripts of both hearings are of record.

In May 2023, these matters were remanded by the Board for further development by the originating agency. The Board finds that there has been substantial compliance with its remand directives. See Stegall v. West, 11 Vet. App. 268 (1998).

Service Connection

Service connection may be granted for a disability resulting from disease or injury incurred in or aggravated by service. 38 U.S.C. § 1110; 38 C.F.R. § 3.303 (a). Service connection requires competent evidence showing: (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, 1167 (Fed. Cir. 2004); see also Caluza v. Brown, 7 Vet. App. 498 (1995).

In addition, certain diseases, including such as arthritis, are presumed to have been incurred in service if manifested to a compensable degree within one year after service. The presumption is rebuttable by probative evidence to the contrary. 38 U.S.C. §§ 1101, 1112, 1113; 38 C.F.R. §§ 3.307, 3.309(a). When chronicity in service is not adequately supported, then a showing of continuity after discharge is required to support a claim for such diseases. 38 C.F.R. § 3.303 (b); see Walker v. Shinseki, 708 F.3d 1331 (Fed. Cir. 2013).

Service connection may also be established on a secondary basis for a disability which is aggravated by, proximately due to, or the result of a service-connected disease or injury. 38 C.F.R. § 3.310. Any additional impairment of earning capacity resulting from an already service-connected condition, regardless of whether or not the additional impairment is itself a separate disease or injury caused by the service-connected condition, should also be compensated. Allen v. Brown, 7 Vet. App. 439 (
claim for such diseases. 38 C.F.R. § 3.303 (b); see Walker v. Shinseki, 708 F.3d 1331 (Fed. Cir. 2013).

Service connection may also be established on a secondary basis for a disability which is aggravated by, proximately due to, or the result of a service-connected disease or injury. 38 C.F.R. § 3.310. Any additional impairment of earning capacity resulting from an already service-connected condition, regardless of whether or not the additional impairment is itself a separate disease or injury caused by the service-connected condition, should also be compensated. Allen v. Brown, 7 Vet. App. 439 (1995); Ward v. Wilkie, 31 Vet. App. 233 (2019) (holding that a "permanent worsening" of a non-service-connected disability is not required to establish secondary service connection on the basis of aggravation (i.e., aggravation may include temporary worsening of a disability)).

Pertinent to a claim for service connection, such a determination requires a finding of current disability that is related to an injury or disease in service. See Brammer v. Derwinski, 3 Vet. App. 223 (1992). The requirement of a current disability is satisfied when the Veteran has a disability at the time he files his service connection claim or during the pendency of that claim, even if the disability resolves prior to the adjudication of the claim. McClain v. Nicholson, 21 Vet. App. 319, 321 (2007). However, when the record contains a recent diagnosis of disability prior to the Veteran's filing of a claim for benefits based on that disability, the report of the diagnosis is relevant evidence that the Board must address in determining whether a current disability existed at the time of the claim was filed or during its pendency. Romanowsky v. Shinseki, 26 Vet. App. 289 (2013). Under applicable regulation, the term "disability" means impairment in earning capacity resulting from diseases and injuries and their residual conditions. 38 C.F.R. § 4.1; see also Hunt v. Derwinski, 1 Vet. App. 49 (1990); Saunders v. Wilkie, 886 F.3d 1356, 1364-65 (Fed. Cir. 2018).

1. Chronic pain syndrome

The Veteran had service in Afghanistan during the Gulf War. Therefore, she is considered a Persian Gulf War veteran. 38 C.F.R. § 3.317(e).

Service connection may be warranted for a Persian Gulf veteran who exhibits objective indications of a qualifying chronic disability that became manifest during active military, naval, or air service in the Southwest Asia theater of operations during the Persian Gulf War or to a degree of 10 percent or more not later than December 31, 2026. 38 U.S.C. § 1117; 38 C.F.R. § 3.317. For purposes of section 3.317, there are two types of qualifying chronic disabilities: (1) an undiagnosed illness, and (2) a medically unexplained chronic multisymptom illness (MUCMI). 38 C.F.R. § 3.317(a)(2).

An undiagnosed illness requires that the illness, by history, physical examination, and laboratory tests, cannot be attributed to any known clinical diagnosis. 38 C.F.R. § 3.317(a)(4). There is no burden on a veteran to demonstrate that a medical professional has eliminated all possible diagnoses before the veteran can be compensated for a disability stemming from an undiagnosed illness. Joyner v. McDonald, 766 F.3d 1393, 1395 (Fed. Cir. 2014).

