INTERVERTEBRAL DISC SYNDROME

GAYLE STROMMEN · 2026 · Case ID: A26033219

MIXED

Summary

The Veteran, an Army Veteran who served from May 1988 to February 1993, appeals the denial of service connection for memory loss and chronic fatigue syndrome, and seeks service connection for cervical spine, lumbar spine, bilateral upper and lower extremity radiculopathy, right hand arthritis, migraines, and GERD. The Board granted service connection for cervical and lumbar spine disabilities, finding the Veteran's testimony of an in-service assault credible and verified, and a June 2025 private medical report probative in establishing a nexus. The Board also granted secondary service connection for bilateral upper and lower extremity radiculopathy, and right hand arthritis, based on the same private medical opinion linking them to the service-connected spine conditions. Migraines were also granted, with the Board finding the evidence met the criteria for service connection. GERD was granted secondary to service-connected PTSD, based on a private medical opinion finding a nexus. The claims for memory loss and chronic fatigue syndrome were denied. The memory loss claim was denied due to lack of competent evidence of a current, distinct disability, and to avoid pyramiding with the PTSD rating. The chronic fatigue syndrome claim was denied due to a lack of competent evidence, with the Board giving more weight to a December 2020 VA examination finding no evidence of the condition, over the Veteran's lay assertion.

Rationale

New and relevant evidence submitted; Proved nexus to service; Credible and verified in-service assault

Service Branch

ARMY

Special Benefit

NO SPECIAL BENEFIT

Docket No.

210513-158889

Full Decision Text

Citation Nr: A26033219
Decision Date: 04/09/26 Archive Date: 04/09/26

DOCKET NO. 210513-158889
DATE: April 9, 2026

ORDER

New and relevant evidence has been submitted and the claim for service connection for a lumbar spine disability is re-adjudicated.

Entitlement to service connection for a cervical spine disability is granted.

Entitlement to service connection for a lumbar spine disability is granted.

Entitlement to service connection for a bilateral upper extremity radiculopathy is to include as secondary to a cervical spine disability granted.

Entitlement to service connection for a bilateral lower extremity radiculopathy to include as secondary to a lumbar spine disability is granted.

Entitlement to service connection for right hand arthritis to include as secondary to a cervical spine disability is granted.

Entitlement to service connection for migraines is granted.

Entitlement to service connection for gastroesophageal reflux disease (GERD) to include as secondary to posttraumatic stress disorder (PTSD) is granted.

Entitlement to service connection for a memory loss disability is denied.

Entitlement to service connection for chronic fatigue syndrome is denied.

FINDINGS OF FACT

1. A May 2019 rating decision denied the Veteran's claims of entitlement to service connection for a lumbar spine disability, and a January 2021 rating decision declined to readjudicate the claim based on new and relevant evidence.

2. The Veteran's lumbar spine disability is at least as likely as not related to his active duty service.

3. The Veteran's cervical spine disability is at least as likely as not related to his active duty service.

4. The Veteran's bilateral upper extremity radiculopathy is at least as likely as not related to his service-connected cervical spine disability.

5. The Veteran's bilateral lower extremity radiculopathy is at least as likely as not related to his lumbar spine disability.

6. The Veteran's right hand arthritis disability is at least as likely as not related to his cervical spine disability.

7. The Veteran's GERD is at least as likely as not related to his service-connected PTSD.

8. The Veteran does not have a current disability associated with memory loss.

9. The Veteran does not have current disability of chronic fatigue syndrome.

CONCLUSIONS OF LAW

1. The criteria for readjudicating the claims of service connection for a lumbar spine disability have been met. 38 C.F.R. § 3.2501.

2. The criteria for service connection for a lumbar spine disability have been met. 38 U.S.C. § 1110, 5107(b); 38 C.F.R. §§ 3.102, 3.303.

3. The criteria for service connection for a cervical spine disability have been met. 38 U.S.C. § 1110, 5107(b); 38 C.F.R. §§ 3.102, 3.303.

4. The criteria for secondary service connection for bilateral upper extremity radiculopathy have been met. 38 U.S.C. § 1110, 5107(b); 38 C.F.R. §§ 3.102, 3.303, 3.310.

