DEGENERATIVE ARTHRITIS OF THE SPINE (SPONDYLOSIS)

Summary

The Veteran, an aviation mechanic who served from October 1987 to October 2007, appeals the denial of service connection for cervical degenerative disc disease (DDD) and related left and right upper extremity radiculopathy. The Veteran has a service-connected lumbar DDD and sought to establish service connection for his neck and upper extremity conditions as secondary to this service-connected disability. The Board reviewed evidence including the Veteran's service treatment records (STRs), VA examinations, and private medical opinions. While the Veteran reported neck pain during service, STRs did not document these complaints. A VA examiner provided a negative opinion, stating lumbar DDD does not cause cervical DDD, but offered minimal supporting rationale. Conversely, a private clinician provided a positive nexus opinion, explaining that lumbar DDD can cause instability and deterioration in the cervical spine, leading to nerve root compression and upper extremity radiculopathy. The Board found the private opinion persuasive due to its detailed explanation and applied the benefit of the doubt, granting service connection for cervical DDD secondary to lumbar DDD, and for left and right upper extremity radiculopathy secondary to cervical DDD. The Board noted that the Veteran's claims for increased ratings or different effective dates would require a separate Notice of Disagreement.

Rationale

Private opinion provided plausible explanation for secondary nexus; Benefit of the doubt applied due to conflicting opinions

Full Decision Text

Citation Nr: A26031667
Decision Date: 04/07/26	Archive Date: 04/07/26

DOCKET NO. 210427-155847
DATE: April 7, 2026

ORDER

Entitlement to service connection for cervical degenerative disc disease (DDD), secondary to lumbar DDD, is granted. 

Entitlement to service connection for left upper extremity radiculopathy, secondary to cervical DDD, is granted.  

Entitlement to service connection for right upper extremity radiculopathy secondary to cervical DDD, is granted.  

FINDINGS OF FACT

1. The Veteran's cervical DDD is due to service-connected lumbar DDD.

2. The Veteran's left upper extremity radiculopathy disability is due to cervical DDD.

3. The Veteran's right upper extremity radiculopathy disability is due to cervical DDD.

CONCLUSIONS OF LAW

1. The criteria for service connection for cervical spine DDD as secondary to service connected low back DDD are met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.310.

2. The criteria for service connection for left upper extremity radiculopathy as secondary to service connected low back DDD are met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.310.

3. The criteria for service connection for right upper extremity radiculopathy as secondary to cervical spine DDD are met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.310.

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Veteran served on active duty from October 1987 to October 2007.

In June 2020, the Veteran submitted a VA Form 20-0996, Decision Review Request: Higher-Level Review (HLR), and requested review of an August 2019 rating decision. In November 2020, the agency of original jurisdiction (AOJ) issued an HLR decision, which considered the evidence of record at the time of the prior (August 2019) decision. It determined that a VA examination should have been obtained. So, it issued the February 2021 supplemental decision on appeal. The Board may only consider the evidence of record up to the February 2021 supplemental decision and the applicable evidentiary window (February 24 to May 27, 2025).  

In the April 27, 2021, VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement), the Veteran elected the Hearing docket. A Board hearing was held on February 24, 2025. So, the Board may only consider the evidence of record at the time of the February 2021 AOJ decision on appeal, as well as any evidence submitted by the Veteran 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 (ending on May 27, 2025), the Board did not consider it in its decision. 38 C.F.R. §§ 20.300, 20.302(a), 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[s], considering the new evidence in addition to the evidence previously considered. Id. Specific instructions for filing a Supplemental Claim are included with this decision. 

1. Entitlement to service connection for cervical DDD, secondary to lumbar DDD.

2. Entitlement to service connection for left and right upper extremity radiculopathy disabilities, secondary to cervical DDD. 

The Veteran continuously pursued his initial (May 2019) service connection claim for a neck disability. See VA 21-526EZ; August 2019 Rating Decision; June 2020 Request for HLR. Since that date, VA has received medical nexus opinions that support grants of service connection for his neck and upper extremity radiculopathy disabilities on a secondary basis. See April 2019 Private Neck Conditions DBQ at 2, 11.
 Supplemental Claim are included with this decision. 

1. Entitlement to service connection for cervical DDD, secondary to lumbar DDD.

2. Entitlement to service connection for left and right upper extremity radiculopathy disabilities, secondary to cervical DDD. 

