DEGENERATIVE ARTHRITIS OF THE SPINE (SPONDYLOSIS)

Summary

The veteran, who served from June 1973 to October 1974, appeals the denial of service connection for a back disability, right lower extremity radiculopathy, and left lower extremity radiculopathy. The Board found that the evidence for service connection for the back disability was in approximate balance, and therefore resolved the doubt in the veteran's favor, granting service connection. The veteran's service treatment records (STRs) were silent regarding back complaints, but noted a motorcycle accident during service and subsequent treatment for head and neck injuries. However, the Board found the veteran credible regarding the onset and continuity of his back symptoms, noting that while VA examiners provided negative nexus opinions, they failed to adequately address the veteran's lay statements and the potential impact of his service-connected right knee disability on his back condition. The Board also found that the June 2023 VA examiner's rationale suggested a link to the in-service accident, despite the negative opinion. For the radiculopathy claims, the Board acknowledged negative VA opinions regarding a link to the service-connected right knee, but found the veteran's assertion that the condition was due to his back condition persuasive. Citing the June 2023 VA examiner's opinion that radiculopathy was likely due to spinal stenosis and degenerative disc disease, and the subsequent service connection for the back, the Board granted service connection for both right and left lower extremity radiculopathy as secondary to the back condition. The Board found the evidence weighed persuasively for these claims.

Rationale

Benefit of the doubt resolved in veteran's favor; Evidence in approximate balance; Lay testimony found credible; Negative VA opinions lacked probative value

Full Decision Text

Citation Nr: A26038964
Decision Date: 04/27/26	Archive Date: 04/27/26

DOCKET NO. 251119-607795
DATE:  April 27, 2026

ORDER

Entitlement to service connection for a back disability is granted.

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

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

FINDINGS OF FACT

1. Resolving reasonable doubt in the Veteran's favor, his back disability had its onset during active service.

2. The Veteran's right and left lower extremity radiculopathy is proximately due to or the result of the Veteran's now service-connected back disability.

CONCLUSIONS OF LAW

1. The criteria for entitlement to service connection for a back disability have been met. 38 U.S.C. §§ 1110, 1112, 5107 (2024); 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309 (2025).

2. The criteria for entitlement to service connection for right lower extremity radiculopathy have been met. 38 U.S.C. §§ 1110, 5107 (2024); 38 C.F.R. §§ 3.102, 3.303, 3.310 (2025). 

3. The criteria for entitlement to service connection for left lower extremity radiculopathy have been met. 38 U.S.C. §§ 1110, 5107 (2024); 38 C.F.R. §§ 3.102, 3.303, 3.310 (2025). 

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Veteran had active military service from June 1973 to October 1974. 

This matter comes before the Board of Veterans' Appeals (Board) on appeal from a January 2025 Higher-Level Review (HLR) rating decision and an April 2025 rating decision by the Department of Veterans Affairs (VA) agency of original jurisdiction (AOJ). Originally, in July 2023 and September 2023 rating decisions, the Veteran's claims for service connection for a back disability and right and left lower extremity radiculopathy were denied. In September 2023 and October 2023, the Veteran submitted supplemental claims requesting review of the July 2023 and September 2023 rating decisions. A January 2024 rating decision was issued in response to those claims. Following the January 2024 rating decision, the Veteran submitted a request for HLR. The January 2025 HLR rating decision on appeal was issued in response to that request. In the January 2025 HLR rating decision, the Higher-Level Reviewer confirmed and continued the denial of service connection for right and left lower extremity radiculopathy, but determined that there had been duty to assist errors with regard to the claim for service connection for a back disability and transferred that claim to the supplemental claim decision review option for additional development. The April 2025 rating decision on appeal was issued following completion of the additional development.

In the November 2025 VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement), the Veteran elected the Evidence Submission docket. As the Veteran elected the Evidence Submission docket and submitted evidence in support of his appeal, he may not subsequently switch dockets. See 38 C.F.R. § 20.202(c)(2). Therefore, the Board may only consider the evidence before the AOJ at the time of the January 2024 decision, which was subsequently subject to HLR, with regard to the claims for service connection for right and left lower extremity radiculopathy and the April 2025 decision on appeal with regard to the claim for service connection for a back disability, as well as any evidence submitted by the Veteran or his representative with, or within 90 days from receipt of, the November 2025 VA Form 10182. 38 C.F.R. § 20.303. If evidence was submitted either (1) during the period after the AOJ issued the decisions on appeal, one of which was subsequently subject to HLR, and prior to the date the Board received the VA Form 10182, or (2) more than 90 days following the date the Board received the VA Form 10182, the Board did not consider it in its decision. 38 C.F.R. §§ 20.300, 20.303, 20.801.

