DEGENERATIVE ARTHRITIS OF THE SPINE (SPONDYLOSIS)

Summary

The veteran, who served in the United States Air Force from December 1984 to December 1988, appeals the denial of service connection for several conditions. The issues before the Board were entitlement to service connection for a cervical spine condition, left hand condition (to include Raynaud syndrome), right hand condition (to include Raynaud syndrome), right ankle condition, left upper extremity radiculopathy, and right upper extremity radiculopathy. The veteran testified that his cervical spine and bilateral hand conditions stemmed from a documented in-service accident and had an onset during service, with continuous symptoms since. The Board found the veteran's lay testimony credible and consistent with the circumstances of his service, particularly regarding the onset and recurrence of symptoms. The Board also considered VA examinations and medical opinions. For the cervical spine and bilateral hand conditions, the Board found the evidence, including the veteran's reports and a January 2024 VA medical opinion, established a link to service, applying the benefit of the doubt doctrine. For the right ankle and bilateral upper extremity radiculopathy conditions, the Board found these were secondarily caused by the veteran's now service-connected cervical spine and back conditions, citing VA medical opinions and the Spicer v. McDonough decision. Service connection for all appealed conditions was granted.

Rationale

Competent and credible lay evidence of in-service onset and continuous symptoms; January 2024 VA medical opinion linking cervical radiculopathy to in-service neck strain; Benefit of the doubt doctrine applied due to approximate balance of evidence

Full Decision Text

Citation Nr: 26000459
Decision Date: 01/13/26	Archive Date: 01/13/26

DOCKET NO. 19-02 168
DATE: January 13, 2026

ORDER

Service connection for cervical spine condition is granted. 

Service connection for left hand condition, to include Raynaud syndrome, is granted. 

Service connection for right hand condition, to include Raynaud syndrome, is granted. 

Service connection for right ankle condition is granted. 

Service connection for left upper extremity radiculopathy is granted. 

Service connection for right upper extremity radiculopathy is granted. 

FINDINGS OF FACT

1. The Veteran's cervical spine condition had its onset in service and is related to service.  

2. The Veteran's left hand condition, to include Raynaud syndrome, had its onset in service and is related to service.  

3. The Veteran's right hand condition, to include Raynaud syndrome, had its onset in service and is related to service.  

4. The Veteran's right ankle condition is proximately due to and caused by his service-connected disabilities.  

5. The Veteran's left upper extremity radiculopathy is proximately due to and caused by his service-connected disabilities.  

6. The Veteran's right upper extremity radiculopathy is proximately due to and caused by his service-connected disabilities.  

CONCLUSIONS OF LAW

1. The criteria for service connection for cervical spine condition have been met.  38 U.S.C. §§ 1154(a), 5107(b); 38 C.F.R. §§?3.102, 3.303. 

2. The criteria for service connection for left hand condition, to include Raynaud syndrome, have been met.  38 U.S.C. §§1154(a), 5107(b); 38 C.F.R. §§?3.102, 3.303. 

3. The criteria for service connection for right hand condition, to include Raynaud syndrome, have been met.  38 U.S.C. §§1154(a), 5107(b); 38 C.F.R. §§?3.102, 3.303. 

4. The criteria for service connection for right ankle condition have been met.  38 U.S.C. §§ 1154(a), 5107(b); 38 C.F.R. §§?3.102, 3.303, 3.310.  

5. The criteria for service connection for left upper extremity radiculopathy have been met.  38 U.S.C. §§ 1154(a), 5107(b); 38 C.F.R. §§?3.102, 3.303, 3.310.

6. The criteria for service connection for right upper extremity radiculopathy have been met.  38 U.S.C. §§ 1154(a), 5107(b); 38 C.F.R. §§?3.102, 3.303, 3.310.  

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Veteran served on active duty in the United States Air Force from December 1984 to December 1988. 

These matters come before the Board of Veterans' Appeals (Board) on appeal from a rating decision from the Department of Veterans Affairs (VA) Regional Office (RO).  

The Veteran presented sworn testimony at a hearing before the undersigned Acting Veterans Law Judge (VLJ) in July 2022.  At the hearing, the VLJ granted the Veteran's motion to keep the record open for a period of 90 days to afford him the opportunity to submit additional evidence in support of his appeal.  The Board will consider that evidence in the adjudication of this matter.  

