DEGENERATIVE ARTHRITIS OF THE SPINE (SPONDYLOSIS)

D. MARTZ AMES · 2026 · Case ID: A26023168

GRANTED

Summary

The Veteran, a Navy Veteran who served from March 2001 to March 2007, appeals the denial of service connection for a back disability, a left leg disability, and a left ankle disability. The Veteran contends these conditions were incurred during or caused by his active service. The Board reviewed evidence including a January 2021 VA examination which found no current left leg or ankle disability, but the Board found these opinions inadequate as they did not consider all evidence. The Veteran submitted a January 2025 private medical opinion which found it was at least as likely as not that the back, left leg, and left ankle conditions were related to service, citing a 2001 in-service injury and subsequent treatment, as well as repetitive stress from submariner duties. This opinion was found thorough, well-reasoned, competent, and credible by the Board. The Board also considered a May 2017 opinion positive for service connection for back pain, and a February 2021 opinion negative for back disability. Finding the evidence in equipoise, the Board applied the benefit of the doubt and granted service connection for the back disability. Based on the persuasive private opinion and the granting of service connection for the back, the Board also granted service connection for the left leg and left ankle disabilities, finding them incurred during or caused by service, with the left ankle being secondary to the service-connected back condition. Service connection for all three conditions was granted.

Rationale

Private medical opinion found it at least as likely as not related to service; Evidence in equipoise, benefit of the doubt applied; Service treatment records noted in-service complaints

Service Branch

NAVY

Special Benefit

NO SPECIAL BENEFIT

Docket No.

210308-146623

Full Decision Text

Citation Nr: A26023168
Decision Date: 03/13/26 Archive Date: 03/13/26

DOCKET NO. 210308-146623
DATE: March 13, 2026

ORDER

Entitlement to service connection for a back disability is granted.

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

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

FINDINGS OF FACT

1. The Veteran's current back disability was incurred during or caused by his period of active service.

2. The Veteran's current left leg disability was incurred during or caused by his period of active service.

3. The Veteran's current left ankle disability was caused by his service-connected low back disability.

CONCLUSIONS OF LAW

1. The criteria for service connection for a low back disability are met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303.

2. The criteria for service connection for a left leg disability are met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303.

3. The criteria for service connection for a left ankle disability are met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.310.

REASONS AND BASES FOR FINDING AND CONCLUSION

The Veteran served on active duty with the United States Navy from March 2001 to March 2007.

The rating decision on appeal was issued in February 2021 and constitutes an initial decision; therefore, the modernized review system, also known as the Appeals Modernization Act (AMA), applies. In the March 2021 VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement), the Veteran elected the Hearing docket. A Board hearing was held on October 21, 2024.

Therefore, the Board may only consider the evidence of record at the time of the February 2021 agency of original jurisdiction (AOJ) decision on appeal, 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).

Evidence was submitted during the period after the AOJ issued the decision on appeal and prior to the Board hearing, and more than 90 days following the hearing, and the Board did not consider it in its decision. 38 C.F.R. §§ 20.300, 20.302(a), 20.801.

The Board must determine the value of all evidence submitted, including lay and medical evidence. Buchanan v. Nicholson, 451 F.3d 1331 (Fed. Cir. 2006). The evaluation of evidence generally involves a three-step inquiry. First, the Board must determine whether the evidence comes from a "competent" source. The Board must then determine if the evidence is credible, or worthy of belief. Barr v. Nicholson, 21 Vet. App. 303, 308 (2007). The third step of this inquiry requires the Board to weigh the probative value of the evidence in light of the entirety of the record.

Neither the Veteran nor his representative have raised any issues with the duty to notify or duty to assist that occurred prior to the rating decision on appeal. See Scott v. McDonald, 789 F.3d 1375, 1381 (Fed. Cir. 2015) (holding that "the Board's obligation to read filings in a liberal manner does not require the Board... to search the record and address procedural arguments when the veteran fails to raise them before the Board."); Dickens v. McDonald, 814 F.3d 1359, 1361 (Fed. Cir. 2016) (applying Scott to a duty to assist argument).