If the Veteran would like VA to consider any evidence that was submitted that the Board could not consider, the Veteran may file a Supplemental Claim (VA Form 20-0995
82. 38 C.F.R. § 20.303. If evidence was submitted either (1) during the period after the AOJ issued the decisions on appeal, one of which was subsequently subject to HLR, and prior to the date the Board received the VA Form 10182, or (2) more than 90 days following the date the Board received the VA Form 10182, the Board did not consider it in its decision. 38 C.F.R. §§ 20.300, 20.303, 20.801.

If the Veteran would like VA to consider any evidence that was submitted that the Board could not consider, the Veteran 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, considering the new evidence in addition to the evidence previously considered. Id. Specific instructions for filing a Supplemental Claim are included with this decision.

In the January 2024 rating decision, which was subsequently subject to HLR, the AOJ did not make any findings regarding whether new and relevant evidence had been received sufficient to warrant readjudication of the previously denied claims for service connection for right and left lower extremity radiculopathy. However, in the rating decision, the AOJ reviewed the claims on a de novo basis. Therefore, the Board finds the AOJ implicitly found new and relevant evidence had been received. In the April 2024 rating decision on appeal, the AOJ found that new and relevant evidence had been received sufficient to warrant readjudication of the previously denied claim for service connection for a back disability. The Board is bound by the AOJ's findings that new and relevant evidence has been submitted and need not address the issue. 38 C.F.R. § 3.104(c).

Service Connection - Back Disability

The Veteran asserts that his back disability had its onset during active service or is otherwise etiologically related to active service. In the alternative, the Veteran has claimed that his back disability was caused and/or aggravated by an altered gait caused by his service-connected right knee disability. Specifically, the Veteran claims that he injured his back in a motorcycle accident during service, and that he has experienced back pain since the accident. 

In the April 2025 rating decision on appeal, the AOJ found that the evidence showed a qualifying event, injury, or disease had its onset during service as the Veteran's service treatment records (STRs) showed he was in a motorcycle accident in November 1973, and that the Veteran had been diagnosed with a disability, degenerative disc disease other than interverbal disc syndrome (IVDS), spinal stenosis, and IVDS. These are favorable findings by which the Board is bound. 38 U.S.C. § 5104A; 38 C.F.R. § 3.104(c). 

The Veteran's STRs, including his October 1974 separation report of medical examination, are silent for any complaints of, treatment for, or diagnosis of back pain or conditions. However, the STRs do contain November 1973 emergency department records that indicate that the Veteran had been involved in a motorcycle accident, had hit his head, and was vomiting persistently. The Veteran reported pain in the cervical area. The skull and cervical spine X-rays were normal, and the Veteran was diagnosed with multiple abrasions over the left side of his face and a contusion to the cervical area. He was admitted for observation to rule out the possibility of a concussion and was released the next day. At discharge, the provider noted that the Veteran was doing well and had no problems whatsoever. While the Veteran's STRs are silent for a diagnosis of a chronic back disability, the Board notes that the Veteran is competent to report the onset and continuity of his symptoms. Moreover, the Board finds the Veteran credible in that regard. Heuer v. Brown, 7 Vet. App. 379 (1995); Falzone v. Brown, 8 Vet. App. 398 (1995); and Caldwell v. Derwinski, 1 Vet. App. 466 (1991). 

Shortly after discharge from service, in October 1974, the Veteran filed a claim for service connection for a back injury due to a November 1973 wreck. In December 1974, the Veteran was afforded a VA examination. The Veteran reported pain in his neck and the lower part of his back, and that he had injured his back during a motorcycle wreck. The Veteran reported that he had been treated in a hospital for the injury to his back and neck, that he had been released after 24 hours, and that after the accident, he had gone back to Fort Bragg where he received no further treatment for his neck or back
 and Caldwell v. Derwinski, 1 Vet. App. 466 (1991). 

