DEGENERATIVE ARTHRITIS OF THE SPINE (SPONDYLOSIS)

H. SEESEL · 2026 · Case ID: 26004050

DENIED

Summary

The veteran, who served honorably in the U.S. Navy from June 1985 to June 1991, appeals the denial of service connection for a back disability, bilateral sciatica in the legs, and bilateral shoulder conditions. The veteran testified to injuring his back while aboard the USS Leahy, experiencing pain since service, and seeking treatment in the 1990s and again in 2017 for back pain with radiating leg pain. Service treatment records indicated two instances of back pain during service, with diagnoses of lumbar strain and mild degenerative disc disease noted in later VA examinations. However, the Board found that the evidence did not establish that the current back diagnoses were etiologically related to service. The Board noted that the entrance examination found the Veteran's spine clinically normal, and while back pain was noted in service, it was acute and resolved without permanent residuals. Post-service records showed treatment beginning in 2017, 26 years after separation, with mild degenerative changes noted. VA medical opinions consistently found the claimed back condition less likely than not incurred in or caused by service, citing the lack of chronic symptoms in service or immediately post-service, and the mild nature of degenerative changes. A private medical opinion stating the condition was "possible" to be secondary to service was found inadequate due to lack of rationale and probability. The Board denied service connection for the back disability, and consequently denied the secondary claims for sciatica and shoulder conditions due to the lack of a primary service-connected back disability.

Rationale

No probative evidence establishes that the current back diagnosis is etiologically related to service.; Service treatment records showed acute back pain, but no chronic disability or recurrent pain.; Post-service treatment began 26 years after separation, with mild degenerative changes noted.; VA medical opinions found the condition less likely than not incurred in or caused by service.

Service Branch

NAVY

Special Benefit

NO SPECIAL BENEFIT

Docket No.

21-00 794A

Full Decision Text

Citation Nr: 26004050
Decision Date: 04/01/26 Archive Date: 04/01/26

DOCKET NO. 21-00 794A
DATE: April 1, 2026

ORDER

Service connection for back disability is denied.

Service connection for left leg sciatica, to include as due to back disability, is denied.

Service connection for right leg sciatica, to include as due to back disability, is denied.

Service connection for left shoulder condition (claimed as bilateral shoulder condition) is denied.

Service connection for right shoulder condition (claimed as bilateral shoulder condition) is denied.

FINDINGS OF FACT

1. The evidence does not support a finding that the Veteran's lumbar spine degenerative disc disease (DDD) or lumbosacral strain began during active service, that either diagnosis has been continuous since service separation, or that either diagnosis is otherwise related to an in-service injury or disease.

2. Because the Veteran is not service connected for a back disability, there is no basis to award service connection for right leg sciatica, left leg sciatica, right shoulder disability, or left shoulder disability as secondary to back disability.

CONCLUSIONS OF LAW

1. The criteria for service connection for a back disability have not been met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309.

2. The criteria for service connection for left leg sciatica, to include as due to back disability, have not been met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309, 3.310.

3. The criteria for service connection for right leg sciatica, to include as due to back disability, have not been met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309, 3.310.

4. The criteria for service connection for left shoulder condition (claimed as bilateral shoulder condition) have not been met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309, 3.310.

5. The criteria for service connection for right shoulder condition (claimed as bilateral shoulder condition) have not been met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309, 3.310.

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Veteran served honorably on active duty in the United States Navy from June 1985 to June 1991.

This appeal has been advanced on the Board's docket pursuant to 38 U.S.C. § 7107(a)(2); 38 C.F.R. §20.900(c).

In July 2022, the Veteran testified at a virtual hearing before the undersigned, and a transcript of that hearing is of record.

The Board remanded the issues in September 2022 and August 2023 for further development, including obtaining VA medical opinions. A series of VA opinions on the nature and etiology of the claimed back disability were subsequently obtained between November 2022 and September 2023 and are discussed below. The claims for service connection for bilateral sciatica and bilateral shoulder disability were remanded as intertwined with the back claim. In August 2024, the Board therefore found there had been substantial compliance with the remand directives with regard to the claims for service connection for back disability, bilateral sciatica, and bilateral shoulders. See D'Aries v. Peake, 22 Vet. App. 97, 105; see also Stegall v. West, 11 Vet. App. 268.