5. The criteria for secondary service connection for bilateral lower extremity radiculopathy have been met. 38 U.S.C. § 1110, 5107(b); 38 C.F.R. §§ 3.102, 3.303, 3.310.

6. The criteria for secondary service connection for right hand arthritis have been met. 38 U.S.C. § 1110, 5107(b); 38 C.F.R. §§ 3.102, 3.303, 3.310.

7. The criteria for service connection for migraine headaches have been ment. 38 U.S.C. § 1110, 5107(b); 38 C.F.R. §§ 3.102, 3.303.

8. The criteria for secondary service connection for GERD have been ment. 38 U.S.C. §1110, 5107(b); 38 C.F.R. §§ 3.102, 3.303, 3.310.

9. The criteria for service connection for memory loss have not been met. 38 U.S.C. § 1110, 5107(b); 38 C.F.R. §§ 3.102, 3.303.

10. The criteria for service connection for chronic fatigue syndrome have not been met. 38 U.S.C. § 1110, 5107(b); 38 C.F.R. §§ 3.102, 3.303.

REASONS AND BASES FOR FINDINGS AND CONCLUS
have been ment. 38 U.S.C. §1110, 5107(b); 38 C.F.R. §§ 3.102, 3.303, 3.310.

9. The criteria for service connection for memory loss have not been met. 38 U.S.C. § 1110, 5107(b); 38 C.F.R. §§ 3.102, 3.303.

10. The criteria for service connection for chronic fatigue syndrome have not been met. 38 U.S.C. § 1110, 5107(b); 38 C.F.R. §§ 3.102, 3.303.

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Veteran served on active duty in the United States Army from May 1988 to February 1993.

The Appeals Modernization Act (AMA) creates a new framework for Veterans dissatisfied with VA's decision on their claim to seek review. The AMA became effective on February 19, 2019, and applies to all initial decisions issued after this date. 38 C.F.R. § 3.2400 (a)(1).

The initial decision in this case was issued in January 2021 and March 2021; thus, this decision has been written consistent with the new AMA framework.

The Veteran in May 2021 submitted a Board Appeal Notice of Disagreement (VA Form 10182) following a January 2021 and March 2021, rating decisions. The Veteran in his May 2021 appeal chose the "Hearing Lane."

As explained in the Form 10182, per the "Hearing Lane," the review is based on evidence of record at the time of January and March 2021, rating decisions and submitted within a 90-day window following the Veteran's March 2025 hearing. The Veteran was provided a hearing in March 2025; a transcript of which has been placed in the claims file. Within the 90-day window of this March 2025, the Veteran submitted a June 2025 private medical report with several positive nexus opinions.

Service Connection

Service connection may be granted for a disability resulting from a disease or injury incurred in or aggravated by active service. 38 U.S.C. §§ 1110, 38 C.F.R. § 3.303 (a). To establish entitlement to service-connected compensation benefits, a Veteran must show: "(1) the existence of a present disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the present disability and the disease or injury incurred or aggravated during service-the so-called "nexus" requirement." Holton v. Shinseki, 557 F.3d 1362, 1366 (Fed. Cir. 2010) (quoting Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004)).

Service connection may alternatively be established on a secondary basis for a disability which is proximately due to, or the result of, a service-connected disability. 38 C.F.R. § 3.310 (a). Secondary service connection may also be established for a disorder which is aggravated by a service-connected disability; compensation may be provided for the degree of disability (but only that degree) over and above the degree of disability existing prior to the aggravation. See 38 C.F.R. § 3.310 (b); Allen v. Brown, 8 Vet. App. 374 (1995).

In order to prevail on the issue of secondary service connection, the record must show: (1) evidence of a current disability; (2) evidence of a service-connected disability; and (3) medical nexus evidence establishing a connection between the service-connected disability and the current disability. See Wallin v. West, 11 Vet. App. 509, 512 (1998); see also Allen, supra.

1. Whether new and relevant evidence has been submitted to readjudicate a claim for service connection for a lumbar spine disability.

