Back to BVA DecisionsDENIEDSpecial Benefit NO SPECIAL BENEFIT Docket No. 200928-112619
INTERVERTEBRAL DISC SYNDROME
S. HENEKS · 2026 · Case ID: A26024687
Summary
The veteran, who served from August 1991 to February 2001, appeals the denial of service connection for a lumbar spine disability and bilateral hip disabilities. The veteran contended that the lumbar spine condition stemmed from an in-service fall and subsequent worsening, while the hip conditions were claimed as secondary to a service-connected bilateral knee disability. The Board reviewed the evidence, including service treatment records, post-service treatment records, and multiple VA examinations. For the lumbar spine, while service treatment records showed an in-service lumbar strain, the veteran denied recurrent back pain at separation and did not report back pain until years after service. VA examiners opined the current degenerative disc disease was less likely than not related to service or aggravated by the knee condition, citing the chronic nature of the condition and the lengthy period between service and symptom onset. The Board found the contemporaneous medical evidence more persuasive than the veteran's later reports. For the bilateral hip conditions, service treatment records were silent, and post-service records showed no complaints until years after separation. VA examiners found no causal link between the service-connected knee disability and the hip conditions, noting different pathophysiologies and the lack of medical literature supporting such a connection. The Board found the evidence weighed against the claims, denying service connection for all three conditions.
Rationale
Contemporaneous medical evidence more probative than later statements; VA examiner opinions found less likely than not related to service/aggravated by knee disability; Lengthy period between service and symptom onset weighs against claim
Full Decision Text
Citation Nr: A26024687 Decision Date: 03/18/26 Archive Date: 03/18/26 DOCKET NO. 200928-112619 DATE: March 18, 2026 ORDER Entitlement to service connection for a lumbar spine disability, to include on a secondary basis, is denied. Entitlement to service connection for a left hip disability, to include on a secondary basis, is denied. Entitlement to service connection for a right hip disability, to include on a secondary basis, is denied. FINDINGS OF FACT 1. The Veteran's lumbar spine disability has not been linked by probative evidence to an in-service disease or injury, or a service-connected disability. 2. The Veteran's left hip disability has not been linked by probative evidence to an in-service disease or injury, or a service-connected disability. 3. The Veteran's right hip disability has not been linked by probative evidence to an in-service disease or injury, or a service-connected disability. CONCLUSIONS OF LAW 1. The criteria for service connection for a lumbar spine disability, to include on a secondary basis, have not been met. 38?U.S.C. §§?1101, 1110, 1112, 1113, 5103, 5103(a), 5107; 38?C.F.R. §§?3.102, 3.159, 3.303, 3.310. 2. The criteria for service connection for a left hip disability, to include on a secondary basis, have not been met. 38?U.S.C. §§?1101, 1110, 1112, 1113, 5103, 5103(a), 5107; 38?C.F.R. §§?3.102, 3.159, 3.303, 3.310. 3. The criteria for service connection for a right hip disability, to include on a secondary basis, have not been met. 38?U.S.C. §§?1101, 1110, 1112, 1113, 5103, 5103(a), 5107; 38?C.F.R. §§?3.102, 3.159, 3.303, 3.310. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from August 1991 to February 2001. The Board notes this claim was originally denied in a May 2017 rating decision, which the Veteran disagreed with in a December 2017 notice of disagreement. The Veteran selected the Supplemental Claim lane when he submitted his Rapid Appeals Modernization Program (RAMP) election form in May 2018. See May 2018 RAMP Opt-in Election. In an August 2019 rating decision, the RO continued to deny the claims on appeal. In an August 2019 VA Form 20-0996, the Veteran requested Higher-Level Review of that decision, which was continued in a September 2019 rating decision. In September 2020, the Veteran submitted VA Form 10182 and selected the hearing docket. In May 2024, the Veteran testified at a Board hearing before the undersigned Veterans Law Judge (VLJ). A transcript of the hearing has been associated with the record. When the Agency of Original Jurisdiction (AOJ) issues a Higher-Level Review decision, the evidentiary record is limited to the evidence of record as of the date the AOJ issued notice of the decision under review. 38 C.F.R. § 3.2601(f). Thus, the Board can only consider the evidence of record at the time of the August 2019 rating decision prior to the Higher-Level Review decision, as well as any evidence submitted by the Veteran or his representative at the May 2024 Board hearing, or within 90 days of the Board hearing. 38 C.F.R. § 20.303. If evidence was submitted either (1) during the period after the AOJ issued the August 2019 rating decision or (2) more than 90 days following the date of the Board hearing, the Board did not consider it in its decision. 38 C.F.R. §§ 20.300, 20.303, 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 38 C.F.R. § 20.303. If evidence was submitted either (1) during the period after the AOJ issued the August 2019 rating decision or (2) more than 90 days following the date of the Board hearing, the Board did not consider it in its decision. 38 C.F.R. §§ 20.300, 20.303, 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, 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 granted for disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303. Establishing service connection generally requires evidence of (1) a current disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a nexus between the claimed in-service disease or injury and the present disability. Shedden v. Principi, 381 F.3d 1163 (Fed. Cir. 2004); 38 C.F.R. § 3.303. 