Back to BVA DecisionsGRANTEDSpecial Benefit NO SPECIAL BENEFIT Docket No. 250424-542570
INTERVERTEBRAL DISC SYNDROME
M. SORISIO · 2026 · Case ID: A26013227
Summary
The Veteran, who served from August 1964 to August 1966, appeals the denial of service connection for lumbosacral strain, left hip strain, and right hip strain. The Veteran claims these conditions are secondary to his already service-connected left ankle sprain, asserting that the ankle injury causes him to limp and favor one side, leading to strain in his back and hips. The May 2024 rating decision had favorably found current diagnoses for these conditions and service connection for the left ankle sprain. A March 2024 VA examination opined that the lumbosacral and bilateral hip strains were less likely than not related to the service-connected ankle sprain, but the examiner failed to address whether the conditions were aggravated by the ankle sprain, rendering the opinion inadequate. In contrast, a December 2025 private medical opinion from Dr. V.W. concluded that the Veteran's lumbosacral and bilateral hip strains were at least as likely as not the result of the service-connected ankle sprains, providing a rationale that altered walking mechanics stressed the lumbar region. The Board found this private opinion probative and concluded the evidence was in approximate balance. Applying the benefit of the doubt, service connection for the lumbosacral strain and bilateral hip strains was granted.
Rationale
Favorable finding of current diagnosis for lumbosacral strain.; Favorable finding of service connection for left ankle sprain.; Inadequate VA exam opinion on aggravation.; Probative private medical opinion linking lumbosacral strain to ankle sprain.; Evidence in approximate balance.; Benefit of the doubt applied.
Full Decision Text
Citation Nr: A26013227 Decision Date: 02/12/26 Archive Date: 02/12/26 DOCKET NO. 250424-542570 DATE: February 12, 2026 ORDER Service connection for lumbosacral strain is granted. Service connection for left hip strain is granted. Service connection for right hip strain is granted. FINDINGS OF FACT 1. The evidence is at least in approximate balance as to whether the Veteran's lumbosacral strain is caused by his service-connected left ankle sprain. 2. The evidence is at least in approximate balance as to whether the Veteran's left hip strain is caused by his service-connected left ankle sprain. 3. The evidence is at least in approximate balance as to whether the Veteran's right hip strain is caused by his service-connected left ankle sprain. CONCLUSIONS OF LAW 1. The criteria for service connection for a lumbosacral strain as secondary to left ankle sprain are met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.310. 2. The criteria for service connection for a left hip strain as secondary to left ankle sprain are met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.310. 3. The criteria for service connection for a right hip strain as secondary to left ankle sprain are met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.310. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from August 1964 to August 1966. The rating decision on appeal was issued in May 2024 and constitutes an initial decision; therefore, the modernized review system, also known as the Appeals Modernization Act (AMA), applies. The Veteran has continuously pursued appeal from a May 2024 rating decision that denied service connection for lumbosacral strain, left hip strain, and right hip strain. In the April 2025 VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement), the Veteran elected the Hearing docket. A hearing before a Veterans Law Judge of the Board of Veterans' Appeals (Board) was held on October 21, 2025. A copy of the transcript has been associated with the record. Therefore, the Board may only consider the evidence of record at the time of the May 2024 AOJ decision on appeal for the issues of lumbosacral strain, left hip strain, and right hip strain, as well as any evidence submitted by the Veteran or his representative at the hearing or within 90 days following the hearing. 38 C.F.R. § 20.302(a). If evidence was submitted either (1) during the period after the AOJ issued the decision on appeal and prior to the Board hearing, or (2) more than 90 days following the hearing, the Board did not consider it in its decision. 38 C.F.R. §§ 20.300, 20.302(a), 20.801. ? Service Connection Service connection will be granted if the evidence demonstrates that a current disability resulted from an injury or disease incurred in or aggravated by active service, even if the disability was initially diagnosed after service. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303. Secondary service connection may be granted for a disability that is caused or aggravated by a service-connected disease or injury. 38 C.F.R. § 3.310. Establishing service connection on a secondary basis requires evidence sufficient to show (1) that a current disability exists, (2) that there is an already service-connected disability, and (3) that there is "but for" causation or aggravation of the disability for which service connection is sought by a service-connected disability. See Spicer v. McDonough, 61 F.4th 1360, 1363 (Fed. Cir. 2023) (invalidating the requirement of "proximate cause" and holding "but for" causation or aggravation is enough to show entitlement to secondary service connection). 1. Service connection for a lumbosacral strain is granted. 