A claimant or his or her authorized representative, if any, who disagrees with a prior VA decision may file a supplemental claim by submitting in writing or electronically a complete application on a form prescribed by the Secretary any time after the agency of original jurisdiction issues notice of a decision, regardless of whether the claim is pending or has become finally adjudicated. If new and relevant evidence is presented or secured with respect to the supplemental claim, the agency of original jurisdiction will readjudicate the claim taking into consideration all of the evidence of record. If new and relevant evidence is not presented or secured, the agency of original jurisdiction will issue a decision finding that there was insufficient evidence to readjudicate the claim. In determining whether new and relevant
lumbar spine disability.

New evidence is evidence not previously part of the actual record before agency adjudicators. Relevant evidence is information that tends to prove or disprove a matter at issue in a claim. Relevant evidence includes evidence that raises a theory of entitlement that was not previously addressed. 38 C.F.R. § 3.2501 (a)(1). For VA to readjudicate the claim, the evidentiary record must include new and relevant evidence that was not of record as of the date of notice of the prior decision. 38 C.F.R. § 3.2501(b).

Merits

In this case, a May 2019 rating decision denied service connection for a back disability. In doing so, the Agency of Original Jurisdiction (AOJ) found that there was no evidence of a nexus between the Veteran's claimed disability and his service. A January 2021 rating decision declined to readjudicate the claim for lack of new and relevant evidence and this decision was appealed to the Board. Thus, the question before the Board is whether new and relevant evidence has been submitted since the May 2019 rating decision.

A review of the record shows that new and relevant evidence has been submitted since his May 2019 denial. Specifically, a June 2025 private medical report wherein a private examiner found that the Veteran's back disability was related to his active duty service. This evidence could be used as a basis to link the Veteran's current disabilities to his active service. Therefore, the Board finds the evidence is new since it has not been previously considered by decision makers. The evidence is also relevant as it tends to prove or disprove the matter at issue, a nexus. Therefore, readjudication of the claim of service connection for a back disability is warranted.

2. Entitlement to service connection for a cervical and lumbar spine disabilities.

There is no dispute that the Veteran has a current disability of the cervical and lumbar spine as noted in a January 2021 rating decision which found that that Veteran had degenerative disc disease of the lumbar and cervical spine.

Turning to an in-service injury, the Board finds the Veteran's testimony of an in-service assault probative. The Veteran stated that he was assaulted during his active service and provided details about a specific place and time. In corroborating his stressor, his wife, a fellow Veteran, submitted an April 2012 lay statement detailing what she heard from the Veteran shortly after the incident, which corroborates the Veteran's current statements. Thus, considering the foregoing, the Board finds the report of in-service assault credible and verified.

On the issue of nexus, the Board finds the June 2025 VA examiner's opinion linking the Veteran's cervical and lumbar disabilities to his assault in service to be probative. In this opinion, the physician examined the treatment records and cited medical principles in forming his positive opinion relating the Veteran's cervical and lumbar disabilities to the Veteran's assault in service. The Court of Appeals for Veterans Claims has held in Nieves-Rodriguez v. Peake that most of the probative value of a medical opinion comes from its reasoning and the Board must be able to conclude that a medical expert has applied valid medical analysis to the significant facts of the particular case in order to reach the conclusion submitted in the medical opinion. See Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 304 (2008). Considering the foregoing, the Board finds that all elements of service connection are met, and thus service connection for the Veteran's cervical and lumbar back disabilities is granted.

3. Entitlement to service connection for a bilateral upper extremity and lower extremity radiculopathy.

The Veteran is service connected for a cervical and lumbar spine disability as noted above, and he has been diagnosed with bilateral upper and lower extremity radiculopathy as noted in a June 202
a medical expert has applied valid medical analysis to the significant facts of the particular case in order to reach the conclusion submitted in the medical opinion. See Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 304 (2008). Considering the foregoing, the Board finds that all elements of service connection are met, and thus service connection for the Veteran's cervical and lumbar back disabilities is granted.