The Veteran continuously pursued his initial (May 2019) service connection claim for a neck disability. See VA 21-526EZ; August 2019 Rating Decision; June 2020 Request for HLR. Since that date, VA has received medical nexus opinions that support grants of service connection for his neck and upper extremity radiculopathy disabilities on a secondary basis. See April 2019 Private Neck Conditions DBQ at 2, 11. The Board sees no reason to disagree with those opinions; it concludes that service connection is warranted for the above listed disabilities on a secondary basis.

Entitlement to service connection requires a Veteran to provide evidence of three elements: (1) a current disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship or nexus between the current disability and the disease or injury incurred or aggravated during active service. 38 U.S.C. § 1131; 38 C.F.R. § 3.303(a); Shedden v. Principi, 381 F.3d 1163, 1166-67 (2007).  

With regards to any disability not caused by service, a Veteran may establish service connection on a secondary basis for a disability which is caused by a service-connected disease or injury. 38 C.F.R. § 3.310(a). Or for any increase in the severity of a nonservice-connected disease or injury that is due to a service-connected disease or injury. 38 C.F.R. § 3.310(b). Entitlement to service connection on a secondary basis requires evidence of three elements: (1) evidence of a service-connected disability (2)  evidence of a current non-service-connected disability; and (3) evidence of nexus establishing a connection between the service-connected disability and the current disability. 38 C.F.R. § 3.310. 

Beginning with the Veteran's service, his (May 1987) entrance examination does not mention any signs and/or symptoms of back or neck problems. He served as an aviation mechanic, which involved installing parts in a large airplane used to transport cargo. For example, air conditioning units (weighing more than 100 pounds). See February 2025 Board Hearing Transcript at 4. His duties included preparing his squadron to deploy to sea. It included carrying heavy equipment (weighing 300 or more pounds) onto the ships his squadron deployed with. Id. at 5-6. This entailed carrying heavy boxes down steep ladders. Over time, his duties led to (now service connected) bilateral knee arthritis, and back problems. See April 2015 Rating Decision (awarding service connection for left and right knee arthritis from February 3, 2012). His back problems were later-diagnosed as (now service connected) degenerative arthritis. See April 2017 Rating Decision (awarding service connection for low back DDD from February 2017). 

The Veteran had complained of his back and knee problems during service. See Service Treatment Records (STRs). He says he complained of neck problems as well. See February 2025 Board Hearing Transcript at 12. The Board would like the Veteran to know it did not find any STR noting complaints of neck problems. He also contends his service connected back disability caused his neck problems. See July 2019 Report of General Information. 

The Veteran has been diagnosed with multiple neck, and neck-related disabilities. See April 2019 Private Neck Conditions Disability Benefits Questionnaire (DBQ) at 1. He has been diagnosed with cervical spondylosis, DDD of the cervical spine, as well as left and right upper extremity radiculopathy. His symptoms include limited range of motion at the neck, pain, stiffness, and tingling and numbness at the upper extremities. Id. at 2. He was working at the time he initially sought service connection for a neck disability. See July 2019 Mental Disorders DBQ at 5 (noting the Veteran has been working as a crossing guard since 2016). The rating decision on appeal was issued in February 2021; he has been awarded a schedular total disability rating based on individual unemployability (TDIU) due to service-connected disabilities from February 20, 2025. See September 2025 Rating Decision. 

VA has received medical nexus opinions that link the Veteran's neck and upper extremity nerve disabilities to low back DDD. See April 2019 Private Neck Conditions DBQ at 2 ("Veteran's [DDD of the cervical
 2. He was working at the time he initially sought service connection for a neck disability. See July 2019 Mental Disorders DBQ at 5 (noting the Veteran has been working as a crossing guard since 2016). The rating decision on appeal was issued in February 2021; he has been awarded a schedular total disability rating based on individual unemployability (TDIU) due to service-connected disabilities from February 20, 2025. See September 2025 Rating Decision. 

VA has received medical nexus opinions that link the Veteran's neck and upper extremity nerve disabilities to low back DDD. See April 2019 Private Neck Conditions DBQ at 2 ("Veteran's [DDD of the cervical spine] has progressively worsened due to lumbar DJD.") VA has also received medical opinions that state there is no link between the Veteran's neck disability and low back DDD. See August 2019 VA Medical Opinion. The opinions disagree on the same issue. That is, whether low back arthritis caused neck arthritis. The VA clinician simply stated that low back DDD does not cause arthritis at the neck. Id. The Board does not view the (August 2019) VA medical opinion persuasive because the clinician does not provide much support for her conclusion. Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 301 (2008) ("[A] medical examination report must contain not only clear conclusions with supporting data, but also a reasoned medical explanation connecting the two."). 

