CERVICAL SPINE LIMITATION OF MOTION

Summary

The Veteran, who served from April 1996 to August 1996, February 2003 to March 2004, and September 2005 to July 2013, appeals the denial of service connection for a neck disorder. The Veteran claims this neck condition is secondary to his service-connected lumbar spine, right foot, and bilateral knee disabilities. The Board reviewed evidence including the Veteran's testimony and a VA rating decision that noted treatment for neck pain. A private nurse practitioner, A.W., provided a statement in June 2024, opining that the Veteran's cervical spine condition began during active duty, though without specific rationale. However, A.W. also opined that the Veteran's neck disorder was as likely as not aggravated by his service-connected lumbar spine, bilateral knee, and right foot conditions, explaining that the gait alterations caused by the lower extremity disabilities affected his neck. The Board found this opinion probative, noting it was based on the Veteran's medical history and current medical understanding, and that no contrary opinion was of record. The Board concluded that the Veteran's neck disorder was caused or worsened by his service-connected lumbar spine, right foot, and bilateral knee disabilities. Consequently, service connection for the neck disorder is granted.

Rationale

Private medical opinion found neck disorder aggravated by service-connected lower extremity disabilities; Opinion based on Veteran's medical history and current medical understanding; No contrary opinion of record

Full Decision Text

Citation Nr: A26023906
Decision Date: 03/17/26	Archive Date: 03/17/26

DOCKET NO. 201216-126596
DATE:    March 17, 2026

ORDER

Entitlement to service connection for a neck disorder, to include as secondary to a service-connected disability, is granted.

FINDING OF FACT

The Veteran's neck disorder is due to his service-connected lumbar spine, right foot, and bilateral knee disabilities.

CONCLUSION OF LAW

The criteria for service connection for a neck disorder have been met. 38 U.S.C. § 1110; 38 C.F.R. § 3.102, 3.303, 3.310.

REASONS AND BASES FOR FINDING AND CONCLUSION

The Veteran served on active duty from April 1996 to August 1996, from February 2003 to March 2004, and from September 2005 to July 2013.

This case comes before the Board of Veterans' Appeals (Board) on appeal from a September 2020 higher-level review decision of a February 2020 rating decision issued by the Department of Veterans Affairs (VA).

The Veteran submitted a VA Form 10182 in December 2020 and elected to have a hearing before a Veterans Law Judge.  Therefore, the Board may only consider the evidence of record at the time of the February 2020 agency of original jurisdiction (AOJ) decision, which was subsequently subject to higher-level review, 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 February 2020 rating decision and prior to the date the Board received the VA Form 10182, or (2) more than 90 days following the date of the hearing, the Board did not consider it in its decision. 38 C.F.R. § 20.302. 

If the Veteran would like VA to consider any evidence that was submitted that the Board could not consider, he 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 claims, considering the new evidence in addition to the evidence previously considered.  Id. Specific instructions for filing a supplemental claim are included with this decision.

A hearing was held before the undersigned in May 2024.  A transcript of the proceeding is of record.

Law and Analysis

Service connection may be established for disability resulting from personal injury suffered or disease contracted in line of duty in the active military, naval, or air service. 38 U.S.C. §§ 1110, 1131.  That an injury or disease occurred in service is not enough; there must be chronic disability resulting from that injury or disease. If there is no showing of a resulting chronic condition during service, then a showing of continuity of symptomatology after service is required to support a finding of chronicity. 38 C.F.R. § 3.303(b).  Service connection may also 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).

Service connection may also be granted on a secondary basis for disability which is due to or the result of a service-connected disease or injury. 38 U.S.C. §§ 1110; 38 C.F.R. § 3.310(a); Spicer v. McDonough, 61 F.4th 1360 (Fed. Cir. 2023) (Fed. Cir. 2023) (holding that, under the causation standard of 38 U.S.C. § 1110, secondary service connection is warranted where a nonservice-connected disability would have been less severe but-for a service-connected disability, either because there is an etiological link (to include worsening of functionality) between the two, or because the service-connected disability resulted in the inability to treat the non-service-connected disability). The Federal Circuit has held that 38 C.F.R. § 3.310(b) is inconsistent with 38 U.S.C. § 1110. Id.

Except as otherwise provided by law, a claimant has the responsibility to present and support a claim for benefits. VA shall consider all information and lay and medical evidence of record in a case and when 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. 
 service-connected disability, either because there is an etiological link (to include worsening of functionality) between the two, or because the service-connected disability resulted in the inability to treat the non-service-connected disability). The Federal Circuit has held that 38 C.F.R. § 3.310(b) is inconsistent with 38 U.S.C. § 1110. Id.

Except as otherwise provided by law, a claimant has the responsibility to present and support a claim for benefits. VA shall consider all information and lay and medical evidence of record in a case and when 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; Lynch v. McDonough, 21 F.4th 776, 781 (Fed. Cir. 2021) (benefit-of-the-doubt rule not for application when evidence persuasively favors one side or the other). 

In considering the evidence of record under the laws and regulations as set forth above, the Board finds that the Veteran is entitled to service connection for a neck disorder. 

The Veteran has asserted that he has a neck disability that was caused or worsened by his service-connected back, knee, and foot disabilities.  See May 2024 Hearing Transcript.  The February 2020 rating decision also made the favorable finding that the Veteran had been treated for neck pain. 

In June 2024, the Veteran submitted a statement from A.W. (initials used to protect privacy), a nurse practitioner.  A.W. noted that the Veteran had a cervical spine condition and was receiving treatment at her facility, Bellevue Family Medicine.  She opined that it was as likely as not that the Veteran's condition began during active duty, however she provided no rationale for the opinion.  See Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 304 (2008) (most of the probative value of a medical opinion comes from its reasoning).   

However, A.W. also opined that it is as likely as not that the Veteran's cervical spine disorder was aggravated by his service-connected lumbar spine, bilateral knee, and right foot conditions.  She explained that his service-connected right foot and bilateral knee disabilities altered the Veteran's gait, which affected his neck disorder.  

In reviewing A.W.'s opinion in the context of the other evidence of record, the Board finds that her determination was based on her consideration of the Veteran's medical history as well as her current medical understanding.  Therefore, the medical opinion should be afforded probative weight.  See Monzingo v. Shinseki, 26 Vet. App. 97, 106 (2012) (providing that an examination is not rendered inadequate where rationale provided by examiner "did not explicitly lay out the examiner's journey from the facts to a conclusion"); Acevedo v. Shinseki, 25 Vet. App. 286, 294 (2012) (stating that medical reports must be read as a whole and in context of evidence of record).  There is also no contrary opinion of record.

    

Based on the foregoing, the Board finds that the Veteran's neck disorder was caused or worsened by his service-connected lumbar spine, right foot, and bilateral knee disabilities.  As such, service connection for a neck disorder is granted.

 

J. SAIKH

Acting Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	Deverter, Rebecca M.

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.