Back to BVA DecisionsMIXEDSpecial Benefit NO SPECIAL BENEFIT Docket No. 250708-562145
THORACOLUMBAR SPINE (BACK) DISABILITY
JENNIFER WHITE · 2026 · Case ID: A26034527
Summary
The veteran, who served in the military from June 2002 to September 2020 with multiple periods of service including combat deployments to Iraq and Afghanistan, appeals the denial of service connection for a thoracolumbar spine (back) disability. The Board granted service connection for a cervical spine (neck) disability, finding the evidence in approximate balance and resolving doubt in the veteran's favor. The Board also granted service connection for left and right upper extremity neurological disabilities and headaches, finding them secondary to the newly service-connected neck condition based on positive nexus opinions from a VA examiner. The examiner noted a "double crush syndrome" linking the cervical spine issue to the radiculopathy in the arms. For headaches, a private medical opinion linked them to the cervical spine condition. The back claim was remanded due to a pre-decisional duty to assist error in the prior VA opinions, which were found insufficient for failing to consider aggravation and relying on an incorrect "chronic" requirement for nexus. The remand requires a new opinion on direct service connection for the back, and if not found, an opinion on aggravation by the service-connected right knee disability, including a baseline severity assessment.
Full Decision Text
Citation Nr: A26034527 Decision Date: 04/14/26 Archive Date: 04/14/26 DOCKET NO. 250708-562145 DATE: April 14, 2026 ORDER Entitlement to service connection for a cervical spine (neck) disability is granted. Entitlement to service connection for left upper extremity neurological disability is granted. Entitlement to service connection for right upper extremity neurological disability is granted. Entitlement to service connection for headaches is granted. REMANDED Entitlement to service connection for a thoracolumbar spine (back) disability is remanded. FINDINGS OF FACT 1. The evidence of record during the relevant period is at least in approximate balance that the Veteran's neck disability is related to service. 2. The evidence of record during the relevant period is at least in approximate balance that the Veteran's left and right upper extremity neurological disability, and headaches are caused by his neck disability. CONCLUSIONS OF LAW 1. The criteria for the establishment of service connection for a neck disability have been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303. 2. The criteria for the establishment of service connection for left and right upper extremity neurological disability and headaches have been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.310. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran had confirmed service in June 2002, from May 2004 to March 2008, from June 2012 to April 2013, and from November 2019 to September 2020. This case comes before the Board of Veterans' Appeals (Board) on appeal from an April 2025 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO). In the July 2025 VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement), the Veteran elected the direct review docket. Therefore, the Board may only consider the evidence of record at the time of the April 2025 Agency of Original Jurisdiction (AOJ) decision on appeal. 38 C.F.R. § 20.301. If evidence was submitted after the AOJ issued the decision on appeal, the Board did not consider it in its decision. Id. The Board notes that the AOJ found that new and relevant evidence had been received and readjudicated the Veteran's claims in the April 2025 rating decision. The determination that new and relevant evidence has been received is a finding favorable to the claimant and is binding on the Board unless rebutted by evidence that identifies a clear and unmistakable error in the favorable finding. 38 C.F.R. §§ 3.104(c), 20.801(a). Service Connection Claims Service connection may be established for disability due to a disease or injury that was incurred in or aggravated by active military service.? 38?U.S.C. §§?1110, 1131; 38?C.F.R. §?3.303.? Service connection may also be granted for any disease initially diagnosed after service, when all the evidence, including that pertinent to service, establishes that the disease was incurred in service.? 38?C.F.R. §?3.303(d).?????? In general, in order to prevail on the issue of service connection the evidence 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.? Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004). Service connection may also be granted for a disability that is due to, or aggravated by, service-connected disease or injury. 38 C.F.R. § 3.310. Neck Disability In his March 2023 Fully Developed Claim (FDC), the Veteran is claiming service connection for a cervical spine disability (also claimed as chronic neck pain). The record contains a February 2023 opinion from a private provider which indicates the Veteran's cervical spine disability is directly related to service, reasoning that the Veteran spent very long hours in full military gear and that the added weight of the gear along with the physical demands of his position directly contributed to his cervical spine disability. The examiner further reasoned that the Veteran had no other known risk factors that may have preceded his current condition and that the degenerative condition of his cervical spine has progressed more than patients in his same age C.F.R. § 3.310. Neck Disability In his March 2023 Fully Developed Claim (FDC), the Veteran is claiming service connection for a cervical spine disability (also claimed as chronic neck pain). The record contains a February 2023 opinion from a private provider which indicates the Veteran's cervical spine disability is directly