DEGENERATIVE ARTHRITIS OF THE SPINE (SPONDYLOSIS)

E. I. VELEZ · 2026 · Case ID: A26033309

GRANTED

Summary

The veteran, who served from March 1972 to October 1978, appeals the denial of service connection for a back disability, bilateral lower extremity sciatica, and left hip osteoarthritis. The Board found that new and relevant evidence was received to readjudicate these claims, implicitly acknowledging the merit of the appeal. The veteran's service treatment records from August 1978 noted swollen and painful joints, but were silent regarding back complaints. However, subsequent lay statements from the veteran, his spouse, and his pastor consistently reported the onset of back and sciatic pain following an in-service knee injury, with a persistent limp and worsening symptoms over many years. The Board found this lay evidence competent and probative, particularly the January 2019 VA treatment note that linked the back and sciatic pain to the in-service knee injury. While some VA and private opinions were deemed inadequate due to lack of rationale, the Board found the evidence in approximate balance regarding the back and sciatica, resolving doubt in the veteran's favor and granting service connection. For the hip claims, the Board found the evidence in approximate balance between the veteran's assertion of gait abnormalities from a service-connected knee injury and VA opinions attributing the hip osteoarthritis to aging and obesity. Resolving this equipoise in the veteran's favor, service connection for bilateral hip osteoarthritis secondary to the service-connected right knee disability was granted. Service connection for all appealed conditions was granted.

Rationale

Lay evidence established in-service onset and persistence; Conflicting medical opinions in equipoise; Benefit of the doubt resolved in veteran's favor

Special Benefit

NO SPECIAL BENEFIT

Docket No.

210603-163906

Full Decision Text

Citation Nr: A26033309
Decision Date: 04/09/26 Archive Date: 04/09/26

DOCKET NO. 210603-163906
DATE: April 9, 2026

ORDER

Whether new and relevant evidence was received to readjudicate the issue of entitlement to service connection for a back disability is granted.

Whether new and relevant evidence was received to readjudicate the issue of entitlement to service connection for bilateral lower extremity sciatica is granted.

Whether new and relevant evidence was received to readjudicate the issue of entitlement to service connection for a left hip disability is granted.

Entitlement to service connection for a back disability is granted.

Entitlement to service connection for right lower extremity sciatica is granted.

Entitlement to service connection for left lower extremity sciatica is granted.

Entitlement to service connection for osteoarthritis of the left hip is granted.

Entitlement to service connection for osteoarthritis of the right hip is granted.

FINDINGS OF FACT

1. The agency of original jurisdiction (AOJ) made an implicit finding that new and relevant evidence had been received to readjudicate the Veteran's claim for service connection for a back disability in the March 2021 rating decision on appeal.

2. The AOJ made an implicit finding that new and relevant evidence had been received to readjudicate the Veteran's claim for service connection for bilateral lower extremity sciatica in the March 2021 rating decision on appeal.

3. The AOJ made an implicit finding that new and relevant evidence had been received to readjudicate the Veteran's claim for service connection for osteoarthritis of the left hip in the March 2021 rating decision on appeal.

4. Resolving all reasonable doubt in the Veteran's favor, the weight of the competent evidence is at least in approximate balance that the Veteran's back disability began in service and has continued since service.

5. Resolving all reasonable doubt in the Veteran's favor, the weight of the competent evidence is at least in approximate balance that the Veteran's right lower extremity sciatica began in service and has continued since service.

6. Resolving all reasonable doubt in the Veteran's favor, the weight of the competent evidence is at least in approximate balance that the Veteran's right lower extremity sciatica began in service and has continued since service.

7. Resolving all reasonable doubt in the Veteran's favor, the weight of the competent evidence is at least in approximate balance that the Veteran's osteoarthritis of the left hip is related to his service-connected right knee disability.

8. Resolving all reasonable doubt in the Veteran's favor, the weight of the competent evidence is at least in approximate balance that the Veteran's osteoarthritis of the right hip is related to his service-connected right knee disability.

CONCLUSIONS OF LAW

1. The criteria for readjudication of the claim for service connection for a back disability have been met. 38 C.F.R. §§ 3.156, 3.2501 (2025).

2. The criteria for readjudication of the claim for service connection for bilateral lower extremity sciatica have been met. 38 C.F.R. §§ 3.156, 3.2501 (2025).