Service Connection

Service connection may be granted 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. That an injury or disease occurred in service is not enough; there must be chronic disability resulting from that injury or disease. In order to prevail on the issue of service connection there must be competent evidence of a current disability; medical evidence, or in certain circumstances, lay evidence of in-service occurrence or aggravation of a disease or injury; and competent evidence of a nexus between an in-service injury or disease and the current disability. See Hickson v. West, 12 Vet. App. 247,
Connection

In addition, where a veteran asserts entitlement to a chronic disease but there is insufficient evidence of a diagnosis in service, service connection may be established under 38 C.F.R. § 3.303(b) by demonstrating a continuity of symptomatology since service, but only if the chronic disease is listed under 38 C.F.R. § 3.309(a). Walker v. Shinseki, 708 F.3d 1331 (Fed. Cir. 2013).

When a chronic disease manifests to a degree of 10 percent or more within 1 year from the date of separation from service, that disease is presumptively service-connected. 38 C.F.R. §§ 3.303 (b), 3.307(a)(3). The Veteran's claimed back disability, to include degenerative arthritis of the spine, is a chronic disease as defined by 38 C.F.R. § 3.309(a).

When a disease is first diagnosed after service, service connection is warranted for that condition if the competent evidence shows it was incurred in service. 38 C.F.R. § 3.303(d).

Service connection may be established on a secondary basis for a disability which is proximately due to or the result of a service-connected disease or injury. 38 C.F.R. § 3.310(a). Secondary service connection may also be established for a nonservice-connected disability which is aggravated by a service-connected disability. In such an instance, the Veteran may be compensated for the degree of disability over and above the degree of disability existing prior to the aggravation. 38 C.F.R. § 3.310(b); see Allen v. Brown, 7 Vet. App. 439, 448 (1995).

1. Entitlement to service connection for a low back disability

The Veteran contends that his current back injury was incurred during or caused by his period of active service.

The Veteran has a current diagnosis of a back disability, degenerative arthritis and intervertebral disc syndrome was diagnosed at a January 2021 back conditions examination. Further, the Veteran's service treatment records note complaints of back pain in October 2001, and again in a report of medical history in May 2006. At issue in the Veteran's claim is whether his current back disability is related to his injuries during active service.

In January 2025, during a period eligible for evidence submission, the Veteran submitted a private medical opinion regarding the etiology of his current back disability. The medical opinion was completed after a thorough review of the Veteran's medical and service treatment records. After review, the medical physician determined it was at least as likely as not that the Veteran's back disability was incurred during or caused by his period of active service. The medical physician reasoned:

It is my opinion that [the Veteran's] current degenerative spinal condition is "more likely than not (a 50% or greater chance") a condition that was initiated in 2001 and established with military examiners diagnosis and treatment at that time. The reason I come to this conclusion is because there is a specific date and place of the injury in 2001 and that he immediately sought and continued to seek medical treatment for his injuries and symptoms...

[The Veteran] has sought diagnostic testing and treatment for his decades long condition which has consistently exhibited the initial symptoms and complaint since 2001...

It is my opinion that [the Veteran's] current degenerative spinal condition and radiculopathies are "more likely than not (a 50% or greater chance") directly due to his 2001 fall injury and the negative impact to his lower kinetic chain which includes his low back, hips, lower extremities, knees, ankles and feet. My opinion is substantiated by the pathobiomechanics seen on [the Veteran's] lumbar x-ray films, MRI and CT scans and the full body scan from Family Chiropractic Complex.

The Board finds that the
...

[The Veteran] has sought diagnostic testing and treatment for his decades long condition which has consistently exhibited the initial symptoms and complaint since 2001...

The Board finds that the January 2025 medical opinion is thorough and well-reasoned. The medical physician is competent and credible. The Board finds the January 2025 medical opinion is highly probative evidence in favor of the Veteran's claim for service connection.