A MUCMI is defined by a cluster of signs or symptoms, such as: (1) chronic fatigue syndrome, (2) fibromyalgia, and (3) functional gastrointestinal disorders (excluding structural gastrointestinal disease). The term MUCMI means a diagnosed illness without conclusive pathophysiology or etiology that is characterized by overlapping symptoms and signs and has features such as fatigue, pain, disability out of proportion to physical findings, and inconsistent demonstration of laboratory abnormalities. Chronic multi-symptom illnesses of partially understood etiology and pathophysiology, such as diabetes and multiple sclerosis, will not be considered medically unexplained. 38 C.F.R. § 3.317(a)(2).

The Sergeant First Class Heath Robinson Honoring our Promise to Address Comprehensive Toxics (PACT) Act, was enacted on August 10, 2022. Section 405 of the PACT
3) functional gastrointestinal disorders (excluding structural gastrointestinal disease). The term MUCMI means a diagnosed illness without conclusive pathophysiology or etiology that is characterized by overlapping symptoms and signs and has features such as fatigue, pain, disability out of proportion to physical findings, and inconsistent demonstration of laboratory abnormalities. Chronic multi-symptom illnesses of partially understood etiology and pathophysiology, such as diabetes and multiple sclerosis, will not be considered medically unexplained. 38 C.F.R. § 3.317(a)(2).

The Sergeant First Class Heath Robinson Honoring our Promise to Address Comprehensive Toxics (PACT) Act, was enacted on August 10, 2022. Section 405 of the PACT Act reduces the threshold for establishing eligibility when considering presumptive service connection for Persian Gulf War veterans. Presumptive conditions under 38 C.F.R. § 3.317(a) and (b) may now manifest to any degree at any time. There is no longer a requirement for a chronic disability to manifest to a degree of 10 percent or more prior to December 31, 2026. The end date is no longer applicable and will be removed in a forthcoming regulation.

In addition, the PACT Act established presumption of in-service exposure to burn pits and other toxins for veterans who served in certain parts of the Southwest Asia Theater of Operations after August 2, 1990. The PACT Act established presumption for numerous respiratory illnesses and cancers, including head cancers of any type, as due to in-service exposure to burn pits and other environmental hazards. The Veteran's claimed disabilities are not subject to presumptive service connection for exposure to burn pits and other toxins; thus, this expansion is not applicable under the facts of this case.

The PACT Act also directs that in certain circumstances, when a veteran is found to have been involved in a toxic exposure risk activity (TERA) during service, VA must obtain an opinion addressing whether such toxic exposure caused a diagnosed disability. 38 U.S.C. § 1168.

A December 2022 memorandum found that the Veteran had military service which constitutes presumptive toxic exposure in accord with 38 U.S.C. § 1119.

The Veteran contends that she has chronic pain syndrome that is related to her service. In July 2022, she testified that it began in her upper body in 2009 during service in Afghanistan.

The STRs note treatment for various joints such as left wrist, left elbow, and left knee disabilities, but they are void for any diagnosis related to chronic pain syndrome.

Post-service VA and private treatment records do not indicate any diagnosis of chronic pain syndrome.

On August 2018 VA fibromyalgia examination the Veteran presented with a history of chronic left elbow pain and symptoms which began after a fall in August 2009 while deployed in Afghanistan. In July 2011, she was evaluated by orthopedics with a suspected diagnosis of lateral epicondylitis.

In an August 2018 VA medical opinion the clinician opined that the Veteran did not have fibromyalgia, nor did she warrant a diagnosis of chronic pain syndrome. Further, many of her complaints of pain have been attributed to known clinical diagnoses such as her disabilities of both shoulders, left elbow, and left wrist.

In April 2021, the Veteran testified that she was diagnosed with chronic pain syndrome.

In July 2022, the Veteran testified that doctors opined that her chronic pain syndrome was directly related to her service.

In a May 2023 remand the Board found that the August 2018 VA examination did not adequately address the claim, particularly given the passage of time and other evidence of record. It was also unclear whether the Veteran had complaints of chronic pain which are not attributed to known clinical diagnoses. The Board remanded the claim for a new medical examination to clarify the nature of the Veteran's claimed chronic pain syndrome, to include fibromyalgia.

Pursuant to the Board's remand, on November 2023 VA fibromyalgia examination the clinician stated that the Veteran did not have a current diagnosis of fibromyalgia. The Veteran denied diffuse muscle pain. The clinician opined that all reported pain was caused by specific underline medical disabilities. The clinician stated that the medical record showed no documentation or diagnosis of fibromyalgia and stated that a diagnosis of fibromyalgia was not warranted.

