CERVICAL SPINE LIMITATION OF MOTION

TIMOTHY COTHREL · 2026 · Case ID: A26021207

GRANTED

Summary

The veteran, who served from February 2002 to February 2006, appeals the denial of service connection for a cervical spine disability, a left knee disability, and a right hip disability. The veteran sought to reopen these claims after the Regional Office denied them in April 2018, finding no service connection. New and relevant evidence was submitted, including a physical therapy note from April 2020, VA examination reports from December 2024 and February 2025, and statements from the veteran. A buddy statement from the veteran's former Battalion Operations Officer in April 2025 also corroborated an in-service injury during military training. The Board found that while the evidence was less than compelling without a specific medical opinion supporting service connection, it was sufficient to apply the benefit-of-the-doubt doctrine. The Board concluded that the veteran's inherently plausible, detailed, and internally consistent accounts of the onset and persistence of her disabilities, combined with the other evidence, entitled her to service connection for all three claimed conditions. The appeal was granted.

Rationale

New and relevant evidence received; Buddy statement corroborated in-service injury; Veteran's accounts inherently plausible and consistent; Benefit of the doubt applied

Special Benefit

NO SPECIAL BENEFIT

Docket No.

250730-567015

Full Decision Text

Citation Nr: A26021207
Decision Date: 03/10/26 Archive Date: 03/10/26

DOCKET NO. 250730-567015
DATE: March 10, 2026

ORDER

New and relevant evidence has been received to readjudicate the service connection claim for a cervical spine disability, to include as secondary to service-connected right knee and/or right ankle disability.

New and relevant evidence has been received to readjudicate the service connection claim for a left knee disability, to include as secondary to service-connected right knee and/or right ankle disability.

New and relevant evidence has been received to readjudicate the service connection claim for a right hip disability, to include as secondary to service-connected right knee and/or right ankle disability.

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

Entitlement to service connection for a left knee disability is granted.

Entitlement to service connection for a right hip disability is granted.

FINDINGS OF FACT

1. New evidence has been received after the September 2023 rating decision that is new and relevant to the issue of entitlement to service connection claim for a cervical spine disability, to include as secondary to service-connected right knee and/or right ankle disability.

2. New evidence has been received after the September 2023 rating decision that is new and relevant to the issue of entitlement to service connection for a left knee disability, to include as secondary to service-connected right knee and/or right ankle disability.

3. New evidence has been received after the September 2023 rating decision that is new and relevant to the issue of entitlement to service connection for a right hip disability, to include as secondary to service-connected right knee and/or right ankle disability.

4. The Veteran's cervical spine, left knee, and right hip injuries were caused by in-service injuries.

CONCLUSIONS OF LAW

1. New and relevant evidence has been received subsequent to the April 2018 rating decision; therefore, readjudication of the claim of entitlement to service connection for entitlement to service connection claim for a cervical spine disability, to include as secondary to service-connected right knee and/or right ankle disability, is required. 38 U.S.C. § 5108; 38 C.F.R. § 3.156(a).

2. New and relevant evidence has been received subsequent to the April 2018 rating decision; therefore, readjudication of the claim of entitlement to service connection for service connection for a left knee disability, to include as secondary to service-connected right knee and/or right ankle disability, is required. 38 U.S.C. § 5108; 38 C.F.R. § 3.156(a).

3. New and relevant evidence has been received subsequent to the April 2018 rating decision; therefore, readjudication of the claim of entitlement to service connection for service connection for a right hip disability, to include as secondary to service-connected right knee and/or right ankle disability, is required. 38 U.S.C. § 5108; 38 C.F.R. § 3.156(a).

4. The criteria for service connection for a cervical spine disability have been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.103, 3.303.

5. The criteria for service connection for a let knee disability have been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.103, 3.303.

6. The criteria for service connection for a right hip disability have been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.103, 3.303.

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Veteran served on active duty from February 2002 to February 2006.

This matter is before the?Board of Veterans' Appeals?(Board) on appeal from a February 2025 Appeals Modernization Act (AMA) rating decision by the Department of Veterans Affairs (VA) Regional Office (RO).

Following the May 2021 AMA rating decision, the RO received a VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement) in July 2025, and the Veteran requested Evidence Lane. Accordingly, the Board may consider evidence of record as of the February 2025 rating decision and evidence submitted within 90 days of the receipt of the VA Form 10182.

1. New and relevant evidence supporting service connection for a cervical spine disability.

2. New and relevant evidence supporting service connection for a left knee disability.

3. New and relevant evidence supporting service connection for a right hip disability.

If new and relevant evidence is presented or secured with respect
Affairs (VA) Regional Office (RO).

