DEGENERATIVE ARTHRITIS OF THE SPINE (SPONDYLOSIS)

KRISTY L. ZADORA · 2026 · Case ID: 26005041

DENIED

Summary

The appellant, surviving spouse of a deceased veteran, appeals the denial of service connection for a lumbar spine disorder, claimed as secondary to service-connected diabetes mellitus. The veteran served from May 1969 to January 1971, including service in Vietnam. The primary issue was whether the veteran's current lumbar spine disorder was related to an in-service injury (helicopter landing in 1970) or aggravated by diabetes mellitus. The Board reviewed the veteran's service treatment records, which showed a 1969 diagnosis of a lower thoracic sprain and a 1969 back muscle strain, but were otherwise negative for lumbar spine complaints. Post-service records showed no objective reports of a lumbar spine disorder until a 1992 surgery, over 20 years after service. A VA examiner in March 2026 opined that the lumbar spine herniated disc was less likely than not related to the in-service injury, citing the lack of continuity of symptoms and the prolonged period without treatment. The examiner also opined that the lumbar spine disorder was less likely than not proximately due to or the result of diabetes mellitus, explaining that lumbar strains do not affect vertebrae and that diabetes complications do not typically include lumbar spine disorders. The Board found the VA opinions highly probative and the veteran's lay assertions of continuity and etiology to be not credible due to inconsistencies with contemporaneous evidence and the prolonged lapse in treatment. Service connection for the lumbar spine disorder was denied.

Rationale

Service treatment records showed a 1969 thoracic sprain and back muscle strain, but were otherwise negative for lumbar spine complaints.; Post-service records showed no objective lumbar spine disorder until 1992 surgery, over 20 years after service.; VA examiner opined less likely than not related to in-service injury due to lack of continuity of symptoms and prolonged period without treatment.; VA examiner opined less likely than not proximately due to diabetes mellitus, citing lack of evidence supporting this link.

Special Benefit

NO SPECIAL BENEFIT

Docket No.

17-22 550

Full Decision Text

Citation Nr: 26005041
Decision Date: 04/29/26 Archive Date: 04/29/26

DOCKET NO. 17-22 550
DATE: April 29, 2026

ORDER

Entitlement to service connection for a lumbar spine disorder, to include as secondary to service connected diabetes mellitus, is denied.

FINDING OF FACT

The Veteran's current lumbar spine disorder was not proximately due to, or aggravated beyond its natural progression by his service connected diabetes mellitus; and did not have its onset during service or for many years thereafter and is not otherwise etiologically related to service.

CONCLUSION OF LAW

The criteria for entitlement to service connection for a lumbar spine disorder, to include as secondary to service connected diabetes mellitus, have not been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309, 3.310.

REASONS AND BASES FOR FINDING AND CONCLUSION

The Veteran had active military service from May 1969 to January 1971, to include service in the Republic of Vietnam. The Veteran died in June 2021. The appellant is his surviving spouse.

This matter comes to the Board of Veterans' Appeals (Board) on appeal from a November 2018 rating decision issued by the Department of Veterans Affairs (VA) Regional Office (RO).

The appellant requested a hearing in this matter in a May 2022 Statement in Support of Claim (VA Form 21-4138). However, the appellant withdrew this request for a hearing in a November 2022 submission. The Board will therefore proceed with its adjudication.

This case was before the Board in January 2023, December 2023, and February 2026, at which times the issues currently on appeal was remanded for additional development. Specifically, the matter was most recently remanded to obtain etiology opinions. VA etiology opinions were obtained in May 2026. The Board therefore determines that there has been substantial compliance with its previous remand. The case has now been returned to the Board for further appellate action.

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

Service Connection Criteria

Establishing service connection generally requires (1) medical evidence of a current disability; (2) medical or, in certain circumstances, lay evidence of in-service incurrence or aggravation of a disease or injury; and (3) medical evidence of a nexus between the claimed in-service disease or injury and the current disability. 38 U.S.C. § 1110; Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004). Service connection also may be established on a secondary basis for a disability that is proximately due to or the result of a service-connected disease or injury. 38 C.F.R. § 3.310.

Generally, to establish service connection a veteran must show: "(1) the existence of a present disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the present disability and the disease or injury incurred or aggravated during service." Davidson v. Shinseki, 581 F.3d 1313, 1315-16 (Fed. Cir. 2009); Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004). Service connection may also be granted for any injury or disease diagnosed after discharge, when all the evidence, including that pertinent to service establishes that the disease or injury was incurred in service. 38 C.F.R. § 3.303(d).

