THORACOLUMBAR OR LUMBAR SPINE LIMITATION OF MOTION

PAUL R. CASEY · 2026 · Case ID: A26007179

DENIED

Summary

The veteran, who served in the United States Army from October 1981 to December 1990, appeals the denial of service connection for a low back condition, a left hip condition, and a right hip condition. All three conditions were claimed as secondary to a service-connected right knee disability. The veteran underwent a VA examination for his low back condition, reporting pain and stiffness, but the examiner found no current diagnosis and no functional impact on earning capacity. The Board noted the lack of objective evidence or treatment records supporting a diagnosis and that the veteran, while experiencing pain, is not competent to provide a medical diagnosis. Citing Saunders v. Wilkie, the Board found that without evidence of a current disability or functional impairment, service connection could not be established. For the hip conditions, the veteran also reported pain and worsening symptoms, but the VA examination revealed normal posture, gait, and range of motion, with no current diagnosis and no functional impairment to earning capacity. Similar to the back claim, the Board found no objective evidence of a diagnosed hip condition or functional impairment, and thus denied service connection for the hip claims. The Board considered the benefit of the doubt doctrine but found it inapplicable as the evidence was not in approximate balance. The appeal was denied for all three conditions.

Rationale

No current diagnosis of low back condition found on VA exam; No functional impairment to earning capacity noted; Lack of objective evidence or treatment records supporting diagnosis

Service Branch

ARMY

Special Benefit

NO SPECIAL BENEFIT

Docket No.

251016-600182

Full Decision Text

Citation Nr: A26007179
Decision Date: 01/27/26 Archive Date: 01/27/26

DOCKET NO. 251016-600182
DATE: January 27, 2026

ORDER

Entitlement to service connection for lower back pain, secondary to right knee disability, is denied.

Entitlement to service connection for left hip condition, secondary to right knee disability, is denied.

Entitlement to service connection for right hip condition, secondary to right knee disability, is denied.

FINDINGS OF FACT

1. The most persuasive evidence weighs against a finding that the Veteran has been diagnosed or treated for a low back condition, at any time during the pendency of the claim.

2. The most persuasive evidence weighs against a finding that the Veteran has been diagnosed or treated for a left hip condition, at any time during the pendency of the claim.

3. The most persuasive evidence weighs against a finding that the Veteran has been diagnosed or treated for a right hip condition, at any time during the pendency of the claim.

CONCLUSIONS OF LAW

1. The criteria for service connection for a low back condition, to include as secondary to the service-connected right knee disability, have not been met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. § 3.303.

2. The criteria for service connection for a left hip condition, to include as secondary to the service-connected right knee disability, have not been met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. § 3.303.

3. The criteria for service connection for a right hip condition, to include as secondary to the service-connected right knee disability, have not been met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. § 3.303.

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Veteran served on active duty in the United States Army from October 1981 to October 1989 and from October 1989 to December 1990.

This matter comes to the Board of Veterans' Appeals (Board) on appeal from an July 2023 rating decision by a Department of Veterans Affairs (VA) Regional Office (RO).

In the October 2025 VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement), the Veteran elected the Direct Review docket. Therefore, the Board may only consider the evidence of record at the time of the July 2023 rating decision, which was subsequently subject to higher-level review. 38 C.F.R. § 20.301. If evidence was submitted during the period after the RO issued the decision, which was subsequently subject to higher-level review the Board did not consider it in its decision. 38 C.F.R. §§ 20.300, 20.301, 20.801.

If the Veteran would like VA to consider any evidence that was submitted that the Board could not consider, the Veteran may file a Supplemental Claim (VA Form 20-0995) and submit or identify this evidence. 38 C.F.R. § 3.2501. If the evidence is new and relevant, VA will issue another decision on the claim[s], considering the new evidence in addition to the evidence previously considered. Id. Specific instructions for filing a Supplemental Claim are included with this decision.