Shortly after discharge from service, in October 1974, the Veteran filed a claim for service connection for a back injury due to a November 1973 wreck. In December 1974, the Veteran was afforded a VA examination. The Veteran reported pain in his neck and the lower part of his back, and that he had injured his back during a motorcycle wreck. The Veteran reported that he had been treated in a hospital for the injury to his back and neck, that he had been released after 24 hours, and that after the accident, he had gone back to Fort Bragg where he received no further treatment for his neck or back. He reported that he had gone to the dispensary, but his injuries were not thought to be serious enough for admission to the hospital. X-rays were performed in conjunction with the examination, and the chest, right knee, and cervical spine were noted as normal. The lumbar spine X-ray revealed a slight right convex scoliosis of the lower thoracic and upper lumbar spine. The examiner diagnosed back injury residuals. However, the AOJ denied the Veteran's claim based on a finding that the Veteran's separation and VA examination did not show a current back disability. 

A post discharge December 1986 private treatment record notes that the Veteran was being evaluated for a left head laceration and right hip and lower back pain following a motor vehicle accident. X-rays of the skull, cervical spine, and lumbar spine were all noted as normal. The provider diagnosed the Veteran with a left scalp laceration and low back strain. A May 2005 private treatment record notes that the Veteran was being evaluated following an altercation with local law enforcement. Cervical spine X-rays at that time showed degenerative changes in the cervical spine, but no evidence of acute fracture or spondylolisthesis. November 2005 private treatment records note that the Veteran reported neck and back pain following a motor vehicle accident. Cervical spine X-rays taken at that time revealed spondylitic changes of the cervical spine with no acute process identified. Another November 2005 private treatment record notes that the Veteran was being referred to a chiropractor for treatment of ongoing neck and back soreness following a car accident. Private chiropractic treatment records from May 2008 to September 2009 reflect ongoing diagnosis and treatment for chronic back pain. 

In June 2008, the Veteran established care with the VA, and the Veteran's VA treatment records from this date to the present note ongoing complaints of and treatment for chronic back pain. A June 2008 VA treatment record reflects that the Veteran reported a history of a forklift accident to his right knee and associated back injury in February. The Veteran reported known cervical narrowing at C7 for the last 2 years. Diagnostic studies revealed cervical spondylosis, left knee mild degenerative changes, and mild dextroscoliosis in the thoracic spine. A September 2008 VA treatment record notes that the Veteran reported ongoing right knee pain that had onset in 1974, and that on physical examination, the provider noted that the Veteran's gait was antalgic. A July 2010 VA emergency department record reflects that the Veteran reported left sided low back pain with no specific cause or event. On examination, the Veteran had tenderness to the left lumbar area and straight leg raising was 90 degrees on both sides with some pain on the left side radiating to the left thigh. The provider diagnosed lumbar strain and prescribed medication to treat the condition. An August 2011 VA treatment record reflects that the Veteran reported right lumbo-pelvic pain. The Veteran reported a history of left ankle fracture, and that he had been putting more weight on his right leg to compensate for his left ankle. The Veteran described the pain as a deep ache in the right lumbo-pelvic area that radiated to his buttock. The provider did not note any specific diagnoses for the Veteran's back but referred him for a lumbar spine MRI. The September 2011 lumbar spine MRI revealed multilevel degenerative disc disease, neural foraminal stenosis, and facet degenerative joint disease with neuroforaminal narrowing most prominent at L5-S1. An October 2011 VA treatment record reflects that the Veteran reported the pain in his bilateral knees limited his gait to short distances. An October 2022 VA treatment record notes that the Veteran reported ongoing right knee pain, and on physical examination, the provider noted that the Veteran walked with a very antalgic gait. 

In June 2013, the Veteran was afforded a VA back conditions examination. The Veteran reported that he had experienced intermittent low back discomfort 2 to 3 times a year since his motorcycle accident during service. The examiner noted that a July
 multilevel degenerative disc disease, neural foraminal stenosis, and facet degenerative joint disease with neuroforaminal narrowing most prominent at L5-S1. An October 2011 VA treatment record reflects that the Veteran reported the pain in his bilateral knees limited his gait to short distances. An October 2022 VA treatment record notes that the Veteran reported ongoing right knee pain, and on physical examination, the provider noted that the Veteran walked with a very antalgic gait. 