3. Entitlement to service connection for a bilateral upper extremity and lower extremity radiculopathy.

Turning to a nexus, the Board finds that the June 2025 private examination report is probative on the issue of a relationship between the Veteran's cervical and lumbar spine disability and his bilateral upper and lower extremity radiculopathy. In this report, the examiner found that it was at least as likely as not that the Veteran's bilateral upper and lower extremity radiculopathy was caused by his cervical and lumbar spine disabilities respectively. The examiner's analysis is based on an exhaustive review of the Veteran's claims file. Additionally, the examiner outlined how he applied medical principles to come to his conclusion that the Veteran's bilateral upper and lower extremity radiculopathy were related to his cervical and lumbar spine disabilities. The Court of Appeals for Veterans Claims has held in Nieves-Rodriguez v. Peake that most of the probative value of a medical opinion comes from its reasoning and the Board must be able to conclude that a medical expert has applied valid medical analysis to the significant facts of the particular case in order to reach the conclusion submitted in the medical opinion. See Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 304 (2008).

Considering the foregoing, the Board finds that all elements of secondary service connection are met, and thus service connection for the Veteran's bilateral upper and lower extremity radiculopathy is granted. See Wallin v. West, 11 Vet. App. 509, 512 (1998); see also Allen, supra.

4. Entitlement to service connection for a right hand disability

The Veteran is service connected for a cervical disability as noted above, and he has been diagnosed with arthritis of the right hand as noted in an June 2025 private examination report, the only remaining question is etiology, i.e., a nexus.

Turning to a nexus, the Board finds that the June 2025 private examination report is probative on the issue of a relationship between the Veteran's cervical spine disability and his right hand arthritis. In this report, the examiner found that it was at least as likely as not that the Veteran's right hand arthritis was caused by his cervical spine disability. The examiner's analysis is based on an exhaustive review of the Veteran's claims file. Additionally, the examiner outlined how he applied medical principles to come to the conclusion that the Veteran's right hand arthritis was related to his cervical spine disability. The Court of Appeals for Veterans Claims has held in Nieves-Rodriguez v. Peake that most of the probative value of a medical opinion comes from its reasoning and the Board must be able to conclude that a medical expert has applied valid medical analysis to the significant facts of the particular case in order to reach the conclusion submitted in the medical opinion. See Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 304 (2008).

Considering the foregoing, the Board finds that all elements of secondary service connection are met, and thus service connection for the Veteran's right hand arthritis is granted. See Wallin v. West, 11 Vet. App. 509, 512 (1998); see also Allen, supra.

5. Entitlement to service connection for a stomach disability to include GERD

There is no dispute that the Veteran has a current disability of GERD as found in the favorable findings of January 2021 rating decision. There is no dispute that the Veteran is service connected for PTSD as found in the January 2021 rating decision. Thus, the only remaining issue is etiology between the Veteran's GERD and his PTSD.

On the issue of nexus, the Board finds the June 2025 private examination report is probative. The examiner found that it was at least as likely as not that the Veteran's GERD was caused by his PTSD. The examiner's analysis is based on an exhaustive review of the Veteran's claims file. Additionally, the examiner outlined how he applied medical principles to come to the conclusion that the Veteran's GERD was related to his PTSD. The Court of Appeals for
as found in the favorable findings of January 2021 rating decision. There is no dispute that the Veteran is service connected for PTSD as found in the January 2021 rating decision. Thus, the only remaining issue is etiology between the Veteran's GERD and his PTSD.

On the issue of nexus, the Board finds the June 2025 private examination report is probative. The examiner found that it was at least as likely as not that the Veteran's GERD was caused by his PTSD. The examiner's analysis is based on an exhaustive review of the Veteran's claims file. Additionally, the examiner outlined how he applied medical principles to come to the conclusion that the Veteran's GERD was related to his PTSD. The Court of Appeals for Veterans Claims has held in Nieves-Rodriguez v. Peake that most of the probative value of a medical opinion comes from its reasoning and the Board must be able to conclude that a medical expert has applied valid medical analysis to the significant facts of the particular case in order to reach the conclusion submitted in the medical opinion. See Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 304 (2008).

Considering the foregoing, the Board finds that all elements of secondary service connection are met, and thus service connection for the Veteran's GERD is granted. See Wallin v. West, 11 Vet. App. 509, 512 (1998); see also Allen, supra.

6. Entitlement to service connection for a memory loss disability

The Veteran contends his memory loss is related to his active duty service.