Service Connection

Service connection may be established for a disability resulting from disease or injury incurred in or aggravated by service. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303. Service connection means that the facts, shown by evidence, establish that a particular injury or disease resulting in disability was incurred coincident with service, or if preexisting service, was aggravated therein. 38 C.F.R. § 3.303(a). Service connection may be granted for any 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).

To establish service connection for a disability, there must be competent evidence of the following: (1) the existence of a present disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship or "nexus" between the present disability and the disease or injury incurred or aggravated during service. Horn v. Shinseki, 25 Vet. App. 231, 236 (2010); Shedden v. Principi, 381 F.3d 1163, 1166-67 (Fed. Cir. 2004); Gutierrez v.? Principi, 19 Vet. App. 1, 5 (2004) (citing Hickson v. West, 12 Vet. App. 247, 253 (1999)). In many cases, medical evidence is required to meet the requirement that the evidence be "competent." However, when a condition may be diagnosed by its unique and readily identifiable features, the presence of the disorder is not a determination "medical in nature" and is capable of lay observation. Barr v. Nicholson, 21 Vet. App. 303, 309 (2007).

Service connection may also be established on a secondary basis when a disability is shown to be proximately due to or the result of a service-connected disease or injury. 38 C.F.R. § 3.310(a). Establishing service connection on a secondary basis requires evidence sufficient to show: (1) that a current disability exists and (2) that the current disability was either (a) caused by or (b) aggravated by a service-connected disability. See Allen v. Brown, 7 Vet. App. 439 (1995).

Pertinent to a claim for direct or secondary service connection, such a determination requires a finding of a current disability that is related to an injury or disease in service. Watson v. Brown, 4 Vet. App. 309 (1993); Brammer v. Derwinski, 3 Vet. App. 223, 225 (1992); Rabideau v. Derwinski, 2 Vet. App. 141, 143 (1992). Under applicable regulation, the term "disability" means impairment in earning capacity resulting from diseases and injuries and their residual conditions. 38 C.F.R. §§ 4.1; see also Hunt v. Derwinski, 1 Vet. App. 292, 296 (1991); Allen v. Brown, 7 Vet. App. 439 (1995); Saunders v. Wilkie, 886 F.3d 1356 (Fed. Cir. 2018) (the term "disability" as used in 38 U.S.C. § 1110" refers to the functional impairment of earning capacity, not the underlying cause of said disability," and held that "pain alone can serve as a functional impairment and therefore qualify as a disability").

In McClain v. Nicholson, 21 Vet. App. 319, 321 (2007), the Court of Appeals for Veterans Claims (Court) held that the requirement of the existence of a current disability is satisfied when a claimant has a disability at the time he files his claim for service connection or during the pendency of that claim, even if the disability resolves prior to adjudication of the claim. However, in Romanowsky v. Shinseki, 26 Vet. App. 289 (2013), the Court held that when the record contains a recent diagnosis of disability prior to a claimant filing a claim for benefits based on that disability, the report of diagnosis is relevant evidence that the Board must address in determining whether a current disability existed at the time the claim was filed or during its pendency.

Except as otherwise provided by law, a claimant has the responsibility to present and support a claim for benefits under the laws administered by VA. VA shall consider all information and medical and lay evidence of record. Where there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, VA shall give the benefit of the doubt to the claimant. 38 U.S.C. § 5107; 38 C.F.R. § 3.102; see also Lynch v. McDonough, 21 F. 4th 776 (Fed. Cir. 2021) (en banc).

1. Service connection for a low back condition.

The Veteran asserts that he is entitled to service connection for a low back
a claimant has the responsibility to present and support a claim for benefits under the laws administered by VA. VA shall consider all information and medical and lay evidence of record. Where there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, VA shall give the benefit of the doubt to the claimant. 38 U.S.C. § 5107; 38 C.F.R. § 3.102; see also Lynch v. McDonough, 21 F. 4th 776 (Fed. Cir. 2021) (en banc).

1. Service connection for a low back condition.

The Veteran asserts that he is entitled to service connection for a low back condition, secondary to his service-connected right knee disability. See May 2023 Claim VA Form 21-526EZ (Application for Disability Compensation and Related Compensation Benefits).