related to service, reasoning that the Veteran spent very long hours in full military gear and that the added weight of the gear along with the physical demands of his position directly contributed to his cervical spine disability. The examiner further reasoned that the Veteran had no other known risk factors that may have preceded his current condition and that the degenerative condition of his cervical spine has progressed more than patients in his same age group. Based on the foregoing, service connection for a cervical spine disability is warranted, and the claim is granted. Left and Right Upper Extremity Neurological disability In his March 2023 FDC, the Veteran is claiming service connection for cervical radiculopathy (also claimed as numbness in both arms and hands). At a February 2024 peripheral nerves examination, the examiner diagnosed bilateral upper extremity radiculopathy. The examiner provided positive opinions finding the Veteran's left and right upper extremity radiculopathy are at least as likely as not caused by his now service-connected cervical spine disability, reasoning that the Veteran has a "double crush syndrome" which affects the cervical spine when the spinal roots are inflamed. Based on the foregoing, service connection for left and right upper extremity neurological disabilities is warranted on a secondary basis, and the claims are granted. Headaches In his March 2023 FDC, the Veteran claimed service connection for headaches/migraines. At his April 2023 headaches examination, the examiner diagnosed tension headaches. The Veteran informed the provider his chiropractor told him that imaging of his neck showed compressed discs and pinched nerves that were causing headaches. In a February 2024 opinion, a medical professional opined it is at least as likely as not that the Veteran's headaches are caused by his now service-connected cervical spine disability noting that the Veteran has reported that movement of his head precipitates a headache, pain goes up from his neck to the back of his head, and that he treats his headaches with, in pertinent part, chiropractic manipulation and laying on his back with a neck support. Based on the foregoing, service connection for headaches is warranted on a secondary basis, and the claim is granted. REASONS FOR REMAND The matters are REMANDED for the following action: BACKGROUND INFORMATION FOR REGIONAL OFFICE ADJUDICATOR: Back Disability: In his March 2023 FDC, the Veteran is claiming service connection for a back disability related to service and/or secondary to a service connected right knee disability. There is no sufficient medical opinion of record regarding direct service connection. A March 2024 VA opinion relies on the fiction that a disability must be "chronic" for a nexus to service to be established and thus the rationale is insufficient. Additionally, a March 2024 VA opinion does not consider aggravation. This is a remand to correct a pre-decisional duty to assist error. THE REMAND DIRECTIVES FOLLOW. 1. Obtain an opinion regarding the following from an appropriate examiner. (a.) Identify any lumbosacral disability, to include osteoarthritis and/or pain amounting to functional impairment of earning capacity (which is deemed a disability for VA purposes). (b.) For all disabilities found, as defined in (a) above, opine as to whether it is at least as likely as not (likelihood is at least approximately balanced or nearly equal, if not higher) that such disability/disabilities had its onset in, or is otherwise etiologically related to active service. Why or why not? (c.) If not, is any lumbosacral disability at least as likely as not (likelihood is at least approximately balanced or nearly equal, if not higher) aggravated by the right knee disability? Why or why not? (d.) If aggravation is found, the examiner must describe the baseline level of severity for the spinal disability based on medical evidence available prior to aggravation or the earliest medical evidence following aggravation by his service-connected right knee disability. The examiner should address whether the current severity of the lumbosacral is greater than the baseline. If the examiner cannot provide a baseline level of severity, he/she must explain why this is the case. The examiner must review the entire record in conjunction with rendering the requested opinion. The examiner's attention is drawn, but not limited to, the following evidence: " VA examinations/opinions dated February 2024 and March 2024. " Medical literature which was submitted in December 2024. " A February 2025 private opinion. The Board notes level of severity for the spinal disability based on medical evidence available prior to aggravation or the earliest medical evidence following aggravation by his service-connected right knee disability. The examiner should address whether the current severity of the lumbosacral is greater than the baseline. If the examiner cannot provide a baseline level of severity, he/she must explain why this is the case. The examiner must review the entire record in conjunction with rendering the requested opinion. The examiner's attention is drawn, but not limited to, the following evidence: " VA examinations/opinions dated February 2024 and March 2024. " Medical literature which was submitted in December 2024. " A February 2025 private opinion. The Board notes that the claims folder must be provided to and reviewed by the examiner for all post-remand cases per AOJ policy. See VBA Manual M21-1, Part IV.i.2.A.8.b. Thus, the examiner must specifically note that the claims folder was received and reviewed in the body of the examination report. 2. Readjudicate. Jennifer White Veterans Law Judge Board of Veterans' Appeals Attorney for the Board J. O'Connell 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.