DEGENERATIVE ARTHRITIS OF THE SPINE (SPONDYLOSIS)

MICHAEL A. PAPPAS · 2026 · Case ID: 26005085

GRANTED

Summary

The Veteran served from February 1986 to March 1988. This case involves appeals for service connection for a lumbar spine disability and a cervical spine disability. The Veteran contended that he injured both his lumbar and cervical spines in motor vehicle accidents during active duty and has experienced continuous pain since service. Service treatment records confirmed complaints of lumbar pain in February 1988 and neck pain in March 1986. The Board found initial VA medical opinions inadequate as they did not fully address the Veteran's claims of continuous pain since service and attributed current conditions to post-service events. After remands for further development, a February 2026 VA examination provided a positive nexus opinion, finding the lumbar and cervical spine disabilities at least as likely as not incurred in or related to service, deeming the Veteran a reliable historian with credible statements of continuity of symptomatology. A subsequent March 2026 VA addendum opinion provided a negative nexus, citing lack of objective medical evidence and post-service events as more likely causes, without reconciling the prior positive opinion. The Board found the evidence in relative balance between the positive February 2026 opinion and the negative March 2026 opinion. Applying the benefit of the doubt doctrine, service connection for both the lumbar and cervical spine disabilities was granted.

Rationale

Positive February 2026 VA opinion finding nexus to service; Veteran's statements of continuity of symptomatology found credible; Evidence in relative balance between positive and negative opinions

Special Benefit

NO SPECIAL BENEFIT

Docket No.

24-00 226

Full Decision Text

Citation Nr: 26005085
Decision Date: 04/30/26 Archive Date: 04/30/26

DOCKET NO. 24-00 226
DATE: April 30, 2026

ORDER

Entitlement to service connection for a lumbar spine disability is granted.

Entitlement to service connection for a cervical spine disability is granted.

FINDINGS OF FACT

1. Resolving reasonable doubt in the Veteran's favor, his lumbar spine disability is related to his military service.

2. Resolving reasonable doubt in the Veteran's favor, his cervical spine disability is related to his military service.

CONCLUSIONS OF LAW

1. The criteria for service connection for a lumbar spine disability have been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. § 3.102, 3.303, 3.307, 3.309.

2. The criteria for service connection for a cervical spine disability have been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. § 3.102, 3.303, 3.307, 3.309.

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Veteran served on active duty from February 1986 to March 1988.

These matters come before the Board on appeal from a December 2017 rating decision issued by a Department of Veterans Affairs (VA) Regional Office (RO).

The Veteran requested a Board hearing in his December 2022 VA Form 9. A hearing was scheduled on February 13, 2025. However, the Veteran, through his representative, explicitly withdrew his hearing request in a February 2025 correspondence. The Board finds the hearing request was appropriately withdrawn.

The matters were previously before the Board in April 2025 and November 2025 at which time they were remanded for further development.

Service Connection

Service connection on a direct basis requires (1) competent and credible evidence confirming the Veteran has the claimed disability or at least has since filing the claim; (2) competent and credible evidence of in-service incurrence or aggravation of a relevant disease or injury; and (3) competent and credible evidence of a nexus or link between the in-service injury or disease and the current disability. See Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004). Service connection may be granted for any disease diagnosed after discharge, when the evidence, including that pertinent to service, establishes that the disease was incurred in service. See 38 U.S.C. § 1113(b); 38 C.F.R. § 3.303(d).

Presumptive service connection can satisfy the requirements of an in-service event and a nexus to military service. Chronic diseases listed under 38 C.F.R. § 3.309(a)-(f) that manifest either during active service or subject to the requirements of 38 C.F.R. § 3.307 after discharge or release from military service are sufficient to establish in-service incurrence or aggravation. If a chronic disease enumerated in 38 C.F.R. § 3.309 does not manifest in-service or within the applicable time limits, the second and third elements of service connection may be granted based on continuity of symptomatology. See Walker v. Shinseki, 708 F.3d 1331 (Fed. Cir. 2013). The United States Court of Appeals for the Federal Circuit (Federal Circuit) clarified that the law providing for awards of service connection on the basis of continuity of symptomatology is limited to those "chronic" diseases listed under 38 C.F.R. § 3.309(a). See id.

1. Entitlement to service connection for a lumbar spine disability is granted.

The Veteran seeks service connection for a lumbar spine disability. In a September 2024 correspondence the Veteran explained that he injured his lumbar spine in a motor vehicle accident while on active duty. He claimed that he has been experiencing pain of the lumbar spine since service.

Service treatment records show the Veteran complained of lumbar pain in February 1988.

In July 2023 the Veteran was afforded a VA examination for his claimed lumbar spine disability. During the clinical portion of the examination the examiner recorded a diagnosis of degenerative arthritis of the lumbar spine. However, the examiner provided a negative nexus opinion, instead attributing the Veteran's current lumbar spine disability to a post-service February 2014 back injury. While the examiner did note the Veteran's lumbar spine treatment in service, she did not address the Veteran's claims that he had experienced lumbar pain since service.

A subsequent lumbar spine examination and opinion in January 2024 came
has been experiencing pain of the lumbar spine since service.

Service treatment records show the Veteran complained of lumbar pain in February 1988.

A subsequent lumbar spine examination and opinion in January 2024 came to the same conclusion. In the body of the opinion the examiner included the Veteran's post-service history of treatment for back pain. These treatments included a June 2009 treatment record noting low back, a June 2013 treatment note recording a reported history of low back pain, and a November 2013 treatment note for back pain. Again, the examiner cited a post-service February 2014 accident as the likely cause of the Veteran's current back disability. While the examiner state "review of the Veteran statements have been completed and taken into consideration," it appears that the Veteran's specific comments of continuity of pain symptoms since service were not addressed.