In August 2024, the Board denied the Veteran's service connection claim for back, shoulders, and legs. The Veteran appealed this decision to the Court of Appeals for Veterans Claims (Court). In September 2025, the Court vacated the Board decision and remanded the Veteran's claim for action consistent with the directives of a joint motion for partial remand (JMPR).

Service Connection

Service connection will be granted if it is shown that the Veteran suffers from a disability resulting from personal injury suffered or disease contracted in the line of duty, or for aggravation during active service of a preexisting injury or disease. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303. Disorders diagnosed after discharge will still be service connected if all the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303(d); see also Combee v. Brown, 34 F.3d 1039, 1043.

To establish service connection, there must be a competent diagnosis of a current disability; medical or, in certain cases, lay evidence of in-service occurrence or aggravation of a disease or injury; and competent evidence of a nexus between an in-service injury or disease and the current disability. Hickson v. West, 12 Vet. App. 247, 252; see Jandreau v. Nicholson, 492 F.3d 1372.

Competent medical evidence is evidence provided by a person who is qualified through education, training, or experience to offer medical diagnoses, statements, or opinions. Competent medical evidence may also include statements conveying sound medical principles found in medical treatises. It also includes statements contained in authoritative writings, such as medical and scientific articles and research reports or analyses. 38 C.F.R. § 3.159(a)(1).

Competent lay evidence is any evidence not requiring that the proponent have specialized education, training, or experience. Lay evidence is competent if it is provided by a person who has knowledge of facts or circumstances and conveys matters that can be observed and described by a lay person. 38 C.F.R. § 3.159(a)(2). This may include some medical matters, such as describing symptoms or relating a contemporaneous medical diagnosis. Jandreau, 492 F.3d 1372.

In determining whether service connection is warranted for a disability, VA is responsible for determining whether the evidence supports the claim or is "nearly equal" or in approximate balance, with the Veteran prevailing in either event, or whether most of the evidence is against the claim, in which case the claim is denied. 38 U.S.C. § 5107; Lynch v. McDonough, 21 F.4th 776.

1. Service connection for back disability is denied.

The Veteran contends that he injured his back while he was stationed aboard the USS Leahy. X-rays could not be done on the ship. The Veteran reported that after service he sought treatment for his back in the 1990s, but the records were hard to find because most of the treatment providers had retired. He testified that he had experienced back pain since service, and it worsened approximately eight years ago. See the July 2022 Board hearing transcript.

Medical treatment records indicate that the Veteran had diagnoses of lumbar spine degenerative disc disease (DDD) and lumbosacral strain. See the March 2018 and December 2020 VA examination reports. Thus, the current disability requirement for service connection for a back disability is satisfied. The question for the Board is whether the Veteran's current diagnoses either began during active service or are etiologically related to service.

The Board finds that probative evidence of record does not establish that any back diagnosis is etiologically related to the Veteran's active service. Service treatment records (STRs) indicate that in a February 1985 entrance examination, the Veteran's spine was found to be clinically normal, and he denied having a history of recurrent back pain. In May 1987, while aboard the USS Leahy, the Veteran reported back pain after lifting soda cases the day before. The Veteran woke up with pain around the "mid-area" of his back and denied any numbness of the lower extremities. He was assessed as having "lumbar mech LBP" (low back pain), given Parafon forte, and put on light duty for five days. Six days later, in a follow-up appointment, the Veteran reported continued persistent pain with mild relief by Parafon Forte and did not appear to be in distress. He was noted to
1985 entrance examination, the Veteran's spine was found to be clinically normal, and he denied having a history of recurrent back pain. In May 1987, while aboard the USS Leahy, the Veteran reported back pain after lifting soda cases the day before. The Veteran woke up with pain around the "mid-area" of his back and denied any numbness of the lower extremities. He was assessed as having "lumbar mech LBP" (low back pain), given Parafon forte, and put on light duty for five days. Six days later, in a follow-up appointment, the Veteran reported continued persistent pain with mild relief by Parafon Forte and did not appear to be in distress. He was noted to have mild spasms of the bilateral lumbar muscles and continued on light duty for three more days. In a July 1989 examination, the Veteran's spine was found to be clinically normal. In December 1989, the Veteran reported a "several days history of back pain" from his shoulder blades down to the top of the pelvis. He noted that he had been wearing a Kevlar flac jacket for 4-hour watches at least three times per 24-hour period. The pain increased after watch was completed and was relieved by rest, but in recent days had not relieved the tenderness. He was noted to have a full range of motion in flexion, extension, and lateral rotation to the left and right sides, and muscular rigidity bilaterally along the spine. The assessment was back strain. In a follow-up appointment approximately 10 days later, the Veteran reported that the tenderness was better but still felt tight. The previous rigidity was lessened, and the back strain was noted to be resolving. In March 1991, the Veteran reported having low back pain, and denied having any numbness, weakness, or tingling. His active range of motion was noted to be limited with mild spasm. He was assessed as having muscle spasms of the low back. In June 1991 separation examination, the Veteran's spine was again found to be clinically normal, and he again denied having a history of recurrent back pain.