The record further contains a May 2017 medical opinion that is positive for service connection for back pain, and a February 2021 medical opinion that is negative for service connection for a back disability. Affording full credit to the addition medical opinions and assigning maximum probative value to the medical opinions, the Board finds that the probative evidence of record is at least in equipoise. In Lynch v. McDonough, 21 F.4th 776 (2021), the Federal Circuit held that a veteran is entitled to the benefit of the doubt when the evidence is in approximate balance, or nearly equal, and does not require that the evidence be in exact equipoise for benefit of the doubt to apply. Accordingly, after resolving all doubt in favor of the Veteran, the Board finds that service connection for a low back disability is warranted, and the claim is granted. 38 U.S.C. § 5107; 38 C.F.R. § 3.102.

2. Entitlement to service connection for a left leg disability, to include as secondary to a service-connected low back disability

3. Entitlement to service connection for a left ankle disability, to include as secondary to a service-connected low back disability

The Veteran contends that his current left leg and left ankle disabilities were incurred during his period of active service.

The Veteran has a current left leg disability and a current left ankle disability, as confirmed in a January 2025 private medical opinion, noting that he experienced radiculopathy in his left leg, and alterations of the kinetic chain resulting in left ankle pain and swelling.

In January 2025, during a period eligible for evidence submission, the Veteran submitted a private medical opinion regarding the etiology of his current back disability. The medical opinion was completed after a thorough review of the Veteran's medical and service treatment records. After review, the medical physician determined it was at least as likely as not that the Veteran's left leg and ankle disabilities were related to his period of active service. The examiner reasoned:

It is my opinion that [the Veteran's] progressive degenerative spinal disc and joint disease, as revealed by his multiple MRI scans, is evidence that his back and low kinetic chain co-condition has progressed over time and ultimately degraded to the necessity for spinal hernia surgery, which are "more likely than not (a 50% or greater chance") due to his initial injuries in 2001.

As a submariner for 6 years, [the Veteran] has doubtlessly been subjected to micro trauma repetitive stress activities. I have sighted multiple published peer-reviewed studies, some of which have been published by the navy and other military divisions. In these published studies it is noted that military personal from all groups, including the Navy, have noted that military personnel are subjected to significant repetitive stress type injuries and that low back and knee conditions are very common. Repetitive stress injuries are micro traumas to the body -joints that are over used, over stressed, high demand for loaded work under fatigued conditions. These work-related repetitive stress conditions are cumulative on the body and should be seriously considered as part of the reason that [the Veteran's] low back, hips, knees, ankles and feet are part of his current complex of health issues...

It is my opinion that, it is As Likely As Not (50% or greater likelihood) that [the Veteran's
military divisions. In these published studies it is noted that military personal from all groups, including the Navy, have noted that military personnel are subjected to significant repetitive stress type injuries and that low back and knee conditions are very common. Repetitive stress injuries are micro traumas to the body -joints that are over used, over stressed, high demand for loaded work under fatigued conditions. These work-related repetitive stress conditions are cumulative on the body and should be seriously considered as part of the reason that [the Veteran's] low back, hips, knees, ankles and feet are part of his current complex of health issues...

It is my opinion that, it is As Likely As Not (50% or greater likelihood) that [the Veteran's] lumbar spine, hips, knees, ankles and feet conditions have been worsened as a result of repetitive stress, microtraumas, he sustained as a result of the required activities while a submariner.

The record contains January 2021 medical opinions noting that the Veteran does not have a current left leg or left ankle disability. However, the Board finds that the January 2021 medical opinions are inadequate for rating purposes as they do not consider the medical evidence of record. Accordingly, the Board assigns no probative value to the January 2021 medical opinions.

Based on the most persuasive evidence of record, the Board finds that the Veteran's left leg and left ankle disabilities were incurred during or caused by his period of active service. Accordingly entitlement to service connection for left leg and left ankle disabilities is warranted.

D. Martz Ames

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board B. Riordan, 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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