DEGENERATIVE ARTHRITIS OF THE SPINE (SPONDYLOSIS)

SHAUN S. SPERANZA · 2026 · Case ID: A26031847

GRANTED

Summary

The Veteran served in the United States Army from June 1981 to June 1984. The Veteran sought service connection for lumbar and left knee disabilities, bilateral lower extremity radiculopathy as secondary to the lumbar condition, and obstructive sleep apnea (OSA) as secondary to diabetes and orthopedic conditions. The Board found that while initial VA examinations were inadequate for failing to address the full scope of evidence and provide sufficient rationale, a private examiner provided a favorable opinion linking the lumbar and left knee disabilities to service. The Veteran's lay testimony regarding the onset and continuity of these conditions was also found credible and probative. The Board determined the evidence was approximately balanced and resolved doubt in the Veteran's favor, granting service connection for the lumbar and left knee conditions. For the bilateral lower extremity radiculopathy claims, the Board found VA treatment records adequately documented the conditions as secondary to the service-connected lumbar disability, despite initial negative VA examinations. Similarly, for OSA, the Board found a private examiner's opinion linking it to service-connected diabetes and orthopedic conditions, considering obesity as an intermediate step, to be highly probative. Despite initial negative VA opinions for OSA, the Board found the evidence approximately balanced and granted service connection for OSA as secondary to diabetes and orthopedic disabilities, resolving doubt in the Veteran's favor.

Rationale

Private examiner found lumbar disability more likely than not related to service.; Veteran's lay testimony regarding onset and continuity found credible.; Evidence for and against claim approximately balanced, doubt resolved in Veteran's favor.

Service Branch

ARMY

Special Benefit

NO SPECIAL BENEFIT

Docket No.

210615-166111

Full Decision Text

Citation Nr: A26031847
Decision Date: 04/07/26 Archive Date: 04/07/26

DOCKET NO. 210615-166111
DATE: April 7, 2026

ORDER

Service connection for lumbar condition is granted.

Service connection for left knee condition is granted.

Service connection for left lower extremity (LLE) radiculopathy, as secondary to service-connected lumbar condition, is granted.

Service connection for right lower extremity (RLE) radiculopathy, as secondary to service-connected lumbar condition, is granted.

Service connection for obstructive sleep apnea (OSA), as secondary to service-connected diabetes and orthopedic conditions is granted.

FINDINGS OF FACT

1. The Veteran's lumbar disability is related to service.

2. The Veteran's left knee condition is related to service.

3. The Veteran's LLE radiculopathy is related to service-connected lumbar condition.

4. The Veteran's RLE radiculopathy is related to service-connected lumbar condition.

5. The Veteran's OSA condition is related to service-connected diabetes and orthopedic conditions.

CONCLUSIONS OF LAW

1. The criteria for service connection of lumbar condition have been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303.

2. The criteria for service connection of left knee condition have been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303.

3. The criteria for service connection of LLE condition have been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.310.

4. The criteria for service connection of RLE condition have been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.310.

5. The criteria for service connection of OSA have been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.310.

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Veteran served on active duty in the United States Army from June 1981 to June 1984.

In January 2017, the regional office (RO) denied service connection for OSA and left knee disabilities. In May 2017, the Veteran filed a legacy notice of disagreement for OSA and left knee disabilities. In November 2017, the Veteran filed a claim for service-connection of lumbar and bilateral lower extremities radiculopathy and in December 2017 the RO denied the claims.

In October 2018, the Veteran opted into the Rapid Appeals Modernization Program (RAMP) electing a higher-level review for service connection of the appealed claims. In October 2019, May 2020, and June 2020, the RO denied the claims.

In the June 2021 VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement), the Veteran elected the Hearing docket. A hearing was held in January 2025. Therefore, the Board may only consider the evidence of record at the time of the June 2020 rating decision on appeal, as well as any evidence submitted by the Veteran or representative at the hearing or within 90 days following the hearing. See 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, the Board did not consider it in its decision. See 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 with respect to the appealed claims, the Veteran may file a Supplemental Claim (VA Form 20-0995) and submit or identify this evidence. See 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.

Service Connection

In general, service connection may be granted for a disability or injury incurred in
. §§ 20.300, 20.302(a), 20.801.

Service Connection

In general, service connection may be granted for a disability or injury incurred in or aggravated by active military service. See 38 U.S.C. § 1110, 1131; 38 C.F.R. § 3.303.

To prevail on a direct service connection claim, there must be competent evidence of (1) a current disability, (2) an in-service incurrence or aggravation of a disease or injury, and (3) a nexus between the in-service disease or injury and the current disability. See Holton v. Shinseki, 557 F.3d 1362, 1366 (Fed. Cir. 2009); 38 U.S.C. § 1110, 1131; 38 C.F.R. § 3.303.

Service connection may be established by credible lay evidence and medical evidence provided by the Veteran or otherwise. See 38 U.S.C. §§ 1110, 1131 (2012); 38 C.F.R. § 3.303 (2018).