Post-service treatment records indicate that the Veteran saw a private chiropractor in July 2017 for "tightness in stiffness into his neck as well as across his belt line" for the last two days. He was noted to have tightness in the left and right lumbar areas and buttock areas, and spinal subluxation at L5 and sacrum. In August 2017, the Veteran was seen in an urgent care department for back pain with radiation. He was given an intramuscular injection of Toradol, prescriptions for hydrocodone and Flexeril, and scheduled for a follow-up office visit. In September 2017, the Veteran reported to his chiropractor that he had been having pain in his low back and down his right leg for approximately one month. In a March 2018 VA back conditions examination, the Veteran reported a history of constant low back pain for 20+ years with radiating numbness, tingling, and pain extending to the knee level since August 2017. He reported that he was seen at an urgent care clinic in August 2017, informed he had right sciatica, and given an injection. He did not have any diagnostic studies done. The Veteran reported that he was unable to stand for more than 20 minutes due to his back condition and denied having flare-ups. X-rays showed mild lumbar spine DDD, which the examiner opined was less likely as not incurred in or caused by back pain during service. The in-service incidents were without structural breakage, and were not known to increase the risk of lumbar spine DDD. The mild DDD was more likely than not a result of normal aging process.

Imaging dated September 2018 from a non-VA hospital shows mild multilevel DDD and mild degenerative face arthropathy. In a December 2020 VA back conditions examination, the Veteran reported that after separating from service in 1991, he dealt with his back pain until 2014 when he went to a chiropractor, and 2017 when he was seen at urgent care. Current symptoms include low back stiffness and trigger point pain. During a flare-up, occurring at the time of the examination, the Veteran had shooting pain down his right leg to the inner knee, and he could not get out of bed without a cane. X-rays showed mild L1-L2 disc space narrowing/bony spurring and vertebral body height maintained, and mild degenerative change of the upper lumbosacral spine. Diagnoses of lumbosacral strain and degenerative arthritis of the spine were noted, but no opinion was provided on the etiology of either diagnosis. In January 2023, a VA medical
4 when he went to a chiropractor, and 2017 when he was seen at urgent care. Current symptoms include low back stiffness and trigger point pain. During a flare-up, occurring at the time of the examination, the Veteran had shooting pain down his right leg to the inner knee, and he could not get out of bed without a cane. X-rays showed mild L1-L2 disc space narrowing/bony spurring and vertebral body height maintained, and mild degenerative change of the upper lumbosacral spine. Diagnoses of lumbosacral strain and degenerative arthritis of the spine were noted, but no opinion was provided on the etiology of either diagnosis. In January 2023, a VA medical opinion was obtained. After reviewing STRs and post-service treatment records, a VA examiner opined that the claimed back condition was less likely than not incurred in or caused by the claimed in-service injury, event, or illness. The rationale was that the separation examination and report of medical history were silent for mention of back pain or back condition, and the examiner was unable to locate any records in which the Veteran was evaluated or treated for lower back condition until 2017 to establish chronicity/nexus. In September 2023, another VA medical opinion was obtained. After reviewing STRs, post-service treatment records, and the Veteran's statements, a VA examiner opined that the claimed back condition was less likely than not incurred in or caused by the claimed in-service injury, event, or illness. The rationale was that the back pain noted in service was not chronic, and there were no treatment records dated immediately post-separation. The Veteran first reported back pain in 2017, which was 26 years after the Veteran's separation from service. The examiner acknowledged the Veteran's testimony in the Board hearing that he was improperly trained in service on how to do his job of hauling a fuel tanker to a ship such that he suffered a spasm in his back and legs; that basic twisting and turning in service required him to see a doctor; and x-rays were not taken until "probably in the 2000s," which showed a hemorrhaged disc. The examiner noted, however, that although those activities could potentially cause the Veteran's back condition, x-rays taken in 2018 showed only mild degenerative changes when moderate to severe degenerative changes would have been expected if the Veteran sustained significant injury in service. An acute back condition was noted in STRs, with no permanent residual or chronic disability shown in STRs or in treatment records after separation from service.