In June 2013, the Veteran was afforded a VA back conditions examination. The Veteran reported that he had experienced intermittent low back discomfort 2 to 3 times a year since his motorcycle accident during service. The examiner noted that a July 2011 lumbar spine X-ray had been normal and there was an MRI of the thoracic spine from September 2008, and that the Veteran reported experiencing low back pain 2 to 3 times a year without radiation that lasted almost a week at a time. The examiner noted that the Veteran denied flare-ups and incapacitating episodes as well as time lost from work due to spine problems. The examiner diagnosed intermittent lumbar strain but did not provide a medical opinion regarding the etiology of the condition. 

In May 2023, the Veteran was afforded another VA back conditions examination. The Veteran reported that the condition had started in relation to his right knee, and that the initial symptoms were back pain. The Veteran described his current symptoms as back pain and the functional impairment due to his back pain as an inability to stand, sit, or walk for long periods of time. The examiner diagnosed degenerative disc disease other than intervertebral disc syndrome (IVDS) and spinal stenosis with 2011 as the date of diagnosis and opined that the condition was less likely than not proximately due to or the result of the Veteran's service-connected condition of residuals of right knee injury. As rationale, the examiner noted that an October 1974 STR indicated that the Veteran had sustained a right knee injury while playing football, and that the October 1974 separation examination was negative for the claimed back condition. The examiner stated that the first report of back pain was 2007/2008, 33 years after separation from active duty, and that September 2011 medical records indicated the diagnosis of degenerative disc disease and neural foraminal spinal stenosis. Citing medical literature, the examiner stated that degenerative disc disease occurred when the cushioning in the spine began to wear away, and that the condition was most common in older adults. The examiner stated that after age 40, most people experienced some spinal degeneration, and that spinal discs wore down as a normal part of aging; however, not everyone experienced pain. The examiner stated that there was no evidence to suggest that degenerative disc disease, and the resulting spinal stenosis was caused by injury to the Veteran's knees, or any other joint of the body, as it had been shown to be a common finding associated with age. The examiner noted that the Veteran had been diagnosed with degenerative disc disease and spinal stenosis in 2011 at the age of 58. 

In June 2023, the Veteran was afforded another VA back conditions examination. The Veteran reported that the condition had onset in 1973 due to a motorcycle accident after getting out of jump school. The Veteran described his symptoms at the time of injury as pain and migraines and his current symptoms as pain in his hips and buttocks. The Veteran described the functional impairment due to his back condition as needing to rest and take a lot of breaks, avoiding social activities due to pain and feeling tired, and an inability to do the things he had done previously like fishing and yard maintenance. The examiner diagnosed degenerative disc disease other than IVDS, spinal stenosis, and IVDS with 2011 as the date of diagnosis for degenerative disc disease other than IVDS and spinal stenosis and 2023 for IVDS. The examiner opined that the condition was less likely than not incurred in or caused by the claimed in-service injury, event, or illness. As rationale, the examiner noted that the examination in 1974 demonstrated that the Veteran did have a lower back injury at that time, but he demonstrated normal range of motion and did not report radiculopathy. Records from a hearing in 2009 showed that while the Veteran did injure his back in 1973, it was while he was on leave, which the Veteran had confirmed during his current examination. Therefore, the examiner found there was no nexus to an in-service injury, event, or illness.

In February 2025, the AOJ obtained an addendum VA medical opinion as the June 2023 VA examiner had provided a negative nexus opinion based on a finding that the 1973 accident had not occurred during active service as the Veteran was on leave at
 the examination in 1974 demonstrated that the Veteran did have a lower back injury at that time, but he demonstrated normal range of motion and did not report radiculopathy. Records from a hearing in 2009 showed that while the Veteran did injure his back in 1973, it was while he was on leave, which the Veteran had confirmed during his current examination. Therefore, the examiner found there was no nexus to an in-service injury, event, or illness.

In February 2025, the AOJ obtained an addendum VA medical opinion as the June 2023 VA examiner had provided a negative nexus opinion based on a finding that the 1973 accident had not occurred during active service as the Veteran was on leave at the time of the accident. The examiner opined that the claimed condition was less likely than not incurred in or caused by the claimed in-service injury, event, or illness. As rationale, the examiner noted that the Veteran had been involved in an MVA (motor vehicle accident) in 1973, and that there was a documented injury to the neck and head, but no complaints/injury in the back. The examiner noted that lumbar spine X-rays in 1986 due to an unrelated event showed a normal lumbar spine; therefore, it was unlikely that the Veteran's current back problems were related to any injury/incident during service. 