In addition, the law provides that, where a veteran served ninety days or more of qualifying service and certain chronic diseases, such as arthritis, becomes manifest to a degree of 10 percent or more within one year from the date of termination of such service, such disease shall be presumed to have been incurred in service, even though there is no evidence of such disease during the period of service. 38 U.S.C. §§ 1101, 1112; 38 C.F.R. §§ 3.307, 3.309. While the disease need not be diagnosed within the presumption period, it must be shown, by acceptable lay or medical evidence, that there were characteristic manifestations of the disease to the required degree during that time. The Board notes the Veteran has not been diagnosed with arthritis of the lumbar spine, right wrist,
chronic diseases, such as arthritis, becomes manifest to a degree of 10 percent or more within one year from the date of termination of such service, such disease shall be presumed to have been incurred in service, even though there is no evidence of such disease during the period of service. 38 U.S.C. §§ 1101, 1112; 38 C.F.R. §§ 3.307, 3.309. While the disease need not be diagnosed within the presumption period, it must be shown, by acceptable lay or medical evidence, that there were characteristic manifestations of the disease to the required degree during that time. The Board notes the Veteran has not been diagnosed with arthritis of the lumbar spine, right wrist, right hip, left hip and/or left knee and that this regulation therefore does not apply.

Continuity of symptomatology may be shown by demonstrating "(1) that a condition was 'noted' during service or any applicable presumptive period; (2) evidence of post-service continuity of the same symptomatology; and (3) medical or, in certain circumstances, lay evidence of a nexus between the present disability and the post-service symptomatology." Barr v. Nicholson, 21 Vet. App. 303, 307 (2007).

In making all determinations, the Board must fully consider the lay assertions of record. A layperson is competent to report on the onset and continuity of his current symptomatology. 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). However, for the purpose of evaluating lay evidence, to include a veteran's statements about his health conditions, competent evidence is "limited to that which the witness has actually observed and is within the realm of his personal knowledge." Layno v. Brown, supra. For example, although a lay person is competent to report observable symptomatology of an injury or illness (such as pain or the visible flatness of his feet), a lay person is "not competent to opine as to medical etiology or render medical opinions." Barr v. Nicholson, supra.

Lay evidence may also include the veteran's reported history at the time of medical examination or treatment. The veteran's report of injury, history of symptoms, history of treatments, and current complaints made to the doctor are lay evidence. Such history and complaints are not transformed into medical evidence just because the veteran tells them to a doctor who writes it down. See LeShore v. Brown, 8 Vet. App. 406, 409 (1995) (ruling that "a bare transcription of a lay history is not transformed into 'competent medical evidence' merely because the transcriber happens to be a medical professional...."); Robinette v. Brown, 8 Vet. App. 69, 77 (1995) (holding that a veteran's account, "filtered as it was through a layman's sensibilities, of what a doctor purportedly said is simply too attenuated and inherently unreliable to constitute 'medical' evidence.").

In rendering a decision on appeal, the Board must analyze the competency, credibility, and probative value of the evidence, account for the evidence that it finds to be persuasive or unpersuasive and provide the reasons for its rejection of any material evidence favorable to the claimant. Buchanan v. Nicholson, 451 F.3d 1331, 1335-37 (Fed. Cir. 2006).

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). When there is an approximate balance of positive and negative evidence as to any issue material to the determination of a matter, VA will resolve reasonable doubt in favor of the claimant. 38 U.S.C. § 5107; 38 C.F.R. § 3.102; Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021) (en banc).

Entitlement to service connection for a lumbar spine disorder, to include as secondary to service connected diabetes mellitus, is denied.

In his September 2018 Application for Disability Compensation and Related Compensation Benefits (VA Form 21-526EZ), the Veteran indicated that he was applying for VA benefits related to previous back surgeries. Specifically, the Veteran reported that his back disorder was related to a 1970 in-service helicopter landing in which he injured his lower back. An April 2019 private treatment note shows that the Veteran underwent back surgery in 1992, 1996, and 2007. In a March
, 21 F.4th 776 (Fed. Cir. 2021) (en banc).

Entitlement to service connection for a lumbar spine disorder, to include as secondary to service connected diabetes mellitus, is denied.