3. The criteria for readjudication of the claim for service connection for osteoarthritis of the left hip have been met. 38 C.F.R. §§ 3.156, 3.2501 (2025).

4. The criteria for service connection for a back disability have been met. 38 U.S.C. §§ 1110, 1141, 5103, 5103A, 5107 (2024); 38 C.F.R. § 3.102, 3.303 (2025).

5. The criteria for service connection for right lower extremity sciatica have been met. 38 U.S.C. §§ 1110, 1141, 5103, 5103A, 5107 (2024); 38 C.F.R. § 3.102, 3.303 (2025).

6. The criteria for service connection for left lower extremity sciatica have been met. 38 U.S.C. §§ 1110, 1141, 5103, 5103A, 5107 (2024); 38 C.F.R. § 3.102, 3.303 (2025).

7. The criteria for service connection for osteoarthritis of the left hip secondary to a service-connected right knee disability have been met. 38 U.S.C. §§ 1110, 1141, 5103, 5103A, 5107 (2024); 38 C.F.R. § 3
.102, 3.303 (2025).

6. The criteria for service connection for left lower extremity sciatica have been met. 38 U.S.C. §§ 1110, 1141, 5103, 5103A, 5107 (2024); 38 C.F.R. § 3.102, 3.303 (2025).

8. The criteria for service connection for osteoarthritis of the right hip secondary to a service-connected right knee disability have been met. 38 U.S.C. §§ 1110, 1141, 5103, 5103A, 5107 (2024); 38 C.F.R. § 3.102, 3.303 (2025).

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Veteran served on active duty from March 1972 to October 1978. This matter came before the Board of Veterans Appeals (Board) on appeal from March 2021 and April 2021 rating decisions of the Department of Veterans Affairs (VA) Regional Office (RO).

In the June 2021 VA Form 10182, Decision Review Request: Board Appeal, the Veteran elected the Hearing docket. In January 2025, he withdrew the hearing request. Therefore, the Board may only consider the evidence of record at the time of the agency of original jurisdiction (AOJ) decision on appeal, as well as any evidence submitted by the Veteran or his representative at the hearing or within 90 days following the hearing withdrawal. 38 C.F.R. §?20.302(a).

The Board notes that, in February 2026, the Veteran submitted a motion to advance his claim on the docket (AOD) on the grounds of a serious illness. February 2026 VA treatment records show that he has been recently diagnosed with vascular dementia, a disorder involving progressive cognitive decline. Therefore, the Board finds that the Veteran's situation meets the requirements for an AOD and grants his request. 38 U.S.C. § 7107(a)(2); 38 C.F.R. § 20.902(c).

The Board notes that the Veteran has another pending appeal. In a May 2021 VA Form 10182, Decision Review Request: Board Appeal, the Veteran elected to appeal for entitlement to service connection for bilateral hearing loss and bilateral ankle disabilities in the modernized Hearing docket. As the current appeal pertains to different issues, rating decisions, and appeal streams, these issues will be addressed in a separate decision.

1. Whether new and relevant evidence was received to readjudicate the issue of entitlement to service connection for a back disability

2. Whether new and relevant evidence was received to readjudicate the issue of entitlement to service connection for bilateral lower extremity sciatica

3. Whether new and relevant evidence was received to readjudicate the issue of entitlement to service connection for a left hip disability

A previously denied claim may be readjudicated if new and relevant evidence is presented or secured with a supplemental claim. 38 C.F.R. § 3.2501. New evidence is evidence not previously part of the actual record before agency adjudicators. 38 C.F.R. § 3.2501(a)(1). Relevant evidence is information that tends to prove or disprove a matter at issue in a claim, including evidence that raises a theory of entitlement that was not previously addressed. Id.

Despite stating in the decision there was no new and relevant evidence regarding the Veteran's claim for service connection for a back disability, bilateral lower extremity sciatica, and osteoarthritis of the left hip, the March 2021 rating decision proceeded to address the claims on their merits and confirm the previous denials. The Board finds this to be an implicit favorable finding that new and relevant evidence has been received to readjudicate the Veteran's claims for service connection for these disabilities. Accordingly, the Board will address the Veteran's service connection claims on their merits, as well.