These matters were previously before the Board in August 2023.  In the August 2023 Board decision, the Board granted new and material evidence to reopen the claims for service connection for cervical spine condition, left upper extremity radiculopathy, right upper extremity radiculopathy, right knee condition, left hand carpal tunnel condition, and right hand carpal tunnel condition.  The Board also remanded the claims for service connection for left shoulder condition, left knee condition, left ankle condition, right ankle condition, cervical spine condition, left upper extremity radiculopathy, right upper extremity radiculopathy, right knee condition, left hand condition to include Raynaud syndrome, right hand condition to include Raynaud syndrome, left hand carpal tunnel condition, and right hand carpal tunnel condition.  

When this case was in remand status, in the April 2024 rating decision, the RO granted service connection for a left shoulder condition, left knee
, right upper extremity radiculopathy, right knee condition, left hand carpal tunnel condition, and right hand carpal tunnel condition.  The Board also remanded the claims for service connection for left shoulder condition, left knee condition, left ankle condition, right ankle condition, cervical spine condition, left upper extremity radiculopathy, right upper extremity radiculopathy, right knee condition, left hand condition to include Raynaud syndrome, right hand condition to include Raynaud syndrome, left hand carpal tunnel condition, and right hand carpal tunnel condition.  

When this case was in remand status, in the April 2024 rating decision, the RO granted service connection for a left shoulder condition, left knee condition, left ankle condition, left hand carpal tunnel condition, and right hand carpal tunnel condition.  Whereas, in the November 2024 rating decision, the RO granted service connection for a right knee condition.  Therefore, the remaining issues before the Board include entitlement to service connection for a right ankle condition, cervical spine condition, left upper extremity radiculopathy, right upper extremity radiculopathy, left hand condition to include Raynaud syndrome, and right hand condition to include Raynaud syndrome.   

In the June 2025 correspondence, the Veteran responded to the May 2025 Supplemental Statement of the Case (SOC) as to all issues and requested "a meeting with an appeals law judge."  In Quinn v. Wilkie, 31 Vet. App. 284 (2019), the Court held that former version of 38 U.S.C. § 7107(b), governing Legacy appeals, entitles an appellant to an additional Board hearing opportunity when a Legacy appeal returns to the Board following remand even if the appellant appeared at a Board hearing prior to the remand.  31 Vet. App. At 289.  The Court acknowledged that VA regulations require a showing of good cause in some situations, such as when an appellant fails to appear for a scheduled hearing, but found that those regulations are not implicated where, such as here, there is a request for an additional Board hearing after a remand, stating that "the right to an opportunity for a hearing is not one that is within the discretion of VA."  Id. at 291, n.9.

Here, however, in light of the grant for service connection for the Veteran's right ankle condition, cervical spine condition, left upper extremity radiculopathy, right upper extremity radiculopathy, left hand condition to include Raynaud syndrome, and right hand condition to include Raynaud syndrome, the Board finds no prejudice and the Veteran's request for a hearing is no longer necessary and will be cancelled.  

Service Connection

Establishing service connection generally requires evidence of (1) a current disability; (2) an in-service incurrence or aggravation of a disease or injury; and (3) a nexus between the claimed in-service disease or injury and the present disability.? See Shedden v. Principi,?381 F.3d 1163?(Fed. Cir. 2004).? ???????? 

Service connection may be granted for any disease initially diagnosed after service, when all the evidence, including that pertinent to service, establishes that the disease was incurred in service. ?38?C.F.R. §?3.303(d).????????? 

The determination as to whether the requirements for service connection are met is based on an analysis of all the evidence of record and the evaluation of its credibility and probative value. ?38?U.S.C. §?7104?(a); Baldwin v. West,?13?Vet. App.?1?(1999); see?38?C.F.R. §?3.303?(a).??? 

The United States Court of Appeals for the Federal Circuit (Federal Circuit) has held that "pain in the absence of a presently diagnosed condition can cause functional impairment," which may qualify as a "disability" for VA compensation purposes.? Saunders v. Wilkie, 886 F.3d 1356, 1368 (Fed. Cir. 2018). The Federal Circuit in Saunders, however, cautioned against the notion that "a veteran could demonstrate service connection simply by asserting subjective pain" because, to establish that a disability is present, the veteran "will need to show that... pain reaches the level of a functional impairment of earning capacity." Id. at 1367-68. "Functional impairment," the Federal Circuit noted, is defined as the inability of the body or a constituent part of it "'to function under the ordinary conditions of daily life including employment.'"? Id. at 1363 (quoting 38 C.F.R. § 4.10). ??? 

