INTERVERTEBRAL DISC SYNDROME

Summary

The veteran, who served in the United States Air Force from May 1986 to August 1991, appeals the denial of service connection for a low back disability. The veteran reported in-service complaints of middle back pain in May 1987, assessed as a mild back strain, and again in December 1987 for lumbar sprain. The Board noted the Appellant's testimony at a November 2024 hearing that he injured his back after falling off an armored personnel carrier, which he asserted was the start of ongoing problems. A January 2021 VA examination diagnosed mild degenerative disc disease but opined it was less likely than not related to service, concluding in-service strains resolved without residuals. Conversely, a November 2024 private medical opinion from L.B., PA-C, reviewed the claims file and concluded the current disability is at least as likely as not the direct result of military service, citing medical literature on chronic back pain development after injury and continuity of symptomatology. The Board found the VA opinion incomplete for failing to address continuity and medical literature, while the private opinion was more probative for its detailed rationale and use of supporting literature. Finding the evidence in approximate balance, the Board resolved doubt in the veteran's favor, granting service connection for the low back disability.

Rationale

In-service complaints of back pain and lumbar sprain.; VA exam found in-service strains resolved without residuals.; Private opinion found current disability related to service, citing continuity and medical literature.

Full Decision Text

Citation Nr: A26037712
Decision Date: 04/22/26	Archive Date: 04/22/26

DOCKET NO. 210617-166883
DATE: April 22, 2026

ORDER

Entitlement to service connection for a low back disability is granted.

FINDING OF FACT

The most probative evidence of record shows that the Appellant's low back disability is related to in-service complaints and treatment for low back pain.

CONCLUSION OF LAW

The criteria for service connection for a low back disability are met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303.

FACTUAL AND PROCEDURAL HISTORY? 

The Veteran served on active duty in the United States Air Force from May 1986 to August 1991.

This matter is before the Board of Veterans' Appeals (Board) on appeal from a February 2021 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO). 

In the June 2021 VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement), the Appellant elected the Hearing docket.  A Board hearing was held on November 13, 2024. Therefore, the Board may only consider the evidence of record at the time of the February 2021 decision on appeal, as well as any evidence submitted by the Appellant or representative 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, the Board did not consider it in its decision. 38 C.F.R. §§ 20.300, 20.302(a), 20.801. 

If the Appellant would like VA to consider any evidence that was submitted that the Board could not consider, the Appellant 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. 

REASONS AND BASES FOR FINDING AND CONCLUSION

Although the Board has an obligation to provide adequate reasons and bases supporting this Decision, there is no requirement that every piece of evidence submitted by the Appellant or obtained on his behalf be discussed in detail. Rather, the Board's analysis below will focus specifically on what evidence is needed to substantiate the claim and what the evidence in the claims file shows, or fails to show, with respect to the claim. See Gonzales v. West,?218 F.3d 1378, 1380-81?(Fed. Cir. 2000); Timberlake v. Gober,?14?Vet. App.?122, 128-130?(2000).

Low Back Disability

Legal Criteria - Service Connection

Service connection may be granted for disability resulting from disease or injury incurred in or aggravated by active service.?38 U.S.C. §§ 1110, 1131, 5107;?38 C.F.R. § 3.303. The three-element test for direct service connection requires evidence of: (1) a current disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the current disability and the in-service disease or injury. Shedden v. Principi,?381 F.3d 1163, 1166-67?(Fed. Cir. 2004).? 

The Board is responsible for determining whether the evidence supports the claims or is in approximate balance, with the veteran prevailing in either event, or whether the evidence is persuasively against the claims, in which case the claims are denied.?38 U.S.C. § 5107(b);?38 C.F.R. § 3.102; Lynch v. McDonough,?21 F.4th 776, 781-82 (2021).? 

The question for the Board is whether the Appellant has a current disability that began during service or is related to an in-service injury, event, or disease.? 

Material Facts

The Appellant was seen several times in service for reports of back pain. In May 1987, the Appellant was seen for complaints of middle back pain. He was noted as suffering an acute injury while playing softball. The injury was assessed as a mild back strain. A December 198
 which case the claims are denied.?38 U.S.C. § 5107(b);?38 C.F.R. § 3.102; Lynch v. McDonough,?21 F.4th 776, 781-82 (2021).? 

