CERVICAL SPINE LIMITATION OF MOTION

PAULETTE VANCE BURTON · 2026 · Case ID: 26002735

DENIED

Summary

The veteran, who served in the United States Marine Corps from January 1999 to January 2003, appeals the denial of service connection for a cervical spine disability. The veteran claimed the condition was caused by service or was secondary to his service-connected low back disability. Service treatment records indicated no cervical spine disability during service, though there were two instances of neck pain diagnosed as muscle strain or somatic dysfunction, not specifically cervical spine disability. The veteran's complaints of neck pain were intermittent and not continuous since service, with a significant gap between service and the first reported neck pain years after discharge. The Board found the veteran's later statements about an in-service neck injury lacked credibility due to inconsistencies with service records and prior statements. Medical opinions from VA examiners consistently found no direct service connection for the cervical strain, citing a lack of contemporaneous medical evidence of chronicity during or after service. Examiners also opined that the low back condition, a degenerative disc disease, did not cause or aggravate the cervical strain, a soft tissue injury, as there was no altered gait or medical literature supporting such a link. Lay assertions regarding the etiology of the cervical strain were given no probative value as it is a complex medical matter. The Board concluded that the evidence weighed against the claim, and the benefit of the doubt doctrine was not applicable. Service connection for the cervical spine disability was denied.

Rationale

No chronicity of cervical spine symptoms during or after service.; Veteran's statements regarding in-service neck injury lacked credibility.; Medical opinions found no direct service connection or secondary causation from low back condition.

Service Branch

MARINE CORPS

Special Benefit

NO SPECIAL BENEFIT

Docket No.

17-05 946

Full Decision Text

Citation Nr: 26002735
Decision Date: 02/27/26 Archive Date: 02/27/26

DOCKET NO. 17-05 946
DATE: February 27, 2026

ORDER

Service connection for a cervical spine disability is denied.

FINDING OF FACT

The Veteran's cervical spine disability is not secondary to a service-connected disability and is not otherwise related to an in-service injury or disease.

CONCLUSION OF LAW

The criteria for service connection for a cervical spine disability as secondary to a service-connected disability have not been met. 38 U.S.C. §§ 1110, 1131, 5107 (2012); 38 C.F.R. §§ 3.102, 3.310 (2020).

REASONS AND BASES FOR FINDING AND CONCLUSION

The Veteran had active service in the United States Marine Corps from January 1999 to January 2003.

This matter comes before the Board of Veterans' Appeals (Board) from an August 2014 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO). In a February 2024 decision, the Board denied entitlement to service connection for a cervical spine disability.

The Veteran appealed the decision to the U.S. Court of Appeals for Veterans Claims (Court). In a July 2025 Memorandum Decision, the Court vacated and remanded the matter for readjudication consistent with its decision. The Court found that the Board failed to discuss favorable evidence, specifically the Veteran's complaint of pain to the left and right of C-5 to C-7 vertebrae in February 1999, and somatic dysfunction of the thoracic/lumbar/cervical spine in August 2002. The Court did not discuss the Veteran's contention of secondary causation and directed the Board to consider whether the Veteran's complaints in the service treatment records indicate a cervical spine disability.

On October 24, 2025, the VA notified the Veteran that he had 90 days from the date of the letter to submit any additional evidence. That 90-day period has passed, and the Veteran did not submit any relevant evidence.

Service Connection

Service connection may be granted for a disability resulting from personal injury suffered or disease contracted in the line of duty. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. §§ 3.303, 3.304. Service connection may also be granted for a disease diagnosed after discharge, when all the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303(d).

Establishing service connection generally requires (1) evidence of a current disability; (2) evidence of in-service incurrence or aggravation of a disease or injury; and (3) evidence of a nexus between the claimed in-service disease or injury and the present disability. Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004).

The standard of proof to be applied in decisions on claims for VA benefits is set forth in 38 U.S.C. § 5107(b). Under that provision, VA shall consider all information and lay and medical evidence of record in a case before the Secretary with respect to benefits under laws administered by the Secretary. When there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, the Secretary shall give the benefit of the doubt to the claimant. Id.; see also Gilbert v. Derwinski, 1 Vet. App. 49 (1990). "It is in recognition of our debt to our veterans that society has [determined that,] [b]y tradition and by statute, the benefit of the doubt belongs to the veteran." Gilbert, 1 Vet. App. at 54.