The private clinician who prepared the positive nexus opinion (K.M., MD) explained that low back arthritis causes instability, and weakness, at the other discs; this results in deterioration of the discs. In this case, the discs at the cervical spine. This degenerative process also causes compression of the nerve roots around the discs of the cervical spine. See April 2019 Private Neck Conditions DBQ at 11 (expressing that upper extremity radiculopathy disabilities are secondary to lumbar DDD). The Board finds the explanation persuasive. D'Aries v. Peake, 22 Vet. App. 97 (2008) (holding that the Board is entitled to favor one (or more) medical opinion over others). 

The Board points out that the Veteran has provided a third (March 2022) medical letter. It expresses that the Veteran has several disabilities that have not been attributed to the neck, to include failed back syndrome, polyarthralgia, lumbar spondylosis, and carpel tunnel syndrome. The clinician did not include a rationale; so, the Board cannot determine if the clinician was speaking to the Veteran's neck disability service connection claim. The Board looked up the definition of the disabilities; the definitions did not indicate the above listed disabilities are neck disabilities. 

A.	Entitlement to service connection for a neck disability, secondary to low back DDD.

To start, the Board did not find evidence that supports a grant of service connection on a direct basis. The Board did not find STRs suggesting that the disability manifested during service. His lay reports of pain are not sufficient to establish that arthritis existed during service, and the Board did not find medical evidence that links any in-service symptom(s) to later-diagnosed cervical DDD. Jandreau v. Nicholson, 492 F.3d 1372, 1377, n. 4 (Fed. Cir. 2007) ("sometimes the layperson will be competent to identify the condition where the condition is simple, for example a broken leg, and sometimes not, for example, a form of cancer").  So, the Board concludes that the evidence does not support a grant of service connection for a neck disability (nor upper extremity radiculopathy disabilities) on a direct basis.

The Board sees evidence that supports a grant of service connection for a neck disability on a secondary basis. The April 2019 DBQ provided a plausible explanation for concluding that the Veteran's low back DDD caused arthritis at the cervical spine. At the very least, the opinion raises reasonable doubt that the Veteran's neck disability is secondary to his already service connected low back disability. He is entitled to have doubt resolved in his favor. Lynch v. McDonough, 21 F.4th 776, 781 (2021) (holding the 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). So, the Board awards service connection for cervical spine DDD on a secondary basis.

B.	Entitlement to service connection for left and right upper extremity radiculopathy disabilities, secondary neck disability.

The Board views the right and left upper extremity nerve disabilities to be associated neurological complications of the (now service connected
 Veteran's neck disability is secondary to his already service connected low back disability. He is entitled to have doubt resolved in his favor. Lynch v. McDonough, 21 F.4th 776, 781 (2021) (holding the 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). So, the Board awards service connection for cervical spine DDD on a secondary basis.

B.	Entitlement to service connection for left and right upper extremity radiculopathy disabilities, secondary neck disability.

The Board views the right and left upper extremity nerve disabilities to be associated neurological complications of the (now service connected) neck disability on appeal. This means the Board considers them part of this appeal. So, the Board adjudicated those disabilities in light of the favorable (April 2019) medical nexus opinion. Chavis v. McDonough, 34 Vet. App. 1, 15 (2021). 

The April 2019 private neck DBQ explained that arthritis at the neck caused the discs to compress; in turn, it put pressure on the nerves affecting the upper extremities. It I s apparent to the Board that the examiner was explaining that the Veteran's upper extremity nerve symptoms are due to his neck disability. See April 2019 Private Neck Conditions DBQ at 11. This is sufficient to establish service connection for left and right upper extremity nerve disabilities on a secondary basis. 

The Board would like the Veteran to know that the issue of service connection is the only issue on appeal. He must submit another Notice of Disagreement if he wants the Board to address any disagreement with the compensation he has been awarded. Grantham v. Brown, 114 F. 3d 1156, 1158 (Fed. Cir. 1997) (holding that a separate notice of disagreement must be filed to initiate appellate review of "downstream" elements such as the disability rating or effective date assigned). 

 

 

DAVID L. WIGHT

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	Dean, Michael S.

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.