The first element of service connection requires a current disability.

Here, the Veteran underwent a VA examination in furtherance of his claim for his low back condition. See May 2023 C&P Exam. He reported that his low back pain started approximately 9 months ago and he has noticed aching and stiffness type of pain in his back worsened with movements and certain turns.

The examiner noted the Veteran's posture and gait were within normal limits. The examiner noted that the Veteran's back condition caused no functional impact on his ability to perform any occupational task. Ultimately, the examiner found that the Veteran did not have a current diagnosis of a low back condition.

Congress specifically limits entitlement for service-connected disease or injury to cases where such incidents have resulted in a disability. See 38 U.S.C. § 1110. In the absence of proof of a current disability, service connection for that disability cannot be established. See Brammer v. Derwinski, 3 Vet. App. 223, 225 (1992).

The Board has considered the holding in Saunders v. Wilkie, 886 F.3d 1356 (Fed. Cir. 2018), in which the Federal Circuit held that "pain alone, without an accompanying diagnosis of a present disease, can qualify as a disability" if it "reaches the level of a functional impairment of earning capacity." Id. at 1367-69. In this case, the Veteran reported back pain, but no diagnosis was found upon examination. Additionally, the Board notes that there are no treatment records in evidence that supports that the Veteran has been diagnosed with any back condition during or in proximity to the appeal period. Most importantly, there is no evidence the Veteran's back pain has resulted in any functional loss to the Veteran.

While the Veteran may believe he has a back disability, he is not competent to provide a diagnosis in this case. The issue is medically complex, as it requires specialized medical education. Jandreau v. Nicholson, 492 F.3d 1372, 1377, 1377 n.4 (Fed. Cir. 2007). Consequently, the Board gives more probative weight to the competent medical evidence.

While the Veteran may have pain in his back, without evidence of a current disability, the Board need not address the other elements of service connection. Because the first element of service connection for a low back condition is not met, the claim must be denied.

In reaching the above conclusion the Board has considered the applicability of the benefit of the doubt doctrine. However, as there is not an approximate balance of positive and negative evidence regarding the claim that doctrine is not applicable in this case. See 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102; Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021) (en banc).

2. Service connection for a left hip condition.

3. Service connection for right hip condition.

The Veteran contends that he is entitled to service connection for right and left hip conditions, secondary to his service-connected right knee disability. See May 2023 Claim VA Form 21-526EZ (Application for Disability Compensation and Related Compensation Benefits).

Again, the first element of service connection requires a current disability.

Here, the Veteran was afforded a VA examination for his bilateral hips in May 2023. See May 2023 C&P Exam. The Veteran reported the onset of his hip conditions in 2022 and explained that he experienced sharp pain in the bilateral hips with worsening symptoms with movements.

Upon examination, the examiner noted normal posture, gait, and range of motion. Importantly, the examiner noted the Veteran did not experience functional impairment to earning capacity as a result of his hip pain. The examiner found no current diagnosis for either
See May 2023 Claim VA Form 21-526EZ (Application for Disability Compensation and Related Compensation Benefits).

Again, the first element of service connection requires a current disability.

Here, while the Veteran has reported bilateral hip pain, no diagnosis was found on examination. Additionally, the Board notes that there are no treatment records in evidence that supports that the Veteran has been diagnosed with any hip conditions during or in proximity to the appeal period.

The Board has considered the holding in Saunders regarding whether the Veteran's subjective pain amounted to a disability. While the Veteran may have pain in his hips, there is no objective evidence contained within the record which demonstrates the Veteran's pain amounted to functional impact of earning capacity.

While the Veteran may believe he has a bilateral hip disability, he is not competent to provide a diagnosis in this case. The issue is medically complex, as it requires specialized medical education. Jandreau v. Nicholson, 492 F.3d 1372, 1377, 1377 n.4 (Fed. Cir. 2007). Consequently, the Board gives more probative weight to the competent medical evidence.

Paul R. Casey

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board M. Murphy

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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