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. 38 C.F.R. § 3.310(a), (b). Secondary causation exists when, but for the service-connected disability, the non-service-connected was caused by a service-connected disability either in a direct, etiological way or via multiple steps in a causal chain. Spicer v. McDonough, 61 F.4th 1360, 1365 (Fed. Cir. 2023) (citations omitted). Secondary aggravation exists when the non-service-connected disability not caused by a service-connected disability would be less severe were it not for a service-connected disability. Id. at 1364. For example, secondary aggravation may be established where the natural progression of the non-service-connected disability could have been arrested or improved but for the service-connected disability. 1. Entitlement to service connection for a lumbar spine disability, to include on a secondary basis, is denied. The Veteran seeks service connection for a lumbar spine disability, which he contends began during service and has continued since that time. Specifically, he has attributed this condition to a fall in the shipyard between 1992 and 1993, as well as an additional injury prior to separation, and stated that his pain became progressively worse during service and continued since separation. See May 2024 Board Hearing Transcript. He further stated that he did not continue to seek treatment during service due to his position as an air traffic controller. As an initial matter, in the September 2019 rating decision on appeal, the RO found that the Veteran had a diagnosis of a lumbar spine disability and had been diagnosed with a lumbar strain during service. The Board is bound by these favorable findings. Service treatment records reflect that the Veteran was treated for back pain in October 1991, at which time he was diagnosed with a lumbar strain. See April 2017 STR - Medical. However, the remainder of those records are silent regarding any complaints or treatment related to the back, to include at the December 2000 separation examination at which time he specifically denied "recurrent back pain." Id. Post-service treatment records reflect that the Veteran denied experiencing back pain in July 2012 and February 2014. See April 2017 CAPRI. He also denied back pain in May 2018, after the current claim for benefits had been filed. See January 2019 CAPRI. In August 2019, he reported back pain but denied any experiencing specific injury as the cause of such pain. See November 2019 CAPRI. In May 2017, the Veteran attended a VA examination for his lower back, at which time he was diagnosed with degenerative disc disease of the lumbar spine. He denied any specific injury and stated that his back pain had begun two years earlier. He further stated that he had not sought treatment for his lower back prior to the examination. The examiner opined that the condition was less likely than RI. He also denied back pain in May 2018, after the current claim for benefits had been filed. See January 2019 CAPRI. In August 2019, he reported back pain but denied any experiencing specific injury as the cause of such pain. See November 2019 CAPRI. In May 2017, the Veteran attended a VA examination for his lower back, at which time he was diagnosed with degenerative disc disease of the lumbar spine. He denied any specific injury and stated that his back pain had begun two years earlier. He further stated that he had not sought treatment for his lower back prior to the examination. The examiner opined that the condition was less likely than not incurred in or caused by service. She noted the in-service documentation of a lumbar strain but explained that this was an acute complaint and that he denied any back pain at the time of separation and did not experience pain until two years earlier, which was many years after service. The examiner further stated that degenerative disc disease was a chronic condition that progressively worsened over time with the natural aging process. She reasoned that the one-time complaint of back pain during service was not severe enough to result in the development of the current degenerative disc disease based upon the medical evidence of record and the Veteran's reported onset of pain. In February 2019, the Veteran underwent another VA back examination, at which time the examiner opined that the lumbar spine disability was less likely than not proximately due to the service-connected bilateral knee disability. He explained that the conditions had different, unrelated pathophysiologies. In a July 2019 addendum opinion, a VA examiner opined that the Veteran's lumbar spine disability was not at least as likely as not aggravated beyond its natural progression by the bilateral knee disability. He explained that degenerative joint disease in one joint is unrelated to that of another joint. The examiner further noted that the aggravation of these symptoms in any joint can be caused by factors such as stress, exercise-related injuries, repetitive movements, cold weather, changes in barometric pressure, infections, and weight gain. The Board places great probative weight on the VA medical opinions that the Veteran's lumbar spine disability was less likely than not related to his military service or a service-connected disability. Notably, the VA examiners clearly reviewed the claims file and lay statements, indicating that they were fully aware of the extent of the Veteran's condition, as well as his military service and medical history. They offered complete discussions analyzing the pertinent evidence