In determining whether service connection is warranted for a disability, VA is responsible for
 (Fed. Cir. 2018). The Federal Circuit in Saunders, however, cautioned against the notion that "a veteran could demonstrate service connection simply by asserting subjective pain" because, to establish that a disability is present, the veteran "will need to show that... pain reaches the level of a functional impairment of earning capacity." Id. at 1367-68. "Functional impairment," the Federal Circuit noted, is defined as the inability of the body or a constituent part of it "'to function under the ordinary conditions of daily life including employment.'"? Id. at 1363 (quoting 38 C.F.R. § 4.10). ??? 

In determining whether service connection is warranted for a disability, VA is responsible for determining whether the evidence supports the claim or is in relative equipoise, with the Veteran prevailing in either event, or whether the weight of the evidence is against the claim, in which case the claim is denied.? 38?U.S.C. §?5107.? When there is an approximate balance of positive and negative evidence regarding any issue material to the determination, the benefit of the doubt is afforded the claimant.??? 

To deny a claim on its merits, the weight of the evidence must persuasively stand against a finding that the evidence is in "approximate balance" or "nearly equal" to the evidence that supports the claim.? Lynch v. McDonough,?21 F.4th 776 (Fed. Cir. 2021) (en banc).????????? 

In making all determinations, the Board must fully consider the lay assertions of record.?? A layperson is competent to report on the onset and recurrence of symptoms.? See Layno v. Brown,?6?Vet. App.?465, 470?(1994) (a Veteran is competent to report on that of which he or she has personal knowledge).? Lay evidence can also be competent and sufficient evidence of a diagnosis or to establish etiology if (1) the layperson is competent to identify the medical condition, (2) the layperson is reporting a contemporaneous medical diagnosis, or (3) lay testimony describing symptoms at the time supports a later diagnosis by a medical professional.?? Davidson v. Shinseki,?581 F.3d 1313, 1316?(Fed. Cir. 2009); Jandreau v. Nicholson,?492 F.3d 1372, 1376-77?(Fed. Cir. 2007).??? 

The Board is charged with the duty to assess the credibility and weight given to evidence.? Madden v. Gober, 125 F.3d 1477, 1481 (Fed. Cir. 1997), cert. denied, 523 U.S. 1046 (1998); Wensch v. Principi, 15?Vet. App.?362, 367 (2001).? Indeed, in Jefferson v. Principi, 271 F.3d 1072 (Fed. Cir. 2001), the Federal Circuit, citing its decision in Madden, recognized that that Board had inherent fact-finding ability.? Id. at 1076; see also 38 U.S.C. § 7104(a).? Moreover, the United States Court of Appeals for Veterans Claims (Court) has declared that in adjudicating a claim, the Board has the responsibility to weigh and assess the evidence.? Bryan v. West, 13?Vet. App.?482, 488-89 (2000); Wilson v. Derwinski, 2?Vet. App.?614, 618 (1992).??? 

As a finder of fact, when considering whether lay evidence is satisfactory, the Board may also properly consider internal inconsistency of the statements, facial plausibility, consistency with other evidence submitted on behalf of the Veteran, and the Veteran's demeanor when testifying at a hearing.? See Dalton v. Nicholson, 21?Vet. App.?23, 38 (2007); Caluza v. Brown, 7?Vet. App.?498, 511 (1995), aff'd per curiam, 78 F.3d 604 (Fed. Cir. 1996).??? 

1. Service connection for cervical spine condition is granted. 

2. Service connection for left hand condition, to include Raynaud syndrome, is granted. 

3. Service connection for right hand condition, to include Raynaud syndrome, is granted. 

The Veteran seeks service connection for his cervical spine condition, and bilateral hand condition to include Raynaud syndrome.  In support, the Veteran testified that his conditions are due to his documented accident in-service, and that these conditions had an onset in-service.  See July 2022 Board hearing transcript.  

Here, as explained below, the
 (1995), aff'd per curiam, 78 F.3d 604 (Fed. Cir. 1996).??? 