The Board notes that lay evidence can be competent and sufficient to establish a diagnosis or etiology of a condition when (1) a layperson is competent to identify the medical condition, (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. In fact, competent medical evidence is not necessarily required when the determinative issue involves either medical etiology or a medical diagnosis. Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007); Buchanan v. Nicholson, 451 F.3d 1331 (Fed. Cir. 2006). As noted, the Veteran is competent to report both the onset and continuity of his symptoms. The Board finds that the Veteran's reporting of his symptoms in support of his claim is credible. 

Ultimately, the Board finds that the evidence in this case is nearly equal. In this regard, the Veteran asserts his back disability had its onset during active service due to his motorcycle accident, and that his back pain has continued since service. This claim is supported by the Veteran's STRs, the 1974 VA examination, and some of the medical evidence. The Board acknowledges the negative VA medical opinions, but finds that they lack significant probative value as the examiners relied primarily on the lack of contemporaneous medical documentation, failed to adequately address the Veteran's lay statements regarding the onset and continuity of his symptoms, and failed to adequately address whether an altered gait due to the Veteran's service connected right knee disability caused and/or aggravated the Veteran's back disability. Further, the June 2023 VA examiner's rationale appears to indicate that the Veteran's current back disability is etiologically related to his in-service accident, but the examiner provided a negative nexus opinion because the accident occurred while the Veteran was on leave.

Accordingly, the Board finds that the evidence for and against the claim is in approximate balance. Therefore, the benefit of the doubt must be resolved in favor of the Veteran and entitlement to service connection for a back disability, is warranted. 38 U.S.C. § 5107(b); Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021) (en banc).

Service Connection - Right and Left Lower Extremity Radiculopathy

The Veteran asserts that his right and left lower extremity radiculopathy is secondary to his back disability, which based on the above, is now service connected. 

In the January 2025 HLR rating decision on appeal, the AOJ found that the Veteran had been diagnosed with a disability, left and right lower extremity diabetic neuropathy. In the July 2023 and September 2023 rating decisions, the AOJ also found that the Veteran had been diagnosed with right and left lower extremity radiculopathy. These are favorable findings by which the Board is bound. 38 U.S.C. § 5104A; 38 C.F.R. § 3.104(c). 

Initially, the Board acknowledges the negative VA medical opinions regarding whether the Veteran's left and right lower extremity radiculopathy was caused and/or aggravated by his service-connected right knee disability. However, the Veteran has stated that he believes that his right and left lower extremity radiculopathy is due to his back condition. 

At the June 2023 VA back conditions examination, the examiner noted that the straight leg raising test on
 decisions, the AOJ also found that the Veteran had been diagnosed with right and left lower extremity radiculopathy. These are favorable findings by which the Board is bound. 38 U.S.C. § 5104A; 38 C.F.R. § 3.104(c). 

Initially, the Board acknowledges the negative VA medical opinions regarding whether the Veteran's left and right lower extremity radiculopathy was caused and/or aggravated by his service-connected right knee disability. However, the Veteran has stated that he believes that his right and left lower extremity radiculopathy is due to his back condition. 

At the June 2023 VA back conditions examination, the examiner noted that the straight leg raising test on the left was positive, and that the Veteran had radicular pain and other signs or symptoms due to radiculopathy, which the examiner described as moderate intermittent pain on the left side and mild numbness on the right and left sides with bilateral involvement of the sciatic nerve. The examiner opined that the likely cause of the abnormal muscle strength, abnormal sensory examination findings, and positive straight leg raising test was spinal stenosis and degenerative disc disease, and that the likely cause of the radiculopathy was IVDS and spinal stenosis. 

Based on the above, as the Veteran is now service connected for a back disability, and the June 2023 VA examiner opined that the Veteran's radiculopathy was likely due to his IVDS and spinal stenosis, the Board finds that the evidence weighs persuasively for the claim. Therefore, entitlement to service connection for right and left lower extremity radiculopathy is warranted. 38 U.S.C. § 5107(b); Lynch, 21 F.4th 776.

 

 

Kristin Haddock

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	E.J. Woodward, Associate 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.