Service connection may also be found on a secondary basis where the following criteria is met: (1) a current disability that is not already service-connected; (2) at least one service-connected disability; and (3) evidence that the non-service-connected current disability is either proximately due to or as the result of a service-connected disability; or, aggravated by a service-connected disability. See 38 C.F.R. § 3.310 (2018); see also El-Amin v. Shinseki, 26 Vet. App. 136 (2013); Allen v. Brown, 7 Vet. App. 439 (1995).

Although obesity is not a condition for which service connection may be granted, obesity may qualify as an "intermediate step" between a service-connected disability and another current disability. See VAOPGCPREC 1-2017; see also Garner v. Tran, 33 Vet. App. 241 (2021); Walsh v. Wilkie, 32 Vet. App. 300 (2020); Adams v. Collins, 23-5064 (2025). In a secondary service connection claim, a theory of obesity as an intermediate step is raised when there is some evidence in the record which draws an association or suggests a relationship between the Veteran's obesity, or weight gain resulting in obesity, and a service-connected condition. See Garner, 33 Vet. App. at 247-49.

In order to determine if obesity is an "intermediate step," an adjudicator must resolve the following issues: (1) whether the service-connected disability caused the Veteran to become obese; (2) if so, whether the obesity was a substantial factor in causing the claimed disability; and (3) whether the claimed disability would not have occurred but for obesity. If these questions are answered in the affirmative, the claimed disability may be service connected on a secondary basis.

Determinations as to service connection will be based on review of the entire evidence of record, to include all pertinent medical and lay evidence, with due consideration to VA's policy to administer the law under a broad and liberal interpretation consistent with the facts in each individual case. See 38 U.S.C. § 1154 (a); 38 C.F.R. § 3.303 (a).

In determining whether service connection is warranted for a disability, VA is responsible for determining whether the evidence supports the claim or is in relative equipoise, with the Veteran prevailing in either event, or whether the evidence persuasively weighs against the claim, in which case the claim is denied. See Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021).

1. Service connection for lumbar condition.

2. Service connection for left knee condition.

The Veteran seeks service connection for lumbar and left knee disabilities.

In support, the Veteran and private examiner reported lumbar and left knee problems since service. See STR (March 1982, August 1982, March 1983, November 1983, and March 1984
VA is responsible for determining whether the evidence supports the claim or is in relative equipoise, with the Veteran prevailing in either event, or whether the evidence persuasively weighs against the claim, in which case the claim is denied. See Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021).

1. Service connection for lumbar condition.

2. Service connection for left knee condition.

The Veteran seeks service connection for lumbar and left knee disabilities.

In support, the Veteran and private examiner reported lumbar and left knee problems since service. See STR (March 1982, August 1982, March 1983, November 1983, and March 1984); BVA hearing transcript (January 2025); non-VA medical treatment record (February 2025).

The medical evidence documents functional impairment with treatment and diagnoses of left knee strain and meniscal tear, and lumbar strain, degenerative arthritis and degenerative disc disease. See non-VA medical treatment record (July 2013 and February 2025); VA medical examination (September 2019); VA medical treatment record (December 2024 and March 2025). Additionally, VA favorably found the Veteran is diagnosed with lumbar and left knee disabilities and suffered qualifying events or injuries in service. See Rating Decision - Narrative (June 2020).

Negative nexus opinions were obtained by VA for left knee disability in September 2019 and lumbar disability in December 2017 and September 2019. See VA medical examinations (December 2017 and September 2019). However, the examiners did not sufficiently address the pertinent lay and medical evidence of record regarding the onset, cause, and nature of the Veteran's appealed conditions. Moreover, the examiners did not apply the correct standard of proof and support the findings with a full rationale. See Miller v. Wilkie, 32 Vet. App. 249, 260 (2020); Barr v. Nicholson, 21 Vet. App. 303, 311 (2007); Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 304 (2008).

The failure to properly address the onset, cause, and nature of the Veteran's appealed conditions, resulted in incomplete findings for the Board to properly adjudicate the claimed conditions. Therefore, the December 2017 and September 2019 examinations findings are inadequate and afforded minimal probative value.

Nevertheless, a private examiner determined that it is more likely than not the Veteran's lumbar and left knee disabilities are related to service. The private examiner discussed the Veteran's lumbar and left knee disabilities originated in service and have continued since. See non-VA medical treatment record (February 2025). Consequently, the private opinion relating the claimed conditions to service is adequate and constitutes highly probative evidence weighing in favor of the claims.

Here, the probative evidence establishes lumbar and left knee disabilities since service. Additionally, the Veteran credibly reported lumbar and left knee problems began during service and have continued since. The Veteran, as a lay person, is "competent to report observable conditions." See Jandreau v. Nicholson, 492 F.3d 1372, 1377 (Fed. Cir. 2007). The competent lay statements are consistent with the medical evidence demonstrating functional impairment since service. Accordingly, the competent lay statements are credible and constitute highly probative evidence weighing in favor of the claims.