1. Service connection for a cervical spine disability

The Veteran contends that his cervical spine disability was caused by his service.

Service treatment records show that the Veteran did not have any cervical spine disabilities in the April 1998 enlistment medical examination. He complained of upper middle back strain in February 1999 with pain to the left and right of C-5 and C-7. The diagnosis was a trapezius strain, a muscle in the back of the neck and upper back, with no mention of a disability involving the joint, to include the cervical spine. In March 1999, the Veteran complained of back strain with no discussion of his neck other than it being supple. In October 2001, he complained of low back pain while lifting drop tanks, but not of any neck or upper back pain. In June
treatment records show that the Veteran did not have any cervical spine disabilities in the April 1998 enlistment medical examination. He complained of upper middle back strain in February 1999 with pain to the left and right of C-5 and C-7. The diagnosis was a trapezius strain, a muscle in the back of the neck and upper back, with no mention of a disability involving the joint, to include the cervical spine. In March 1999, the Veteran complained of back strain with no discussion of his neck other than it being supple. In October 2001, he complained of low back pain while lifting drop tanks, but not of any neck or upper back pain. In June 2002, he complained of back pain mostly in the mid back. He did not report any neck pain.

In August 2002, the Veteran was seen for a follow-up on his mid-back pain. He denied having new trauma but was assessed with somatic dysfunction of the thoracic/lumbar/cervical spine. In a follow-up visit approximately three weeks later, he complained of recurrent middle-to-low back pain while lifting a gas tank. The diagnosis was chronic low back strain. In September 2002, only the thoracolumbar and lumbar spine were discussed. The Veteran reported that there was no known trauma. In a November 2002 report of medical assessment, the Veteran denied having any injury while on active duty for which he did not seek medical care and that he had no chronic problems. The purpose of the November 2002 report was "separation," and the Veteran was discharged from active duty in January 2003.

In summary, during the Veteran's service, there are two mentions of neck pain, once in February 1999 that was diagnosed as a muscle strain not involving the cervical spine, and in August 2002 where the initial assessment of somatic dysfunction of the cervical spine was not repeated even in a follow-up visit in the same month. The Veteran has also denied having any injury that he did not report and denied having any chronic problems in his report of medical assessment for separation.

As discussed in the prior February 2024 Board decision, the Veteran again denied having neck pain in March 2004 despite complaining of chronic back pain. In other words, the Veteran denied having continuity of symptoms, not only during service between February 1999 and August 2002, and from August 2002 to November 2002, but also from November 2002 to March 2004.

Since then, the records are silent for neck pain until September 2011, and even then, it was a cursory mention of his low back pain "occasionally" reaching his "neck on the right."

In October 2013, the Veteran submitted a claim of service connection for "neck."

There was no diagnosis of any cervical spine disability. It would not be until November 2013 that he had reported neck pain specifically, pinpointing the onset date as the "past 1 month" in contrast to his lower back pain which he has been experiencing "for several years." In short, if the Veteran is to be found credible, he has had two acute episodes of neck pain in February 1999 and August 2002, with no continuous symptoms at any time other than the two complaints, only to experience pain for the first time since discharge around October 2013, over a decade since his active duty as well as his last report of neck pain.

In May 2014, the Veteran reported that he believed his neck pain was secondary to his lower back condition and that he did not report an injury to his neck in service. The Board notes that the Veteran did not state that his neck pain was continuous since service, nor did he attribute it to a specific injury in service. As the Veteran did not contend that he had a neck injury in service, only that he believed that it was caused by his back disability, the VA examiner only opined on secondary causation, stating that there was no "documentation in the medical literature establishing a direct cause and effect relationship between degenerative arthritis of the [lumbar] spine and the development of cervical strain."

This May 2014 opinion was supported by the March 2017 VA examiner who also opined that there is "no objective medical evidence in the medical literature establishing a direct cause and effect between lumbar [degenerative disc disease] as a cause or result including aggravation beyond its natural progression of cervical strain. These are two distinct musculoskeletal structures without direct relation." The Board notes that the Veteran again did not report any neck injury in service.