The Board finds the March 2018 and December 2020 VA examination reports and the March 2018, January 2023, and September 2023 VA medical opinions to have, in aggregate, at least some probative value. See Gabrielson v. Brown, 7 Vet. App. 36, 39-40. The March 2018 opinion was rendered after reviewing the Veteran's STRs and other medical records, soliciting a medical history from the Veteran, and physical examination of the Veteran; the January 2023 opinion was rendered after review of the entire record including STRs and post-service treatment records; and the September 2023 opinion was rendered after reviewing the entire claims file, including consideration and discussion of the Veteran's lay statements. See Prejean v. West, 13 Vet. App. 444 (factors for assessing the probative value of a medical opinion include the examiner's access to the claims folder and the Veteran's history, and the thoroughness and detail of the opinion).

As the JMR noted, the Veteran submitted a July 2024 medical opinion, which says: "To Whom It May Concern: This is to certify [Veteran] was a patient with [T. L. H.], NP. He was last seen 1/10/2022. He has a history of chronic low back pain. It is possible that this chronic low back pain is secondary to his years of military service." The Board finds this opinion inadequate, for two reasons. First, it does not qualify as a medical opinion on which service connection can be granted, since the level of probability does not meet the standard of "as likely as not." "Possible" is speculative and a much lower standard than is needed for service connection. See Swann v. Brown, 5 Vet. App. 229, 232 (1993) (noting that the weight of a medical opinion is diminished where that opinion is ambivalent, based on an inaccurate factual premise, based on an examination of limited scope, or where the basis for the opinion is not stated); see also Tirpak v. Derwinski, 2 Vet. App. 609, 611 (1992) (a letter from a physician indicating that Veteran's death "may or may not" have been
connection can be granted, since the level of probability does not meet the standard of "as likely as not." "Possible" is speculative and a much lower standard than is needed for service connection. See Swann v. Brown, 5 Vet. App. 229, 232 (1993) (noting that the weight of a medical opinion is diminished where that opinion is ambivalent, based on an inaccurate factual premise, based on an examination of limited scope, or where the basis for the opinion is not stated); see also Tirpak v. Derwinski, 2 Vet. App. 609, 611 (1992) (a letter from a physician indicating that Veteran's death "may or may not" have been averted if medical personnel could have effectively intubated the Veteran held to be speculative). Second, the opinion offers no rationale. It is a cursory statement without explanation, other than pointing to "his years of military service," as justification. See Stefl v. Nicholson, 21 Vet. App. 120, 124-125 (2007) (holding that "a mere conclusion by a medical doctor is insufficient to allow the Board to make an informed decision as to what weight to assign to a doctor's opinion"). Additionally, the NP does not report having reviewed the Veteran's claims file, STR, or other medical records. While the nurse practitioner is competent as a medical professional to offer an opinion, the opinion offered does not meet the criteria to establish service connection and carries little weight.

In addition, although the Veteran can describe observable symptoms including pain, his statements cannot be used to determine whether a back condition is related to service or to an in-service injury. See Jandreau v. Nicholson, 492 F.3d 1372, 1377 (explaining in footnote 4 that a Veteran may be competent to provide a diagnosis of a simple condition such as a broken leg, but not competent to provide evidence as to more complex medical questions). There is no evidence that the Veteran has the medical education and training required to make competent clinical diagnosis, or to attribute such a diagnosis to specific events or injuries. As such, the Board finds the Veteran's statements probative with regard to establishing his current symptoms but finds little probative value with regard to establishing service connection. In any case, their probative value is outweighed by the probative value assigned to an evaluation conducted by a person who has expertise and training pertinent to musculoskeletal diagnoses.