4. Entitlement to service connection for a back disability

5. Entitlement to service connection for right lower extremity sciatica

6. Entitlement to service connection for left lower extremity sciatica

Service connection may be established for any disease diagnosed after discharge, when all the evidence, including that pertinent to service, establishes the disease was incurred in service. 38 C.F
2021 rating decision proceeded to address the claims on their merits and confirm the previous denials. The Board finds this to be an implicit favorable finding that new and relevant evidence has been received to readjudicate the Veteran's claims for service connection for these disabilities. Accordingly, the Board will address the Veteran's service connection claims on their merits, as well.

4. Entitlement to service connection for a back disability

5. Entitlement to service connection for right lower extremity sciatica

6. Entitlement to service connection for left lower extremity sciatica

Service connection may be established for any disease diagnosed after discharge, when all the evidence, including that pertinent to service, establishes the disease was incurred in service. 38 C.F.R. § 3.303(d). Establishing service connection generally requires medical or, in certain circumstances, lay evidence of (1) a current disability; (2) an 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). See Davidson v. Shinseki, 581 F.3d 1313 (Fed. Cir. 2009); Hickson v. West, 12 Vet. App. 247, 253 (1999); 38 C.F.R. § 3.303(a).

VA is required to give due consideration to all pertinent medical and lay evidence in evaluating a claim for disability benefits. When the evidence is in approximate balance in the veteran's favor or nearly equal regarding any issue material to the determination of a matter, the Secretary shall give the benefit of the doubt to the claimant. 38 U.S.C. § 5107; see also Gilbert v. Derwinski, 1 Vet. App. 49, 53 (1990). If the evidence is not in approximate balance or nearly equal, the claim is to be denied. See Lynch v. McDonough, 21 F. 4th 776 (Fed. Cir. 2021).

While the Veteran endorsed swollen and painful joints on his August 1978 separation examination, nothing was noted in the clinical evaluation and the record is silent for any complaints, treatment, or diagnoses related to his back.

The Veteran wrote in a May 2013 statement that his bilateral knee disability caused him to walk with an antalgic gait resulting in discomfort to his spine.

In May and June 2013 treatment records, the Veteran's treating providers determined that it was reasonable that his back pain was likely due at least in part to his long history of bilateral knee pain and resulting uneven gait. However, the providers did not include any supporting rationale or citations to evidence of record. Therefore, the opinions are inadequate and will be afforded no probative weight. See Nieves- Rodriguez v. Peake, 22 Vet. App. 295 (2008); Stefl v. Nicholson, 21 Vet. App. 120, 124 (2007).

In February 2014, the Veteran's provider wrote that he had been walking unevenly a long time because of chronic low back pain, that x-ray imaging showed advanced degenerative joint disease with left sciatica with pain radiating into the legs, and facet arthropathy worsened by uneven walking due to degenerative joint disease of the knees and left sciatica.

The Veteran was afforded a VA back examination in April 2014. The examiner diagnosed him with degenerative disc and joint disease of the lumbosacral spine. No issues with gait or leg length were documented on the report. The examiner found that the Veteran's back disability was not secondary to his service-connected knee disability but did not address any other theory of service connection.

In a May 2014 statement, the Veteran's spouse wrote that ever since service, the Veteran had favored his right knee resulting in a visible limp, noting that she had observed uneven wear patterns on the soles of his shoes.

A January 2019 VA treatment note included the Veteran's report that his back pain began in service, following his left knee injury, and that both joints had progressively worsened since. The provider noted that there was no evidence of any other mechanical injury that would have manifested the degree abnormalities shown in imaging, or the level of reported functional impairment. He therefore concluded that it was as likely as not that his sciatic and back pain were due to his in-service injury and military duties.

A March 2019 VA back examination diagnosed the Veteran with degenerative changes of the lumbar spine and noted that the Veteran reported symptoms had been present for many years. The examiner concluded, however, that the Veteran's back disability was less likely than not related to his service-connected knee disabilities. He did not address any other theory of service connection, the January 2019 private
that both joints had progressively worsened since. The provider noted that there was no evidence of any other mechanical injury that would have manifested the degree abnormalities shown in imaging, or the level of reported functional impairment. He therefore concluded that it was as likely as not that his sciatic and back pain were due to his in-service injury and military duties.