In September 2022, nearly 9 years after submitting his claim of service connection for "neck" in October 2013, the Veteran reported for
a direct cause and effect relationship between degenerative arthritis of the [lumbar] spine and the development of cervical strain."

In September 2022, nearly 9 years after submitting his claim of service connection for "neck" in October 2013, the Veteran reported for the first time that he injured his neck while assisting with loading bombs on aircraft, between 2001 and 2002. As discussed above, the Veteran was assessed with somatic dysfunction of the cervical spine in August 2002, but has consistently denied having neck pain since, including during follow-up visits in the same month. The examiner opined that the Veteran's cervical strain was not directly caused by service as there is no medical evidence of the disability during service. Regarding secondary causation, the examiner opined that barring an altered gait, there is no mechanism for the Veteran's low back disability to cause his cervical strain. In an October 2022 addendum medical opinion, the examiner opined that there is no correlation between the Veteran's cervical spine strain and low back disability as joint disease does not "spread" to another or cause damage.

In March 2023, the VA examiner diagnosed the Veteran has having cervical strain. The Veteran again reported that he injured his neck during service but did not seek medical attention at the time and reported that his onset was in 2001. He described a 500-pound bomb fell, pulling him down and causing whiplash. His neck "continued to be painful" and has worsened with decrease in range of motion and stiffness. Again, service treatment records are contrary to the Veteran's report as he denied having neck pain and did not report decrease in range in motion even in August 2002 when he was following up for his low back pain and assessed as having somatic dysfunction. The examiner opined that the Veteran's cervical strain was less likely than not related to his military service as there was no chronicity during or after service. Regarding aggravation, the examiner again relied on the lack of contemporaneous medical evidence and explained that there was "no [connection]" between the Veteran's service-connected low back disability and his cervical disability. An addendum opinion was submitted in September 2023 based not only on the absence of evidence but also considering the presence of other complaints. The examiner added that the Veteran's lay statements were consistent with a muscle strain of the neck, which is a soft tissue injury, rather than an injury to the joint or the cervical spine. Another opinion was added in December 2023 explaining that the Veteran's first complaint of neck pain was in October 2013. The Board notes that there was a mention of his low back pain reaching his "neck on the right" in September 2011 but agrees that the Veteran did not report neck pain specifically until November 2013 when he reported having pain in the "past 1 month." The examiner also opined that the Veteran's current cervical spine strain started in 2013 and that the altered gait from the lumbar spine would not significantly impact the neck and reiterated that there is no medical literature showing a causal relationship.

In a July 2025 memorandum decision, the Court found that the Board did not discuss evidence favorable to the Veteran's claim, namely the February 1999 and August 2002 complaints. As the two complaints have been explicitly discussed above, the Board moves on to the analysis of the Veteran's claim.

After reviewing the evidence of record, the Board finds that the Veteran's cervical spine disability was less likely than not caused by his service or his service-connected disabilities.

As an initial matter, the Board will discuss the Veteran's statement of a neck injury in service. In September 2022, the Veteran contended that he injured his neck when a 500-pound bomb fell in 2001 but did not report his injury. The Board notes that he reported back pain in October 2001 when he experienced low back pain from loading drop tanks.

The Board finds that had the Veteran experienced symptoms of neck pain, he would have reported it in a clinical setting as he did with his low back pain. Cf. Kahana v. Shinseki, 24 Vet. App. 428, 440 (2011) (Lance, J., concurring) (holding that silence in a medical record can be weighed against lay testimony if the alleged injury, disease, or related symptoms would ordinarily have been recorded in the medical record being evaluated by the fact finder (citing Fed. R. Evid. 803(7))); see AZ v. Shinseki, 731 F.3d 1301 (Fed. Cir. 2013) (recognizing the widely held view that the absence of an entry in a record may be considered evidence that the fact did not occur if it appears that the fact would have been recorded if present). The Veteran's service treatment records show that he consistently reported pain and injury throughout his service, including in the year he contends that he injured his neck but did not report. Moreover, in May 2014, when he first filed the claim of service connection for cervical strain, he stated that he believed it to have been caused by his lower back disability, rather than reporting a neck injury that he did not report in service. As discussed above, he had consistently denied having neck pain after discharge, as early as in March 2004 and up until September 2011. It was not until much later, in September 2022, that he recalled a neck injury that he failed to report while reporting other ailments. Thus, the Board finds that the Veteran's statement of having injured his neck in 2001 to be not credible and therefore of no probative value especially when he reported his back pain in October 2001 and August 2002. See Caluza v. Brown, 7 Vet. App. 498, 511-12, aff'd, 78 F.3d 604 (Fed. Cir. 1996) (per curium) (table); Madden v. Gober, 125 Fed. Cir. 1477, 1481 (Fed. Cir. 1997) (holding that the Board has the "authority to discount the weight and probative value of evidence in light of its inherent characteristics in its relationship to other items of evidence").