Finally, the earliest evidence of complaints related to the Veteran's back disability was in 2017. The Veteran himself noted that he did not seek treatment until 2014, which was 23 years after the Veteran's separation from service. This lengthy period of time without diagnosis or treatment weighs against finding that any current back diagnosis has existed since service. Additionally, in 1991, the Veteran's back was examined and found to be normal and the Veteran denied the presence of recurrent back pain. As noted above, there is no medical evidence showing relevant symptoms or a diagnosis of a chronic disability within one year from service separation; and the competent and credible evidence does not establish chronic and continuous symptoms of a back condition. As such, service connection on a presumptive basis under 38 C.F.R. § 3.303(a) or (b) is not warranted.

In sum, the probative evidence of record weighs against the claim for service connection for back disability. As such, there is no benefit of the doubt to resolve in the Veteran's favor. See Lynch v. McDonough, 21 F.4th 776.

2. Service connection for left leg sciatica, to include as due to the back disability, is denied.

3. Service connection for right leg sciatica, to include as due to the back disability, is denied.

4. Service connection for left shoulder condition (claimed as bilateral shoulder condition) is denied.

5. Service connection for right shoulder condition (claimed as bilateral shoulder condition) is denied.

The Veteran contends that these claimed disabilities are secondary to the claimed back disability. He states that he has radiating pain and numbness in his upper and lower extremities, and that he has never been in a car accident or a plane crash or had any past injuries to explain the pain in his extremities other than the in-service back injury. See the July 2022 Board hearing transcript.

Service connection on a secondary basis requires that a current disability be caused or aggravated by an already service-connected disease or injury. Here, the Veteran's claim for service connection for a back disability was denied herein. While he has other service-connected disabilities, he has not contended that the upper or lower extremity conditions are due to anything other than the claimed back condition nor does the record raise such a theory. Therefore, service connection for right leg sciatica, left leg sciatica, right shoulder disability, and
lower extremities, and that he has never been in a car accident or a plane crash or had any past injuries to explain the pain in his extremities other than the in-service back injury. See the July 2022 Board hearing transcript.

Service connection on a secondary basis requires that a current disability be caused or aggravated by an already service-connected disease or injury. Here, the Veteran's claim for service connection for a back disability was denied herein. While he has other service-connected disabilities, he has not contended that the upper or lower extremity conditions are due to anything other than the claimed back condition nor does the record raise such a theory. Therefore, service connection for right leg sciatica, left leg sciatica, right shoulder disability, and left shoulder disability as secondary to the claimed back disability must be denied as a matter of law because there is no primary disability upon which secondary service connection may be granted. See 38 C.F.R. § 3.310(a), (b); Sabonis v. Brown, 6 Vet. App. 426, 430.

To the extent that he seeks direct service connection, the evidence does not reflect that any of these claimed conditions arose during service or within one year after discharge from service, and there is no indication that any of these claimed conditions are due directly to service. See 38 C.F.R. §§ 3.303, 3.307, 3.309(a). As noted above, STRs show two instances of back pain, and follow-up appointments; however, the Veteran specifically denied having lower extremity numbness in May 1987. Furthermore, in a July 1989 examination, the Veteran's upper extremities and lower extremities were found to be clinically normal; and in a July 1991separation examination, his upper extremities and lower extremities were again found to be clinically normal. The Veteran denied having a history of painful or trick" shoulder or neuritis in an accompanying June 1991 report of medical history. Post-service private treatment records indicate that the Veteran was found to have right shoulder degenerative changes in December 2016 and back pain with sciatica in August 2017; and he was noted to have left shoulder rotator cuff tendonitis in a February 2021 VBA shoulder conditions examination, which he reported started in 2012. None of the records suggests the sciatica or shoulder conditions were incurred during service.

Accordingly, the benefit of the doubt doctrine is not for application, and service connection for right leg sciatica, left leg sciatica, right shoulder disability, and left shoulder disability as secondary to the claimed back disability are denied.

H. SEESEL

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board J. Black

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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