A March 2019 VA back examination diagnosed the Veteran with degenerative changes of the lumbar spine and noted that the Veteran reported symptoms had been present for many years. The examiner concluded, however, that the Veteran's back disability was less likely than not related to his service-connected knee disabilities. He did not address any other theory of service connection, the January 2019 private opinion, or the Veteran's report regarding the in-service onset and persistence of his symptoms. Therefore, this opinion is inadequate and will be afforded no probative weight. See Nieves-Rodriguez, supra.

An August 2019 VA treatment record noted that the Veteran had likely hip mechanical deviations from his prior knee position practiced over many years, with additional chronic lower back pain, sciatica, right hip weakness, and left hip compression. The examiner noted that this all contributed to increased lower back stress and was likely the most limiting factor to his gait, distance endurance, and activity tolerance.

The Veteran submitted a June 2020 private medical opinion which found that his back, sciatica, and hip disabilities were most likely caused by, a result of, or aggravated by his service. However, the examiner did not include any supporting rationale or citations to evidence. This opinion is therefore inadequate and will be afforded no probative weight. See Nieves-Rodriguez, supra.

During a February 2021 VA back examination, the Veteran reported that he began to experience back pain following a 1973 accident that led to his service-connected left knee disability, and that this progressively worsened since. The examiner diagnosed him with degenerative arthritis of the spine and spinal stenosis, but found that these were less likely than not related to his service-connected knee disabilities. He did not address any other theory of service connection, the January 2019 private opinion, the August 2019 VA treatment record, or the Veteran's report regarding the in-service onset and persistence of his symptoms. Therefore, this opinion is inadequate and will be afforded no probative weight. See Nieves-Rodriguez, supra.

In a January 2025 statement, the Veteran reported that he has limped since the time of his original bilateral knee injuries in service, and that this resulted in pressure to his hips, back, and sciatica. He submitted medical literature and internet articles discussing the relationship between knee and back disabilities. His spouse also submitted a March 2025 statement in which she wrote that the Veteran had complained of back and sciatic pain since service. She again reported that she had observed him limping since service, as well. The Veteran's pastor wrote in a March 2025 statement that the Veteran walked with an observable limp and had complained of serve back pain for the past 39 years. The Board notes that the Veteran and his witnesses are competent to report lay-observable symptoms such as pain and limping, as well as the time of their onset, and accords their statements to that effect significant probative weight. See Layno v. Brown, 6 Vet. App. 465, 470 (1994). However, the record does not show that the Veteran or his witnesses possess the training or experience necessary to provide a competent etiology opinion. Therefore, the Board affords any of their opinions regarding the attribution of those lay-observable symptoms to particular injuries or disabilities no probative weight. Id.

Upon review of the above, the Board finds that the weight of the competent evidence is at least in approximate balance that the Veteran's back disability with bilateral lower extremity sciatica began in service and has continued since service. The Veteran and his witnesses have made competent statements that his back and sciatic pain began during service, following the 1973 injury for which his left knee disability is already service connected, and that they have persisted since. These cannot be disregarded merely because they are unaccompanied by contemporaneous medical evidence. Buchanan v. Nicholson, 451 F.3d 1331, 1336-37 (Fed. Cir. 2006). The January 2019 VA treatment record found that these lay reports were consistent with the disease process, imaging results, and level of functional impairment resulting from both his back and sciatic disabilities. As the VA and private etiology opinions of record were all found to be inadequate, there is no other evidence competently disassociating the reported in-service symptoms from the current back and sciatic disabilities. This reasonable
which his left knee disability is already service connected, and that they have persisted since. These cannot be disregarded merely because they are unaccompanied by contemporaneous medical evidence. Buchanan v. Nicholson, 451 F.3d 1331, 1336-37 (Fed. Cir. 2006). The January 2019 VA treatment record found that these lay reports were consistent with the disease process, imaging results, and level of functional impairment resulting from both his back and sciatic disabilities. As the VA and private etiology opinions of record were all found to be inadequate, there is no other evidence competently disassociating the reported in-service symptoms from the current back and sciatic disabilities. This reasonable doubt must be resolved in the Veteran's favor. Service connection is therefore warranted for the Veteran's back disability with bilateral lower extremity sciatica.