2. Service connection for a left hip strain is granted. 3. Service connection for a right hip strain is granted. The Veteran contends that he has a lumbosacral strain and bilateral hip strains secondary to his service-connected left ankle sprain. He reports that his service-connected of the disability for which service connection is sought by a service-connected disability. See Spicer v. McDonough, 61 F.4th 1360, 1363 (Fed. Cir. 2023) (invalidating the requirement of "proximate cause" and holding "but for" causation or aggravation is enough to show entitlement to secondary service connection). 1. Service connection for a lumbosacral strain is granted. 2. Service connection for a left hip strain is granted. 3. Service connection for a right hip strain is granted. The Veteran contends that he has a lumbosacral strain and bilateral hip strains secondary to his service-connected left ankle sprain. He reports that his service-connected left ankle sprain requires him to limp on his ankle and constantly favor one side to compensate for the injured side, in turn hurting other parts of his body and causing problems with his back and bilateral hips. See October 2025 Transcript. The May 2024 rating decision made favorable findings that the Veteran is currently diagnosed with a lumbosacral strain, left hip strain, and right hip strain, and that the Veteran is service connected for a left ankle sprain. The Board is bound by these favorable findings. 38 C.F.R. § 3.104. The Veteran was provided with a VA examination in March 2024 for his lumbosacral strain, left hip strain, and right hip strain. The VA examiner opined that the Veteran's lumbosacral strain, left hip strain, and right hip strain were less likely than not proximately due to or the result of the Veteran's service-connected disabilities, to include his left ankle sprain. As to the Veteran's lumbosacral strain, the VA examiner rationalized that the lumbar spine and the ankle joint have distinct roles in motion and function due to their different anatomical structures and locations in the body. As to the Veteran's bilateral hip strains, the VA examiner rationalized that the hip and ankle joints serve distinct functions due to their anatomical structures and positions. The examiner further rationalized that the claimed disorders are separate entities entirely from the service-connected condition and unrelated to it, and that there is no anatomical, pathophysiological, neuronal, hormonal, or pharmacological correlation to causation. The examiner provided a rationale based on the Veteran's particular history in determining that the Veteran's lumbosacral strain and bilateral hip strains were not "proximately due to or the result of" the Veteran's service-connected left ankle sprain, and the opinions are entitled to probative value on whether the Veteran's left ankle sprain caused the claimed disabilities. However, the examiner failed to address whether the Veteran's lumbosacral strain and bilateral hip strains were aggravated by the service-connected left ankle sprain. Therefore, the opinions are inadequate as related to whether the Veteran's lumbosacral strain and bilateral hip strains were aggravated by his left ankle sprain, as they did not address this question at all. See El-Amin v. Shinseki, 26 Vet. App. 136 (2013) (finding that an examination was inadequate on the question of aggravation when aggravation was not addressed by the examiner). In a December 2025 private medical opinion, Dr. V.W. concluded that the Veteran's lumbosacral strain is at least as likely as not the result of the Veteran's service-connected bilateral ankle strains. Dr. V.W. further opined that it is at least as likely as not that the Veteran's current bilateral hip strains are the result of the service-connected ankle strains. In support of the opinion, Dr. V.W. reasoned that the bilateral alterations in the normal walking mechanics produced more stress on the muscles of the lumbar region, causing the lumbosacral strain. While the opinion is not flawless, the opinion has a clear conclusion and rationale based on the provider's examination of the Veteran's medical history and serves to link the claimed lumbosacral strain and bilateral hip strains to the service-connected bilateral ankle strains. See Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 304 (2008). Therefore, the Board assigns this opinion probative weight. As such, the Board concludes that the evidence is at least in approximate balance as to whether the Veteran's lumbosacral strain and bilateral hip strains are caused by his service-connected left ankle sprain. Therefore, the Board resolves all reasonable doubt in the Veteran's favor and grants service connection for lumbosacral strain and bilateral hip strains. 38 U.S.C. § 5107; 38 C.F.R. § 3.102. M. SORISIO bilateral ankle strains. See Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 304 (2008). Therefore, the Board assigns this opinion probative weight. As such, the Board concludes that the evidence is at least in approximate balance as to whether the Veteran's lumbosacral strain and bilateral hip strains are caused by his service-connected left ankle sprain. Therefore, the Board resolves all reasonable doubt in the Veteran's favor and grants service connection for lumbosacral strain and bilateral hip strains. 38 U.S.C. § 5107; 38 C.F.R. § 3.102. M. SORISIO Veterans Law Judge Board of Veterans' Appeals Attorney for the Board K. Knerr 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.