1. Service connection for cervical spine condition is granted. 

2. Service connection for left hand condition, to include Raynaud syndrome, is granted. 

3. Service connection for right hand condition, to include Raynaud syndrome, is granted. 

The Veteran seeks service connection for his cervical spine condition, and bilateral hand condition to include Raynaud syndrome.  In support, the Veteran testified that his conditions are due to his documented accident in-service, and that these conditions had an onset in-service.  See July 2022 Board hearing transcript.  

Here, as explained below, the Board finds that all three elements of direct service connection are established by the competent and credibly lay and medical evidence of records as to the Veteran's cervical spine and bilateral hand conditions. 38 U.S.C. § 1110; 38 C.F.R. § 3.303; Shedden v. Principi, 381 F.3d 1163, 1166-67 (Fed. Cir. 2004).???

The record demonstrates that the Veteran has a diagnosis of degenerative disc disease of the cervical spine, and bilateral hand condition, to include Raynaud syndrome.  See November 2018 and January 2024 VA examinations; see also December 2017 and February 2018 VA treatment records.  

As the finder of fact, the Board concludes that the first and second element of service connection can be reasonably conceded.  All that remains to be resolved is whether the medical evidence of record establishes a link between the Veteran's service and his conditions.  

The Board notes that the Veteran has been afforded VA examinations and opinions to determine the nature and etiology of his conditions.  While the Board acknowledges the negative nexus opinions, the Board emphasizes the rationale behind these opinions, the etiology found for his conditions, and the Veteran's report during these examinations.  

During the January 2024 VA examination, the Veteran reported that his neck condition and pain had an onset in-service following the documented accident.  In addition, the Veteran continuously reports self-medicating his symptoms since service.  See July 2022 Board hearing transcript; see also June 2025 correspondence.   Further, in the January 2024 VA medical opinion, the examiner opined that the Veteran's cervical radiculopathy secondary to impingent from progressive cervical degenerative disc disease is the likely sequala from cervical neck strain from his traumatic lifting injury while in-service."  

As to the Veteran's hand conditions, during the January 2024 VA examinations, the Veteran reported that his hand conditions, to include Raynaud syndrome, had an onset in-service.  Specifically, the Veteran reported that his symptoms were more noticeable with any cold exposure and that he experienced these symptoms while in-service in Alaska.  In addition, the January 2024 VA medical opinion determined that the Veteran's Raynaud syndrome was partially due to in-service events such as cold exposure and working with power tools, suggesting a direct association with service.  

The Board notes that the Veteran's reports are consistent with the circumstances of his service.? 38?U.S.C. §?1154; 38?C.F.R. §?3.303(a).? Thus, the lay and medical evidence shows that the Veteran's neck and bilateral hand conditions and symptoms, which have been linked to the current diagnosis, had their onset in service and have been recurrent since that time and thus service connection is warranted.??? 

The evidence shows that the Veteran's conditions are related to service, thus, service connection is warranted.? See Flynn v. Brown, 6?Vet. App.?500, 503 (1994) (noting that "the element of cause and effect has been totally by-passed in favor of a simple temporal relationship between the incurrence of the disability and the period of active duty"); see also 38?C.F.R. §?3.303(a) (Service connection connotes many factors but basically it means that the facts, shown by evidence, establish that a particular injury or disease resulting in disability was incurred coincident with service in the Armed Forces).??? 

The Board acknowledges the negative VA nexus opinion of record; however, because the Board finds the Veteran's report that his symptoms started in service, and has been recurrent since, to be credible, service connection is warranted.? The competent and credible evidence is at least approximately balanced, and benefit of the doubt doctrine applies.? 38?U.S.C. §?5107(b); see Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021) (en banc).??? 

In light of the foregoing, and after resolving any doubt in the Veteran's favor,
, shown by evidence, establish that a particular injury or disease resulting in disability was incurred coincident with service in the Armed Forces).??? 

The Board acknowledges the negative VA nexus opinion of record; however, because the Board finds the Veteran's report that his symptoms started in service, and has been recurrent since, to be credible, service connection is warranted.? The competent and credible evidence is at least approximately balanced, and benefit of the doubt doctrine applies.? 38?U.S.C. §?5107(b); see Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021) (en banc).??? 

In light of the foregoing, and after resolving any doubt in the Veteran's favor, the Board finds that service connection for cervical spine condition, and bilateral hand conditions, to include Raynaud syndrome, is warranted.? See Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021) (en banc).??? 