On November 2023 VA peripheral nerves disabilities examination the clinician diagnosed left ulnar nerve neuropathy (due to service-connected left wrist fracture, left wrist arthritis, ulnar nerve impingement status post-surgical reconstruction).

Regarding chronic pain syndrome the clinician stated that there was no objective evidence to support a diagnosis of chronic pain syndrome. All reported symptoms or pain can be explained by specific underline
not have a current diagnosis of fibromyalgia. The Veteran denied diffuse muscle pain. The clinician opined that all reported pain was caused by specific underline medical disabilities. The clinician stated that the medical record showed no documentation or diagnosis of fibromyalgia and stated that a diagnosis of fibromyalgia was not warranted.

Regarding chronic pain syndrome the clinician stated that there was no objective evidence to support a diagnosis of chronic pain syndrome. All reported symptoms or pain can be explained by specific underline disabilities. The symptoms should be categorized under those specific disabilities, rather than calling "chronic pain syndrome" which usually applies to pain that cannot be explained by any disabilities. Therefore, the diagnosis of chronic pain syndrome is not warranted.

The clinician further stated that left ulnar nerve neuropathy (due to service-connected left wrist fracture, left wrist arthritis, ulnar nerve impingement status post-surgical reconstruction) is a disease with a clear and specific etiology and diagnosis.

Finally, the clinician opined that left ulnar nerve neuropathy was less likely than not caused by the indicated toxic exposure risk activity(ies), after considering the total potential exposure through all applicable military deployments of the Veteran and the synergistic, combined effect of all toxic exposure risk activities of the Veteran.

In a November 2023 VA medical opinion the clinician opined that the claimed disability was less likely than not caused by the indicated toxic exposure risk activity(ies), after considering the total potential exposure through all applicable military deployments of the Veteran and the synergistic, combined effect of all toxic exposure risk activities of the Veteran. The rationale was that the Veteran has no diagnosis of chronic pain syndrome or fibromyalgia.

The Board finds that the claim must be denied.

The evidence of record persuasively weighs against finding that the Veteran has any diagnosis of chronic pain syndrome or fibromyalgia, related to service, at any time during the pendency of the claim or recent to the filing of the February 2016 claim. Accordingly, service connection is denied. See Brammer, supra; see also McClain, supra; Romanowsky, supra; Saunders, supra.

To the extent that the Veteran complained of diffuse pain, separate from symptoms of her variously diagnosed service-connected disabilities, (as suggested by the VA examiners), there is no indication that any subjective complaints resulted in functional impairment of earning capacity. See Hunt, supra, Saunders, supra. More importantly, there is no objective evidence of any diagnosed chronic pain syndrome or fibromyalgia. Consequently, the Board finds that, at no time during the pendency of the claim did the Veteran have a currently diagnosed chronic pain syndrome and the record does not contain a recent diagnosis of disability prior to the Veteran's filing of a claim. Therefore, service connection for chronic pain syndrome is not warranted.

2. Neck disability

The Veteran contends that her cervical spine disability is either directly related to her service or secondary to her service-connected disabilities of the left elbow, left wrist, and right shoulder.

Turning to the evidence, the STRs are void of any findings, complaints, symptoms, or diagnosis of any neck disability.

Private treatment records include a January 2013 report which shows that the Veteran complained of recent onset neck pain. An April 2022 report indicates a diagnosis of severe arthritis of the cervical spine.

VA treatment records include an August 2016 report which shows that the Veteran described a several-year history of neck pain. She denied any specific injury or accident leading to her increased symptoms, but attributed her neck pain to years of military service. Multilevel cervical spondylosis was diagnosed.

On August 2018 VA neck disabilities examination the clinician diagnosed cervical spondylosis with radiculopathy since June 2016. The Veteran presented with a history of an onset of neck pain with the heavy work in the military. In an August 2018 VA medical opinion the clinician opined that the Veteran's neck disability less likely than not began during her active service. The rationale was that there is no medical evidence that the Veteran was diagnosed with cervical spondylosis with radiculopathy while in service.

Regarding direct service connection, the clinician further opined that the neck disability is less likely than not related to her service. In the rationale the clinician stated that the Veteran's report of pain with heavy activities is a normal physiologic response. There is no evidence that the Veteran was evaluated and found to have an abnormal examination that would indicate evidence of pathology during service. She was diagnosed with her current neck disability in 201
In an August 2018 VA medical opinion the clinician opined that the Veteran's neck disability less likely than not began during her active service. The rationale was that there is no medical evidence that the Veteran was diagnosed with cervical spondylosis with radiculopathy while in service.