of record and explaining the basis for the opinions. See Nieves-Rodriguez v. Peake, 22?Vet. App.?295 (2008). To the extent the Veteran asserts that his current lumbar spine disability is related to his military service, as a layperson without any demonstrated expertise concerning the etiology of a spine disability, this general assertion may not be afforded any significant probative value. See Jandreau v. Nicholson, 492 F.3d 1372, 1376-77 (Fed. Cir. 2007). Additionally, the record reflects no evidence of symptoms or treatment related to this condition until 2017, which is about 16 years following separation from active duty. The lengthy period between service and the earliest indication of lower back symptoms while not dispositive, is evidence that weighs against the claim. Maxson v. West, 12?Vet. App.?452 (1999), aff'd, 230 F.3d 1330 (Fed. Cir. 2000). The Board acknowledges that the Veteran has reported experiencing symptoms of lower back pain since service. However, given the inconsistency between his reporting and the medical evidence itself, which contains no indication of any complaints or treatment involving such symptoms following service until the filing of the claim in 2017; and given that there is no other evidence which tends to corroborate the Veteran's reporting, the Board is not able to credit his reports of these symptoms for many years following service separation. Rather, the Board must credit the history of events indicated by the medical evidence of record, which shows that the Veteran did not report any additional back complaints following the lumbar strain in October 1991, and that he did not seek treatment prior to the filing of the current claim in 2017. He also specifically reported to the VA examiner that his back pain began two years earlier, as opposed to during service, and he did not mention anything about not being able to receive treatment during service because he was an air traffic controller. The Board finds the contemporaneous evidence, which did not reflect complaints of back pain more probative and ultimately persuasive than his later statements. Indeed, the Board notes that service treatment records reflect that the Veteran sought , the Board must credit the history of events indicated by the medical evidence of record, which shows that the Veteran did not report any additional back complaints following the lumbar strain in October 1991, and that he did not seek treatment prior to the filing of the current claim in 2017. He also specifically reported to the VA examiner that his back pain began two years earlier, as opposed to during service, and he did not mention anything about not being able to receive treatment during service because he was an air traffic controller. The Board finds the contemporaneous evidence, which did not reflect complaints of back pain more probative and ultimately persuasive than his later statements. Indeed, the Board notes that service treatment records reflect that the Veteran sought treatment for numerous conditions during active duty, including knee pain, ear pain, abdominal pain, and dermatological issues, but did not seek treatment for lower back pain outside of the documented October 1991 complaint. See April 2017 STR - Medical. Additionally, the Veteran denied recurrent back pain at the December 2000 separation examination. It is logical to assume that if he complained and was evaluated for these issues, if he was also experiencing continuous back pain, he would have reported this at some point during or following active duty. Thus, the medical evidence of record does not support the contentions that he experienced continuous lower back symptoms during service. Based on the foregoing, the Board finds that the weight of the evidence is against the claim and service connection for a lumbar spine disability is denied.? 2. Entitlement to service connection for a left hip disability, to include on a secondary basis, is denied. 3. Entitlement to service connection for a right hip disability, to include on a secondary basis, is denied. The Veteran seeks service connection for a bilateral hip disability, which he contends is related to his service-connected bilateral knee disability. At the May 2024 Board hearing, he testified that his hip pain began between 10 and 15 years earlier. As an initial matter, in the September 2019 rating decision on appeal, the RO found that the Veteran had a diagnosis of a bilateral hip disability and had a service-connected bilateral knee disability. The Board is bound by these favorable findings. Service treatment records do not reflect any complaints, diagnoses, or treatment related to a hip disability, to include at the December 2000 separation examination. See April 2017 STR - Medical. Post-service treatment records do not reflect any reports of hip pain following separation and prior to the filing of the claim. In May 2017, the Veteran attended a VA examination for his hips, at which time he was not diagnosed with a disability. He reported that he began to have pain in his hips about six to eight months earlier and that he had not sought treatment for this condition prior to the examination. The examiner explained that the hip joint was in a distinctly separate anatomical location from the knee joint and that medical literature did not support a causal relationship between the bilateral knee disability and the claimed bilateral hip disability. In February 2019, the Veteran underwent another VA hip examination, at which time he was diagnosed with trochanteric pain syndrome in both hips. At that time, he reported that his pain began during active duty and had progressed. The examiner opined that the bilateral hip disability was less likely than not proximately due to the service-connected bilateral