4. Service connection for right ankle condition is granted. 

5. Service connection for left upper extremity radiculopathy is granted. 

6. Service connection for right upper extremity radiculopathy is granted. 

The Veteran seeks service connection for his right ankle condition, and bilateral upper extremity radiculopathy.  In support, the Veteran testified that his conditions are due to his documented accident in-service.  See July 2022 Board hearing transcript.  

The record demonstrates that the Veteran has a diagnosis of a right ankle condition, to include a right ankle sprain and pain, and bilateral upper extremity radiculopathy.  See November 2018 and January 2024 VA examinations; see also December 2017 and February 2018 VA treatment records.  

The critical question in this case is the etiology of the disabilities.  The Board is required to consider theories of entitlement to benefits that are either reasonably raised by the claimant or reasonably raised by the record.  Here, the Board finds that entitlement is warranted in that his right ankle condition, and bilateral upper extremity radiculopathy are secondarily caused by his service-connected disabilities.  

Service connection may be granted for a disability resulting from a disease or injury incurred in or aggravated by active service.? See?38 U.S.C. §§?1110, 1131;?38 C.F.R. § 3.303.? A veteran seeking compensation under these provisions must establish three elements: "(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."? Saunders v. Wilkie,?886 F.3d 1356, 1361?(Fed. Cir. 2018) (quoting Shedden v. Principi,?381 F.3d 1163, 1167?(Fed. Cir. 2004)).?? 

Service connection may be established for disability that is proximately due to or the result of a service-connected disability. ?38 C.F.R. § 3.310?(a).? Further, a disability which is aggravated by a service-connected disability may be service-connected to the degree that the aggravation is shown.? 38 C.F.R. § 3.310; El-Amin v. Shinseki,?26?Vet. App.?136?(2013); Allen v. Brown,?7?Vet. App.?439?(1995).?? 

The Board notes that the Veteran has been afforded VA examinations and opinions to determine the nature and etiology of his conditions.  While the Board acknowledges the negative nexus opinions, the Board emphasizes the rationale behind these opinions, the etiology found for his conditions.   

For instance, in the January 2024 VA medical opinion, the examiner opined that the Veteran's cervical radiculopathy secondary to impingent from progressive cervical degenerative disc disease is the likely sequala from cervical neck strain from his traumatic lifting injury while in-service."  Therefore, the January 2024 VA examiner found that the Veteran's bilateral upper extremity radiculopathy is secondary to the Veteran's now service-connected cervical spine condition.  As such, in its role as a finder of fact, the Board finds that the competent and credible evidence shows that the Veteran's bilateral upper extremity radiculopathy is caused at least in part by his now service-connected cervical spine condition.? See Spicer v. McDonough, 61 F.4th 1360 (Fed. Cir. 2023). 

As to the Veteran's right ankle condition, in the May 2024 VA medical opinion, the examiner opined that the Veteran's service-connected back disability alters curvature of the lower spine, causing increased stiffness and
 January 2024 VA examiner found that the Veteran's bilateral upper extremity radiculopathy is secondary to the Veteran's now service-connected cervical spine condition.  As such, in its role as a finder of fact, the Board finds that the competent and credible evidence shows that the Veteran's bilateral upper extremity radiculopathy is caused at least in part by his now service-connected cervical spine condition.? See Spicer v. McDonough, 61 F.4th 1360 (Fed. Cir. 2023). 

As to the Veteran's right ankle condition, in the May 2024 VA medical opinion, the examiner opined that the Veteran's service-connected back disability alters curvature of the lower spine, causing increased stiffness and pain in the lower extremities, resulting in change to normal mechanical function causing strain and damage to the joints of the hips, knees, ankles, and feet.  The examiner further notes that compensation and overuse on the right side over time would lead to additional strain and damage.  As such, in its role as a finder of fact, the Board finds that the competent and credible evidence shows that the Veteran's right ankle conditions are caused at least in part by his service-connected back disability.? See Spicer v. McDonough, 61 F.4th 1360 (Fed. Cir. 2023).  

(Continued on the next page)

?

In light of the foregoing, the Board finds that service connection for a right ankle and bilateral upper extremity radiculopathy conditions is warranted on a secondary basis.  See38 C.F.R. §?3.310(a).   In reaching this determination, the Board reiterates that the benefit of the doubt doctrine applies to the Veteran's claims.? 38 U.S.C. §?5107(b), Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021).

 

N. Rippel

Acting Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	S. Nettles, Associate 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.