The question for the Board is whether the Appellant has a current disability that began during service or is related to an in-service injury, event, or disease.? 

Material Facts

The Appellant was seen several times in service for reports of back pain. In May 1987, the Appellant was seen for complaints of middle back pain. He was noted as suffering an acute injury while playing softball. The injury was assessed as a mild back strain. A December 1987 service medical record shows that the Appellant was seen for complaints of back pain and assessed as having a lumbar sprain. 

A January 2021 Back Conditions Disability Benefits Questionnaire noted the Appellant to have a diagnosis of mild degenerative disc disease. The examiner opined that the claimed disability was less likely than not the result of active service. Regarding in-service treatment, it was reasoned that "back muscle strains typically heal with time, many within a few days, and most within 3 to 4 weeks. Most patients with mild or moderate lumbar strains make a full recovery and are free of symptoms within days, weeks, or possibly months." As such, the examiner concluded the in-service complaints and treatment were acute in nature and "resolved with no evidence of recurrence/ progression/ chronicity/ residuals/ sequelae."

During the November 2024 Board hearing, the Appellant testified to injuring his back after falling off of an armored personnel carrier. It was asserted that this was the beginning of ongoing back problems.

Thereafter, the Appellant submitted a private treatment letter. In the November 2024 private treatment letter, L.B., PA-C. L.B. provided a detailed background of her work with veterans and prior work as a contracted VA medical health professional. It was indicated that a thorough review of the Appellant's claims file was conducted and that there was an understanding of the circumstances of the Appellant's service. The examiner concluded that the current disability on appeal is at least as likely as not the direct result of military service. In support of this, the examiner stated the following:

Medical literature shows that mechanical low back pain, which is defined as pain secondary to overuse of a normal anatomic structure, is most often the result of mechanical damage. Medical evidence shows that chronic low back pain can begin after overuse or a single injury, and that sub failure injuries of ligaments may cause chronic back pain due to muscle control dysfunction after overuse or injury to the back.

Beyond that, she highlighted medical literature that shows that service members who experience back pain while in service have a higher likelihood of developing chronic back pain and other back conditions. These factors, coupled with the reports of continuity of symptomatology, were used to support the positive nexus opinion.

Analysis

The Appellant asserts that entitlement to service connection for a low back disability is warranted because the claimed disability is the result of an in-service injury.

The January 2021 VA examination shows the Appellant has a current diagnosis of mild degenerative disc disease. During service, the Appellant was seen for complaints of back pain. Thus, the question becomes whether the current disability is related to service. On this question there are probative opinions in favor of and against the claim.

The evidence against the claim includes the negative January 2021 VA medical opinion. However, this opinion did not properly address the reports of continuity of symptomatology, concluded the in-service back strains were resolved, and did not reference medical literature to support their findings. There was no discussion of how in-service back strain diagnoses would not lead to the possible development of degenerative disc disease. As such, the medical opinion appeared incomplete and is of little probative value.

The evidence in favor of the claim includes private November 2024 private medical opinion. In addition to providing an extensive list of credentials, the examiner also included medical literature to support the conclusion that the claim in-service injury caused the present low back disability. The examiner highlighted reports of continuity of symptomatology, and how the in-service injury is known to develop among veterans, to further support their findings.

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Upon review of the record, the Board finds the evidence to at least be in approximate balance as to whether the Appellant's current low back disability is related to service. Accordingly, after resolving all doubt in favor of the Appellant, the Board finds that service connection for a low back disability is warranted. 38 U.S.C. § 5107; 38 C.F.R. § 3.102.

 

 

TIFFANY HANSON

Acting Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	K. Cross, Counsel

The
 reports of continuity of symptomatology, and how the in-service injury is known to develop among veterans, to further support their findings.

(CONTINUED ON NEXT PAGE)

Upon review of the record, the Board finds the evidence to at least be in approximate balance as to whether the Appellant's current low back disability is related to service. Accordingly, after resolving all doubt in favor of the Appellant, the Board finds that service connection for a low back disability is warranted. 38 U.S.C. § 5107; 38 C.F.R. § 3.102.

 

 

TIFFANY HANSON

Acting Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	K. Cross, Counsel

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.