1. New and relevant evidence supporting service connection for a cervical spine disability.

2. New and relevant evidence supporting service connection for a left knee disability.

3. New and relevant evidence supporting service connection for a right hip disability.

If new and relevant evidence is presented or secured with respect to a supplemental claim, the Secretary shall readjudicate the claim taking into consideration all of the evidence of record. 38 U.S.C. § 5108. New evidence means existing evidence not previously submitted to agency decisionmakers. Relevant evidence means evidence that tends to prove or disprove a matter in issue. 38 U.S.C. § 101(35).

The Board finds that new and relevant evidence has been submitted to readjudicate the claims of service connection for a cervical spine disability, a left knee disability and a right hip disability. The claims were previously denied by the Agency of Original Jurisdiction (AOJ) in an April 2018 rating decision. At that time, the AOJ determined for the cervical spine disability that since the condition neither occurred in nor was caused by service, it was denied. For the Veteran's claimed left knee and right hip disabilities, service connection on a direct basis was denied since the conditions neither occurred in nor were caused by service and since the evidence did not show that a status post left knee surgery or right hip strain were related to the service-connected right knee disability. The VA opinions used in this rating decision noted that the Veteran's left knee and right hip disabilities were not caused by the service-connected disability, but there was no discussion in those opinions concerning potential aggravation.

In November 2024, the Veteran timely filed a claim seeking to reopen the April 2018 rating decision denials of the service connection claims. In the February 2025 rating decision, the AOJ found that new and relevant evidence had not been received to readjudicate the previously denied service connection claims. Of note, a favorable finding of diagnosed disabilities for each claimed condition was found.

However, the Board finds that the following new and relevant evidence has been received since the April 2018 rating decision: April 2020 physical therapy note from S.B, December 2024 and February 2025 VA examination reports and statements by the Veteran. This evidence is new because it was not previously part of the actual record before agency adjudicators. It is also relevant because it tends to prove or disprove matters at issue in the claims.

Therefore, new and relevant evidence has been received to readjudicate the service connection claims for a cervical spine disability, a left knee disability and a right hip disability.

4. Service connection for a cervical spine disability.

5. Service connection for a left knee disability.

6. Service connection for a right hip disability.

When adjudicating entitlement to service connection, only a "but-for" causal relationship between an in-service disease or injury and a present disability is required. Thus, an in-service injury, disease, or event need not be the sole or even the primary cause of the present disability, provided it was an essential factor in the development of the disability. In other words, no matter how much or how many other factors contributed to the claimed disability, if removing the service-connected injury, disease, or event from the equation would have prevented the disability, then service was an essential factor in and a "but-for" cause of the disability, and therefore, service connection is established. Spicer v. McDonough, 61 F.4th 1360, 1363 (Fed. Cir. 2023); see also, Burrage v. United States, 571 U.S. 204, 211-12 (2014).

When adjudicating entitlement to service connection, the Veteran is entitled to a favorable finding when positive evidence is at least "approximately balanced" with or "nearly equal" to the negative evidence on any material issue, thereby triggering the benefit-of-the-doubt doctrine. 38 U.S.C. § 5107; 38 C.F.R. § 3.102; Ortiz v. Principi, 274 F.3d 131, 1365 (Fed. Cir. 2001).

In American jurisprudence, there is a "wide spectrum" of standards, and the VA's benefit-of-the-doubt doctrine lies at "the farthest end of the spectrum...." Gilbert v.
(2014).

In American jurisprudence, there is a "wide spectrum" of standards, and the VA's benefit-of-the-doubt doctrine lies at "the farthest end of the spectrum...." Gilbert v. Derwinski, 1 Vet. App. 49, 53-54 (1990). That is, no party in any forum is entitled to greater deference in establishing their case than a veteran who has brought an appeal to the Board. See also, Wise v. Shinseki, 26 Vet. App. 517, 531 (2014) (the benefit-of-the-doubt doctrine was created to be "intentionally generous" in recognition of the nation's great debt to its veterans).

Here, there is no question that the Veteran has the claimed disabilities. Therefore, the Board need determine only if there is enough evidence concerning their origin to trigger the benefit-of-the-doubt doctrine as to the existence of a but-for causal relationship between those disabilities and the Veteran's service.

The medical evidence provided in July 2025 concerning the nature of the Veteran's disabilities included references to neck, lower extremity and knee injuries om 2005, which was during the Veteran's time in service. Additionally, the Veteran provided a "buddy statement" from her former Battalion Operations Officer in April 2025 that expressly mentioned the Veteran injuring herself during military training. Finally, the Veteran has provided inherently plausible, well detailed, and internally consistent accounts of the onset and persistence of her disabilities.

All told, without a medical opinion supporting service connection, the evidence as a whole admittedly remains less than compelling, but it is nonetheless sufficient to entitle the Veteran to the benefit of the doubt and, as a result, to service connection for these disabilities. This appeal is granted.

Timothy Cothrel

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board Evans, A-L

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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