Turning back to the two "favorable" evidence of record, the Board finds that none of the medical practitioners found them relevant to the Veteran's current disability. As discussed above, the Veteran had not contended that he had a neck injury during service until September 2022, so the May 2014 and March 2017 VA examiners did not opine on direct causation. The September 2022 examiner noted that the medical records did not show treatment of a "cervical spine condition" during service, which is technically true as the February 1999 complaint was for the trapezius muscle and the August 2002 assessment of somatic dysfunction did not single out the cervical spine, but rather all of the thoracic, lumbar, and cervical spines. The March 2023 examiner also opined that it was less likely as not that the Veteran's cervical spine strain was caused by service as there was no evidence of chronicity during service or after service. A September 2023 VA examiner then added that the Veteran's statements, even true, is consistent with "muscle strain of the neck," which is supported by the February 1999 service treatment record diagnosing the Veteran as having trapezius muscle strain when he reported that there was pain near the C-5 and C-7 joints. The September 2023 VA examiner also pointed out the lack of evidence documenting chronicity of neck symptoms. Put another way, the examiners have determined, based on the evidence of record and their medical expertise, that the Veteran's current cervical strain was not caused by his service, not only because there were no specific complaints of cervical strain, but also because he did not complain of any symptoms until years after discharge.

There are no medical opinions to the contrary, nor any medical evidence of record showing chronicity of symptoms since service. To the extent the Veteran asserts that a relationship exists between his cervical spine strain and his service, the Board finds that such assertions do not provide persuasive evidence in support of the claim. The matter of the medical etiology of the disability here at issue is one within the province of trained medical professionals. Jones v. Brown, 7 Vet. App. 134, 137-38 (1994). Although lay people are competent to attest to matters within their own personal knowledge, to include symptoms experienced or observed (as appropriate), as well as to provide opinions on some medical issues, such as those perceived through the senses (see Kahana, 24 Vet. App. at 435), here, the etiology of the Veteran's cervical strain is a complex medical matter that falls outside the realm of common knowledge of a lay person, especially when there is no chronicity of symptoms. See Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007). Thus, lay assertions as to the etiology of the Veteran's cervical spine strain have no probative value.

Turning to the contention of his cervical strain being caused or aggravated by his service-connected low back disability, the Board again finds that the evidence weighs against the Veteran's claims. All medical opinions of record consistently diagnose the Veteran as having a cervical strain, which, as the September 2023 VA examiner explained, is a soft tissue injury, that is medically unrelated to the Veteran's low back disability. Although the examiners do not agree whether an altered gait can cause or aggravate the Veteran's cervical strain, this is not pertinent to the Veteran as his gait was normal throughout the period on appeal, or at least as recently as in March 2023 where guarding and muscle spasms did not result in abnormal gait or abnormal spinal contour.

The Board acknowledges that the VA examiners did not explicitly address the Veteran's report of radiating pain but finds that the examiners implicitly addressed the Veteran's statements in their explanations of the distinct nature of the Veteran's low back disability, a degenerative disc disease, and the Veteran's cervical strain, a soft tissue injury that requires, at minimum, an altered gait for there to exist causation or even aggravation. Put another way, by describing the relationship, or lack thereof, between the two disabilities, the Board finds that the VA examiners addressed the Veteran's contentions including his back pain "radiating" to his neck.

There is also no medical opinion contrary to the VA medical opinions that the Veteran's low back disability did not cause or aggravated his cervical strain.

As the evidence weighs against the claim, the benefit of the doubt doctrine is not for application, and the Veteran's claim of service connection for a cervical spine disability is denied. See 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102; Gilbert, 1 Vet. App. at 53-56.

Paulette Vance Burton

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board H. Yun

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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