The Veteran's service treatment records show a September 1969 diagnosis of a lower thoracic sprain, and a 1969 back muscle strain. The treatment records are otherwise negative for complaints, treatment, or diagnosis of a lumbar spine disorder during active service. In his January 1971 Report of Medical History, the Veteran denied experiencing past or present swollen or painful joints, broken bones, arthritis, bone or joint deformity, or recurrent back pain. Additionally, a review of the Veteran's post-service medical records shows that the first objective report of a lumbar spine disorder is noted in an April 2019 private treatment note indicating that the Veteran underwent back surgery in 1992. Prior to this date, there is no evidence of a lumbar spine disorder of record.

The Board has first considered whether service connection for arthritis is warranted on a presumptive basis, to include on the basis of continuity of symptomatology. In this regard, the clinical evidence of record fails to show that the Veteran manifested such disease to a compensable degree within the year following his discharge from active duty service. The Veteran's post-service treatment record did not reflect any complaints for his lumbar spine until 1991. Therefore, the Board finds that presumptive service connection for arthritis, to include on the basis of continuity of symptomatology, is not warranted. 38 U.S.C. §§ 1101, 1112; 38 C.F.R. §§ 3.307, 3.309.

By way of background, the claim was most recently before the Board in February 2026, at which time the issue was remanded to obtain a VA etiological opinion. In a March 2026 opinion report, the VA examiner opined that the Veteran's diagnosed lumbar spine herniated disc was less likely than not incurred in or caused by the claimed in-service injury, event, or illness, to include a 1970 in-service helicopter in which the Veteran claimed he injured his back. In support of this conclusion, the examiner stated that a September 1969 service treatment record showed a diagnosis of a lower thoracic sprain, and that a 1969 report of medical examination notes a back muscle strain, while the remainder of the Veteran's service treatment records are silent for continued complaints related to his back. The examiner commented that a back strain is an injury to either a muscle or tendon and does not effective the spine's vertebra. The examiner indicated that the Veteran's post-service medical records are silent for continued complaints of back pain in 1992, which is noted on an April 2019 private treatment note showing that the Veteran underwent back surgery in 1991, which the examiner noted is 21 years following the Veteran's separation from service. The examiner reasoned that without competent medical evidence showing a continuation of symptoms related to a back injury, a claim for service connection for the lumbar spine herniated disc disability is not possible or plausible. The examiner commented that while the Veteran experienced an in-service back injury, this does not guarantee that the Veteran experienced lasting damage that resulted in a chronic back condition. Rather, the examiner reasoned that there needed to be objective evidence to support the Veteran's claim. Without objective evidence to support the Veteran's contention that his lumbar spine condition continued since service, and despite the Veteran's lay reports of such, the examiner indicated that the Veteran's statements regarding onset and continuation of a back disability alone, coupled with the evidence of record, was insufficient to establish such relationship.

Next, the examiner opined that the Veteran's lumbar spine disorder was less likely than not proximately due to or the result of his service-connected diabetes mellitus. In support of this conclusion, the examiner again acknowledged the Veteran's September 1969 in-service thoracic sprain, and muscle strain. However, the examiner explained that a strain is an injury to either a muscle or tendon, and that tendons are the tough, fibrous bands of tissue that connect muscle to bone. The examiner explained that with a back strain, the muscles and tendons that support the spine are twisted, pulled or torn. The examiner indicated that lumbar strains have no effect on the spine vertebra. The examiner explained that persistent hyperglycemia uncontrolled diabetes mellitus can cause several complications, both acute and chronic. The examiner indicate that acute conditions included hypoglycemia, ketoacidosis, hyperglycemic hyperosmolar state, and hyperglycemic diabetic coma. Chronic conditions included microvascular peripheral artery disease, and cerebrovascular disease. After a thorough review of the medical literature and understanding the complications that can occur due to diabetes mellitus, the examiner reported that there was no evidence supporting a finding that the Veteran's lumbar spine disorder was caused or aggravated beyond its natural progression by diabetes mellitus.

The Board finds the February 2026 VA opinions are highly probative as the examiner reviewed the claims file, interviewed the Veteran, and provided an opinion supported by a clear rationale. Nieves-Rodriguez v. Peake, 22 Vet. App. 295 (2008). These opinions are therefore afforded great probative weight. There are no contrary opinions of record.