knee disability. He explained that medical literature did not reflect that a hip condition could be caused by conditions affecting other joints. In a July 2019 addendum opinion, a VA examiner opined that the Veteran's bilateral hip disability was not at least as likely as not aggravated beyond its natural progression by the bilateral knee disability. He explained that the common causes of trochanteric hip pain were trauma, overuse, poor posture, bone spurs or calcium deposits, a history of certain chronic diseases, previous surgery, and weight gain. The Board places great probative weight on the VA medical opinions that the Veteran's bilateral hip disability was less likely than not related to his service-connected disability. Notably, the VA examiners clearly reviewed the claims file and lay statements. They offered complete discussions analyzing the pertinent evidence of record and explaining the basis for the opinions. See Nieves-Rodriguez, supra. The Board notes that, at the May 2024 Board hearing, the Veteran contended that his hip condition may be the result of obesity due to his service-connected knee disability. Although he attended multiple VA examinations for the bilateral hip disability, an opinion was not provided addressing obesity as an intermediate step of secondary service connection. The record reflects that the Veteran did previously raise this theory regarding a separate appeal for service connection for sleep apnea, but not the bilateral hip claim. As this theory of contention was raised after the August VA examiners clearly reviewed the claims file and lay statements. They offered complete discussions analyzing the pertinent evidence of record and explaining the basis for the opinions. See Nieves-Rodriguez, supra. The Board notes that, at the May 2024 Board hearing, the Veteran contended that his hip condition may be the result of obesity due to his service-connected knee disability. Although he attended multiple VA examinations for the bilateral hip disability, an opinion was not provided addressing obesity as an intermediate step of secondary service connection. The record reflects that the Veteran did previously raise this theory regarding a separate appeal for service connection for sleep apnea, but not the bilateral hip claim. As this theory of contention was raised after the August 2019 rating decision, the Board finds that there was no pre-decisional duty to assist error regarding such an opinion. McLendon v. Nicholson, 20?Vet. App.?79, 81 (2006); see 38?U.S.C. §?5103A(d)(2); 38?C.F.R. §?3.159(c)(4)(i); see also Waters v. Shinseki, 601 F.3d 1274, 1278-79 (Fed. Cir. 2010). To the extent the Veteran asserts that his current bilateral hip disability is related to his military service, and/or obesity, as a layperson without any demonstrated expertise concerning the etiology of a hip disability, this general assertion may not be afforded any significant probative value. See Jandreau, supra. The Board finds that an opinion regarding direct service connection is not necessary as the evidence of record is against a finding of an in-service injury and there is no probative evidence of a hip disability until decades after this separation from service. Additionally, the record reflects no evidence of symptoms or treatment related to this condition until a diagnosis was provided by a VA examiner in February 2019, which is almost two decades following separation from active duty. The lengthy period between service and the earliest indication of hip symptoms while not dispositive, is evidence that weighs against the claim. Maxson, supra. The Board acknowledges that the Veteran reported experiencing symptoms of hip pain since service at the February 2019 VA examination. However, at the May 2017 VA examination, he reported that his pain had only begun several months earlier. Given the inconsistency between his reporting and the medical evidence itself, which contains no indication of any complaints or treatment involving such symptoms following service until the diagnosis in 2019; and given that there is no other evidence which tends to corroborate the Veteran's reporting, the Board is not able to credit his reports of these symptoms for many years following service separation. Rather, the Board must credit the history of events indicated by the medical evidence of record, which shows that the Veteran did not report any hip complaints during service, that he did not seek treatment prior to the filing of the current claim in 2017, and that he was not diagnosed with a hip disability until 2019. The Board finds the contemporaneous evidence, which did not reflect complaints of hip pain, more probative and ultimately persuasive than his later statements. Indeed, the Board notes that service treatment records reflect that the Veteran sought treatment for numerous conditions during active duty, including ear pain, knee pain, abdominal pain, and dermatological issues, but did not seek treatment for bilateral hip pain. See April 2017 STR - Medical. Additionally, the Veteran did not report any hip symptoms or injuries at the December 2000 separation examination. It is logical to assume that if he complained and was evaluated for these issues, if he was also experiencing continuous hip pain, he would have reported this at some point during or following active duty. Thus, the medical evidence of record does not support the contentions that he experienced continuous bilateral hip symptoms during service. Based on the foregoing, the Board finds that the weight of the evidence is against the claim and service connection for a bilateral hip disability is denied.? S. HENEKS Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Erin J. Trojanowski, 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.