The Veteran's service treatment record does not contain any evidence that the Veteran was seen for complaints of or was treated for any memory loss while in service.

The post-service medical evidence of record show that the Veteran has been diagnosed with posttraumatic stress disorder with symptoms of memory loss. The evidence of record does not establish a disability related to memory loss other than his already service-connected PTSD for which he is already receiving compensation. Further, as noted there is no in service incurrence or event related to memory loss.

As noted above, service connection requires a showing of a current disability. Brammer v. Derwinski, 3 Vet. App. 223, 225 (1992). A current disability is shown if the claimed condition is demonstrated at the time of the claim or while the claim is pending. McClain v. Nicholson, 21 Vet. App. 319 (2007).

As mentioned above, the Board notes that the record does reflect that the Veteran is service-connected for PTSD (see the January 2021 rating decision), and the rating is based in part on memory loss. As such, assigning the Veteran a separate rating for another disability based on memory loss would violate the pyramiding prohibition contained in 38 C.F.R. § 4.14. Evaluation of the same disability under various diagnoses is to be avoided, and the evaluation of the same manifestations under different diagnoses, a practice known as "pyramiding," is to be avoided. See 38 C.F.R. § 4.14; Esteban v. Brown, 6 Vet. App. 259 (1994).

In light of the absence of any competent evidence of a current diagnosis or a separate and distinct memory loss disability this claim must be denied.

7. Entitlement to service connection for chronic fatigue syndrome.

The Veteran contends that he has chronic fatigue syndrome due to Persian Gulf Service.

Service treatment records are silent for a diagnosis of chronic fatigue syndrome. The Veteran's post-service treatment records are silent for a diagnosis or treatment for chronic fatigue syndrome.

In a December 2020 VA examination, after physical examination of the Veteran, a VA examiner found that no evidence of chronic fatigue syndrome or any related disability.

With respect to the Veteran's conclusion that he has chronic fatigue syndrome, in Jandreau v. Nicholson, 492 F. 3d 1372 (Fed. Cir. 2007), the Federal Circuit determined that lay evidence can be competent and sufficient to establish a diagnosis of a condition when (1) a layperson is competent to identify the medical condition (noting that 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), (2) the layperson is reporting a contemporaneous medical diagnosis, or (3) lay testimony describing symptoms at the time supports a later diagnosis by a medical professional. The relevance of lay evidence is not limited to the third situation but also extends to the first two. Whether lay evidence is competent and sufficient in a particular case is a factual issue.

In this case, the criteria under Jandreau have not been met. Initially, the Board notes that the Veteran has not reported a contemporaneous medical
) a layperson is competent to identify the medical condition (noting that 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), (2) the layperson is reporting a contemporaneous medical diagnosis, or (3) lay testimony describing symptoms at the time supports a later diagnosis by a medical professional. The relevance of lay evidence is not limited to the third situation but also extends to the first two. Whether lay evidence is competent and sufficient in a particular case is a factual issue.

In this case, the criteria under Jandreau have not been met. Initially, the Board notes that the Veteran has not reported a contemporaneous medical diagnosis of chronic fatigue syndrome, nor has a medical professional diagnosed him with chronic fatigue syndrome based on his lay symptoms. As for the Veteran being competent to diagnose chronic fatigue syndrome, the Board finds that this diagnosis requires greater medical knowledge than a lay person possesses. However, even if he was competent to do so, the Board finds the most probative evidence as to whether he has chronic fatigue syndrome to be the medical evidence. The Veteran's conclusion that he has chronic fatigue syndrome is outweighed by the objective studies conducted in the December 2020 VA examination and clinical expertise of the VA examiner who reviewed the Veteran's service treatment records and found no evidence of chronic fatigue syndrome.

On review of the evidence above, the Board finds no evidence that the Veteran currently suffers from chronic fatigue syndrome or related disability. Given the lack of competent evidence showing that the Veteran has chronic fatigue syndrome at present, the claim for chronic fatigue syndrome must be denied. Brammer v. Derwinski, 3 Vet. App. 223, 225 (1992

GAYLE STROMMEN

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board Acosta, J.

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.

Analyze in VA Law Explorer