Regarding direct service connection, the clinician further opined that the neck disability is less likely than not related to her service. In the rationale the clinician stated that the Veteran's report of pain with heavy activities is a normal physiologic response. There is no evidence that the Veteran was evaluated and found to have an abnormal examination that would indicate evidence of pathology during service. She was diagnosed with her current neck disability in 2016, six years after active duty which does not support a nexus for service connection.

Regarding causation, the clinician also opined that the Veteran's neck disability was less likely than not caused by or the result of her service-connected left elbow arthritis and/or left ulnar neuropathy (to include as due to any altered biomechanics resulting from the service-connected disabilities).

The rationale was that neither left elbow arthritis nor left ulnar neuropathy are known risk factors for cervical spondylosis with radiculopathy.

Regarding aggravation, the clinician opined that the Veteran's neck disability was not aggravated by her service-connected left elbow arthritis and/or left ulnar neuropathy (to include as due to any altered biomechanics resulting from the service-connected disability). The rationale was that left elbow arthritis, left ulnar neuropathy and abnormal biomechanics from service connected disabilities were not known aggravating factors for cervical spondylosis with radiculopathy. Known aggravators of the disability include significant neck trauma, smoking, aging, and time.

On February 2021 VA neck disabilities examination the Veteran was diagnosed with degenerative arthritis of the spine and degenerative disc disease and degenerative arthritis of the cervical spine with Grade I spondylolisthesis in 2016. The Veteran presented with a history of chronic neck pain which gradually developed approximately in 2013. She denied acute injury to the neck.

In a February 2021 VA medical opinion the clinician opined that the Veteran's degenerative disc disease and degenerative arthritis of the cervical spine with Grade I spondylolisthesis and foraminal stenosis is likely caused by aging, chronic wear and tear, and/or history of injury. The clinician stated that radiculopathy of the right upper extremity can contribute to and aggravate her right shoulder disability, but not the other way around.

In a June 2021 VA medical opinion a clinician opined that the claimed neck disability is not proximately due to or the result of Veteran's service connected disabilities. In the rationale the clinician stated that the disabilities of degenerative disc disease and degenerative arthritis of the cervical spine with Grade 1 spondylolisthesis and left upper extremity disabilities are not medically related. The degenerative disc disease and degenerative arthritis of the cervical spine is a separate entity entirely from the left upper extremity disabilities and unrelated to it. The cervical degenerative disc disease and degenerative arthritis with spondylolisthesis are more likely than not due to the effects of aging on the spine. A thorough review of medical literature failed to demonstrate a causal relationship. A nexus has not been established.

On October 2021 VA neck disabilities examination the Veteran presented with a history of reports of an onset of neck pain with the heavy work in the military. She was diagnosed with muscle strain. In 2009 she fell and broke her arm causing increased neck pain. Cervical spondylosis with radiculopathy and degenerative disc disease of multiple levels of the cervical spine was diagnosed in 2016.

In a May 2023 remand the Board observed that the Veteran had been afforded multiple VA examinations for her cervical spine disability. However, the Board found that the VA examinations and opinions did not adequately address the Veteran's contentions of secondary service connection, particularly the issue of secondary aggravation.

Pursuant to the Board's remand, on November 2023 VA neck disabilities examination the Veteran was diagnosed with degenerative arthritis, degenerative disc disease other than intervertebral disc syndrome (IVDS) and IVDS and radiculopathy of the right upper extremity. The Veteran developed chronic neck pain since 2009 without injury or trauma.

In a November 2023 VA medical opinion the clinician opined that the Veteran's right shoulder pain and other symptoms can be contributed or aggravated by her neck disability in the presence of degenerative disc disease, and foraminal narrowing, but the shoulder disability does not cause cervical degenerative changes. The diagnosis of degenerative disc disease and degenerative arthritis of the cervical spine with Grade I spondylolisthesis is likely caused by aging, chronic wear and tear, and/or history of injury. The clinician further opined that it is unlikely caused by his service-connected shoulder disability. The left elbow injury fracture with left ulnar nerve neuropathy also did not contribute to development of cervical spine disability.

Therefore, it is less likely than not that her degenerative disc disease and degenerative arthritis of the cervical spine with Grade I spondylolisthesis are proximately due to or the result of a right shoulder disability. The radiculopathy of the right upper extremity is a direct result of degenerative disc disease and degenerative arthritis of the cervical spine with Grade I spondylolisthesis or left ulnar nerve neuropathy.