The Board acknowledges that the Veteran believed that his lumbar spine disorder, namely lumbar spine herniated disc, is related to his active service. However, while the Veteran was competent to report about what happened in service and observable symptomatology, he was not competent to link his lumbar spine disorder to his active service. Opinions and findings of that nature require medical expertise and are outside the realm of common knowledge of a layperson. Kahana v. Shinseki, 24 Vet. App. 428 (2011); Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007). Therefore, the Veteran was not competent to provide an etiology opinion in this case. Moreover, to the extent that the Veteran was competent to opine on this matter, the Board finds that the specific, reasoned opinion of the February 2026 VA examiner is of greater probative weight than the Veteran's lay assertions in this regard. The examiner reviewed the claims file and the Veteran's own reported history, and he has training, knowledge, and expertise on which he relied to form his opinion. The examiner also provided a rationale for the conclusion reached.

In addition, in adjudicating claims, the Board must assess not only competency of the Veteran's statements, but also their credibility. See Buchanan v. Nicholson, 451 F.3d 1331 (Fed. Cir. 2006). The former, the Court has held, is a legal concept, which is useful in determining whether testimony may be heard and considered by the trier of fact, while the latter is a factual determination going to the probative value of the evidence to be made after the evidence has been admitted. Rucker v. Brown, 10 Vet. App. 67, 74 (1997). Credibility can be generally evaluated by considering interest, bias, or inconsistent statements, the demeanor of the witness, facial plausibility of the testimony, and the consistency of the witness testimony. Caluza v. Brown, 7 Vet. App. 498, 510-511 (1995), aff'd per curiam, 78 F.3d 604 (Fed. Cir. 1996). The Board must analyze the credibility and probative value of the evidence, account for the evidence it finds persuasive or unpersuasive, and provide the reasons for its rejection of any material evidence favorable to the claimant. Caluza, 7 Vet. App. at 506 (citing State v. Asbury, 415 S.E.2d 891, 895 (W.Va. 1992)).

To the extent the Veteran asserted a continuity of symptomatology beginning during service, the Board finds these statements to lack credibility as they are in direct conflict with the evidence. In this regard, there is no evidence that the Veteran has
78 F.3d 604 (Fed. Cir. 1996). The Board must analyze the credibility and probative value of the evidence, account for the evidence it finds persuasive or unpersuasive, and provide the reasons for its rejection of any material evidence favorable to the claimant. Caluza, 7 Vet. App. at 506 (citing State v. Asbury, 415 S.E.2d 891, 895 (W.Va. 1992)).

To the extent the Veteran asserted a continuity of symptomatology beginning during service, the Board finds these statements to lack credibility as they are in direct conflict with the evidence. In this regard, there is no evidence that the Veteran has sought treatment for a lumbar spine disorder and no evidence of complaints of a lumbar spine disorder until his back surgery in 1992. If the Veteran had, in fact, began experiencing lumbar spine problems since service, the Board logically presumes that he would have reported at his January 1971 Report of Medical History that he experienced recurrent back pain, and a spine problem would have been noted during the January 1971 clinical evaluation. Further, the Board would have expected the Veteran would have sought treatment at some point within the more than 20 years following his separation from service if he did, in fact, experience a lumbar spine disorder since service. As such, the Board logically presumes that the Veteran's lack of treatment or complaints of a lumbar spine disorder until more than 20 years following service separation indicate that he did not, in fact, experience a lumbar spine disorder during service. See Fountain v. McDonald, 27 Vet. App. 258, 272 (2015).

Notably, the United States Court of Appeals for the Federal Circuit has determined that such a lapse of time is a factor for consideration in deciding a service connection claim. Maxson v. Gober, 230 F.3d 1330 (Fed. Cir. 2000) (ruling that a prolonged period without medical complaint can be considered, along with other factors, as evidence of whether an injury or a disease was incurred in service which resulted in any chronic or persistent disability). Here, the Veteran's statements, made in connection with his pending claim for VA benefits that his current lumbar spine disorder was due to an in-service injury, are inconsistent with the contemporaneous evidence and, therefore, are not credible. Consequently, the Board assigns no probative weight to such statements.

Accordingly, the Board finds that service connection for a lumbar spine disorder is not warranted. The appeal is denied. 38 U.S.C. § 5107; 38 C.F.R. § 3.102; Lynch v. McDonough, supra.

KRISTY L. ZADORA

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board Christopher O'Donnell, 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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