For the above reasons, the probative evidence for and against the claims is at least approximately balanced. After resolving any reasonable doubt in the Veteran's favor, the Board finds the evidence links the Veteran's lumbar and left knee disabilities with service. Therefore, service connection for lumbar and left knee disabilities is warranted.

3. Service connection for LLE radiculopathy.

4. Service connection for RLE radiculopathy.

The Veteran seeks service connection for bilateral lower extremity radiculopathy as secondary to service-connected lumbar disability.

In support, the Veteran reported bilateral lower extremities symptoms after suffering from lumbar condition in service. See BVA hearing transcript (January 2025).

The medical evidence documents functional impairment with treatment and diagnosis of lumbar bilateral lower extremity radiculopathy. See VA medical treatment record (February 2020 and April 2025).

In support, the Veteran reported bilateral lower extremities symptoms after suffering from lumbar condition in service. See BVA hearing transcript (January 2025).

The medical evidence documents functional impairment with treatment and diagnosis of lumbar bilateral lower extremity radiculopathy. See VA medical treatment record (February 2020 and April 2025).

Although the December 2017 and September 2019 VA lumbar examinations noted no radiculopathy symptoms, the examiners did not provide any rationale for their findings. Additionally, the examiners did not address the pertinent lay and medical evidence of record regarding the onset, cause, and nature of the Veteran's appealed conditions. Moreover, the examiners did not apply the correct standard of proof and support the findings with a full rationale, including the required "but-for" analysis for secondary service connection. See Miller v. Wilkie, 32 Vet. App. 249, 260 (2020); Barr v. Nicholson, 21 Vet. App. 303, 311 (2007); Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 304 (2008); Spicer v. McDonough, 61 F.4th 1360 (Fed. Cir. 2023).

The failure to properly address the onset, cause, and nature of the Veteran's appealed conditions, resulted in incomplete findings for the Board to properly adjudicate the claimed conditions. Therefore, the December 2017 and September 2019 findings are inadequate and afforded minimal probative value.

Nevertheless, the Veteran's VA treatment record demonstrates bilateral lower extremity radiculopathy disabilities due to service-connected lumbar condition with treatment. See VA medical treatment record (February 2020 and April 2025). These findings are adequate and probative evidence. Consequently, the medical treatment records constitute highly probative evidence weighing in favor of the claims.

For the above reasons, the probative evidence for and against the claims is at least approximately balanced. After resolving any reasonable doubt in the Veteran's favor, the Board finds the evidence links the Veteran's claimed conditions with service-connected lumbar condition. Therefore, service connection for bilateral lower extremity radiculopathy disabilities, as secondary to service-connected lumbar condition, is warranted. See 38 C.F.R. § 3.310.

5. Service connection for OSA.

The Veteran seeks service connection for OSA condition to include as secondary to service-connected disabilities.

The medical evidence establishes functional impairment with treatment and a diagnosis of OSA. See non-VA medical treatment record (January 2016 and February 2025); VA medical examination (September 2019); VA medical treatment record (March 2025). Additionally, VA favorably found the Veteran is diagnosed with OSA and suffered a qualifying event or injury in service. See Rating Decision - Narrative (June 2020).

A negative nexus opinion was obtained for OSA in September 2019. However, the examiner did not sufficiently address the pertinent lay and medical evidence of record regarding the onset, cause, and nature of the Veteran's appealed condition. Moreover, the examiner did not apply the correct standard of proof and support the findings with a full rationale, including the required "but-for" analysis for secondary service connection and obesity as an intermediate step. See Miller v. Wilkie, 32 Vet. App. 249, 260 (2020); Barr v. Nicholson, 21 Vet. App. 303, 311 (2007); Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 304 (2008); Spicer v. McDonough, 61 F.4th 1360 (Fed. Cir. 2023); Adams v. Collins, 23-5064 (2025).

The failure to properly address the onset, cause, and nature of the Veteran's appealed condition, resulted in incomplete findings for the Board to properly adjudicate the claimed condition. Therefore, the September 2019 findings are inadequate and afforded minimal probative value.

On the other hand, a private examiner determined that it is more likely than not the Veteran's OSA condition is related to service-connected diabetes and orthopedic disabilities. The private examiner reasoned the Veteran's diabetes aggravates OSA and the orthopedic symptoms contribute to weight gain and obesity which, in turn, caused OSA. See non-VA medical treatment record (February 2025). Consequently, the private opinion relating the claimed condition to service-connected diabetes and orthopedic disabilities is adequate and constitutes highly probative evidence weighing in favor of the claim.

For the above reasons, the probative evidence for and against the claim is at least approximately balanced. After
findings are inadequate and afforded minimal probative value.

For the above reasons, the probative evidence for and against the claim is at least approximately balanced. After resolving any remaining reasonable doubt in the Veteran's favor, the Board finds the evidence links the Veteran's claimed condition with service-connected diabetes and orthopedic disabilities. Therefore, service connection for OSA disability, as secondary to service-connected diabetes and orthopedic disabilities, is warranted. See 38 C.F.R. § 3.310.

SHAUN S. SPERANZA

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board M. Alvarado

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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