7. Entitlement to service connection for osteoarthritis of the left hip

8. Entitlement to service connection for osteoarthritis of the right hip

Service connection may be established for any disease diagnosed after discharge, when all the evidence, including that pertinent to service, establishes the disease was incurred in service. 38 C.F.R. § 3.303(d). Establishing service connection generally requires medical or, in certain circumstances, lay evidence of (1) a current disability; (2) an 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). See Davidson v. Shinseki, 581 F.3d 1313 (Fed. Cir. 2009); Hickson v. West, 12 Vet. App. 247, 253 (1999); 38 C.F.R. § 3.303(a).

While the Veteran endorsed swollen and painful joints on his August 1978 separate examination, nothing was noted in the clinical evaluation and the record is silent for any complaints, treatment, or diagnoses related to his back.

An August 2019 VA treatment record noted that the Veteran had likely hip mechanical deviations from prior knee position practiced over may years that resulted in right hip weakness and left hip compression.

During a November 2019 VA hip examination, the Veteran reported that his hip pain developed over the years after he favored his left ankle and walked with a limp. The examiner diagnosed the Veteran with bilateral hip osteoarthritis but concluded that this was less likely than not related to his service-connected knee disabilities. He reasoned that there was no evidence of leg length discrepancy in the medical record, that his provider had noted that his gait had considerably improved, and therefore his arthritis was most likely due to aging and obesity, rather than an abnormal gait.

A December 2020 treatment record noted a moderate antalgic gait favoring the right side. The provider wrote that he had reviewed the Veteran's military record and concluded that his bilateral hip disabilities could certainly be attributed to, and have been exponentiated by, his military duties in the same way as his bilateral knee disabilities.

An April 2021 VA hip examination noted the Veteran's reported that he began to develop bilateral hip pain in 2015 without any specific injury. The examiner found that the Veteran's right hip osteoarthritis was less likely than not related to his service-connected knee disabilities because there is no medical literature to support that an injury/surgery of one joint is causative of osteoarthritis in another joint. As the examiner did not address the issue of aggravation of the right hip disability by the service-connected knee disabilities, the opinion is inadequate and will be afforded no probative weight. See El-Amin v. Shinseki, 26 Vet. App.
duties in the same way as his bilateral knee disabilities.

An April 2021 VA hip examination noted the Veteran's reported that he began to develop bilateral hip pain in 2015 without any specific injury. The examiner found that the Veteran's right hip osteoarthritis was less likely than not related to his service-connected knee disabilities because there is no medical literature to support that an injury/surgery of one joint is causative of osteoarthritis in another joint. As the examiner did not address the issue of aggravation of the right hip disability by the service-connected knee disabilities, the opinion is inadequate and will be afforded no probative weight. See El-Amin v. Shinseki, 26 Vet. App. 136, 140-41 (2013); Allen v. Brown, 7 Vet. App. 439 (1995).

In March 2025 statements, the Veteran's spouse and pastor reported that they had observed the Veteran limping since service and that he had complained of hip pain for many years. The Board notes that the Veteran and his witnesses are competent to report lay-observable symptoms such as pain and limping, as well as the time of their onset, and accords their statements to that effect significant probative weight. See Layno v. Brown, 6 Vet. App. 465, 470 (1994). However, the record does not show that the Veteran or his witnesses possess the training or experience necessary to provide a competent etiology opinion. Therefore, the Board affords any of their opinions regarding the attribution of those lay-observable symptoms to particular injuries or disabilities no probative weight. Id.

Upon review of the above, the Board finds that the weight of the competent evidence is at least in approximate balance that the Veteran's bilateral hip disabilities are related to his service-connected right knee disability.

The Board notes that the December 2020 treatment record found that the Veteran's hip disabilities "could certainly" be attributed to his military duties. However, the Veteran has not reported, and the record does not show, that his hip disability began during service.

Instead, he has consistently maintained that his hip disabilities began insidiously without injury during or after service, and he has attributed this to gait and leg length differences resulting from his service-connected knee disabilities. The August 2019 treatment record competently associated the Veteran's mechanical hip deviations with his antalgic gait due to his right knee positioning over many years. By contrast, the November 2019 VA examination attributed the Veteran's hip disabilities to his aging rather than any gait or leg length abnormalities. The two conflicting medical opinions are therefore in equipoise. In the absence of any other competent evidence or medical opinions of record, this reasonable doubt must be resolved in the Veteran's favor.

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Therefore, the Board finds that service connection is warranted for his bilateral hip osteoarthritis secondary to his service-connected right knee disability.

E. I. VELEZ

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board E. Bock

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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