The clinician also opined that her right shoulder pain and other symptoms can be contributed by or aggravated by her cervical spine disability in the presence of degenerative disc disease, spondylolisthesis and foraminal narrowing, but that the shoulder disability did not cause cervical degenerative changes.

The diagnosis of degenerative disc disease and degenerative arthritis of the cervical spine with Grade I spondylolisthesis is likely caused by aging, chronic wear and tear, and/or history of injury. It is unlikely caused by the Veteran's service-connected shoulder disability. The left elbow disability also does not contribute to the development of cervical spine disability.

In a January 2024 VA medical opinion another clinician opined that the Veteran's cervical degenerative arthritis with right upper extremity radiculopathy was less likely than not aggravated beyond its natural progression by her service-connected left elbow, left wrist, and/or right shoulder disabilities. The rationale was that there is no evidence that her cervical degenerative arthritis with right upper extremity radiculopathy has been aggravated beyond the natural, expected progression of degenerative arthritis. The clinician explained that degenerative arthritis is a progressive disease that is expected to gradually worsen over time. Based on review of the Veteran's medical records, previous VA examination(s), the current examination, her cervical spine symptoms, range of motion, and imaging have overall only shown mild worsening since 2016. The clinician stated that this is the expected course for degenerative arthritis. There is no evidence in her medical records to show that her service-connected left elbow, left wrist, and/or right shoulder disabilities caused any aggravation of her cervical spine disability. The clinician also stated that medical literature and pathophysiology do not support that her service-connected left elbow, left wrist, and/or right shoulder disabilities would aggravate her cervical spine degenerative arthritis with radiculopathy. Rather, her cervical spine disabilities might aggravate her service-connected left elbow, left wrist, and/or right shoulder disabilities. This is supported by "The American Academy of Orthopaedic Surgeons" who report that cervical spondylosis can cause/aggravate shoulder pain, numbness/weakness in the arms, hands, and fingers.

The clinician also stated that she agreed with the prior examiners' opinions that the Veteran's cervical spine degenerative arthritis with right upper extremity radiculopathy is less likely than not caused by the Veteran's service-connected disabilities of the left elbow, left wrist, and/or right shoulder. There is no evidence in her medical records stating a causal relationship between her service-connected disabilities and her cervical spine disabilities. Medical literature and pathophysiology do not support a causal relationship between her service connected left elbow, left wrist, and/or right shoulder disabilities and cervical spine degenerative arthritis with radiculopathy.

The Board finds that the claim must be denied. The evidence of record persuasively weighs against finding that the Veteran has any neck disability that was incurred in or aggravated by her service or service-connected disability.

The Veteran's STRs are void of any findings, complaints, symptoms, or diagnoses related to any neck disability. In this case, the earliest post service medical evidence of the Veteran's neck disability was in January 2013 which is over 2 years after service. To the extent that the
disabilities and her cervical spine disabilities. Medical literature and pathophysiology do not support a causal relationship between her service connected left elbow, left wrist, and/or right shoulder disabilities and cervical spine degenerative arthritis with radiculopathy.

The Veteran's STRs are void of any findings, complaints, symptoms, or diagnoses related to any neck disability. In this case, the earliest post service medical evidence of the Veteran's neck disability was in January 2013 which is over 2 years after service. To the extent that the Veteran contends that she has a neck disability that is related to service, the Board finds that any such claim is not credible based on conflicting reports of an onset of neck pain during service and in 2013 after service. Accordingly, her contentions are afforded no probative value. Finally, there is no competent medical evidence that the Veteran has any neck disability that is related to her service or any service-connected disability.

The Board has taken the contention that the Veteran has a diagnosed chronic pain syndrome and a neck disability that were caused by service, seriously. The Board has also closely reviewed the medical and lay evidence in the Veteran's claims file and finds no evidence that may serve as a medical nexus between the Veteran's service and her claimed disabilities. Although laypersons are competent to provide opinions on some medical issues, see Kahana v. Shinseki, 24 Vet. App. 428, 435 (2011), the specific issues in this case, the existence of a diagnosed chronic pain syndrome and the etiology of a neck disability, fall outside the realm of common knowledge of a lay person. See Jandreau v. Nicholson, 492 F.3d 1372, 1377 n.4 (Fed. Cir. 2007) (laypersons not competent to diagnose cancer).

In light of the above discussion, the Board is not persuaded that the evidence supports granting service connection for chronic pain syndrome and a neck disability. As such, these claims are denied.

KELLI A. KORDICH

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board T. Adams, 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.

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