In April 2025, the Board remanded this matter in order to obtain a new addendum opinion which specifically addressed the Veteran's contentions that he experienced back pain in and since service.

An addendum was provided in September 2025. That VA examiner provided a negative opinion. In explanation the VA examiner stated that the back injury in service was acute only and that there was no evidence of a chronic disability in service, citing post-service imaging studies. Unfortunately, the examiner did not address the Veteran's complaints of continuous symptoms since service as required by the prior Board remand. Stegall, 11 Vet. App. 268, 271 (1998).

Having found that the medical opinions of record were inadequate, the Board last remanded the matter in November 2025 for a new opinion.

The Veteran was afforded a new VA medical opinion in February 2026. The examiner reviewed the claims file and opined that the lumbar spine disability was at least as likely as not incurred in or otherwise related to service. Crucially, the examiner found that the Veteran was a reliable historian and considered his statements of continuity of symptomatology credible. The examiner explained that these statements were indicative of a history of repeated trauma of the lumbar spine, and that his post service injury would not have contributed to the currently diagnosed spondylosis. The examiner cited MRI evidence and medical literature in support of the conclusion.

Concerningly, VA obtained a new addendum opinion in March 2026. The Board is reminded that seeking to obtain negative evidence against the Veteran is prohibited by VA law. See Mariano v. Principi, 17 Vet. App. 305, 312 (2003). That examiner found that the lumbar spine disability was less likely than not incurred in or otherwise related to service. The examiner acknowledged the Veteran's contentions that he experienced back pain since service, but cited the lack of "objective medical evidence" and finding that the "post-service events provided a more likely plausible explanation for the development of the lumbar spine disability." The examiner did not reconcile the conclusions the February 2026 positive medical opinion.

The Board has considered both post-remand medical opinions of record, and acknowledges the negative nexus opinion. However, the positive medical report offers an equally persuasive opinion. When there is an approximate balance of positive and negative evidence regarding the merits of an issue material to the determination of a matter, the benefit of the doubt in resolving each such issue shall be given to the claimant. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102. While there is some negative evidence consisting of the opinion provided by the March 2026 VA examiner, the Board finds that the evidence is in relative balance. All reasonable doubt resolved in the Veteran's favor, service connection for a lumbar spine disability is warranted, and the appeal is granted. See 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102.

2. Entitlement to service connection for a cervical spine disability is granted.

The Veteran seeks service connection for a cervical spine disability. In a September 2024 correspondence the Veteran explained that he injured his cervical spine in a motor vehicle accident while on active duty. He claimed that he has been experiencing pain of the cervical spine since service.

Service treatment records show the Veteran complained of neck pain in March 1986.

The Veteran was provided a VA neck examination in September 2025. That VA examiner provided a negative
the Veteran's favor, service connection for a lumbar spine disability is warranted, and the appeal is granted. See 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102.

2. Entitlement to service connection for a cervical spine disability is granted.

Service treatment records show the Veteran complained of neck pain in March 1986.

The Veteran was provided a VA neck examination in September 2025. That VA examiner provided a negative opinion. In explanation the VA examiner stated that the neck injury in service was acute only and that there was no evidence of a chronic disability in service, citing post-service imaging studies. Unfortunately, the examiner did not address the Veteran's complaints of continuous symptoms since service as required by the prior Board remand. Stegall, 11 Vet. App. 268, 271 (1998).

Having found that the medical opinion of record was inadequate, the Board last remanded the matter in November 2025 for a new opinion.

The Veteran was afforded a new VA medical opinion in February 2026. The examiner reviewed the claims file and opined that the cervical spine disability was at least as likely as not incurred in or otherwise related to service. Crucially, the examiner found that the Veteran was a reliable historian and considered his statements of continuity of symptomatology credible. The examiner explained that these statements were indicative of a history of repeated trauma of the cervical spine, and that his post service injury would not have contributed to the currently diagnosed spondylosis. The examiner cited MRI evidence and medical literature in support of the conclusion.

Concerningly, VA obtained a new addendum opinion in March 2026. The Board is reminded that seeking to obtain negative evidence against the Veteran is prohibited by VA law. See Mariano v. Principi, 17 Vet. App. 305, 312 (2003). That examiner found that the cervical spine disability was less likely than not incurred in or otherwise related to service. The examiner vaguely acknowledged the Veteran's contentions that he experienced neck pain since service, but found that the Veteran's neck injury in service was acute only, and that that post service medical evidence supports that the current diagnosis was age related or due to a post-service injury. The examiner did not reconcile the conclusions the February 2026 positive medical opinion.

(Continued on next page.)

The Board has considered both post-remand medical opinions of record, and acknowledges the negative nexus opinion. However, the positive medical report offers an equally persuasive opinion. When there is an approximate balance of positive and negative evidence regarding the merits of an issue material to the determination of a matter, the benefit of the doubt in resolving each such issue shall be given to the claimant. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102. While there is some negative evidence consisting of the opinion provided by the March 2026 VA examiner, the Board finds that the evidence is in relative balance. All reasonable doubt resolved in the Veteran's favor, service connection for a cervical spine disability is warranted, and the appeal is granted. See 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102.

Michael A. Pappas

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board R. E. Geary

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.

Analyze in VA Law Explorer