DEGENERATIVE ARTHRITIS

CYNTHIA M. BRUCE · 2026 · Case ID: A26039807

DENIED

Summary

The Veteran, a veteran who served from October 1965 to October 1969, including combat service in Vietnam, appeals the denial of service connection for a lumbar spine disability. The Veteran alleges the disability resulted from a truck accident during combat in June 1967, causing chronic low back pain. The Board acknowledged favorable findings from a prior AOJ decision, confirming a current lumbar spine disability and an in-service incurrence of a lumbar strain in February 1968. However, the Board found the Veteran's account of the June 1967 combat injury was rebutted by clear and convincing evidence. Specifically, a February 1968 treatment record noted no history of previous injury and prescribed different medication than alleged by the Veteran. The Board also noted inconsistencies in the Veteran's reports regarding post-service injuries and continuity of symptoms, deeming him an unreliable medical historian. The service separation examination in October 1969 found the Veteran's spine normal, with no listed defects. The Board found the August 2018 and April 2023 VA medical opinions, which questioned the claimed in-service injury and suggested age-related changes, to be the most probative. The Board concluded that the nexus element was not met, and the combat presumption was rebutted. The claim for chronic disease presumptive service connection was also denied due to lack of continuity of symptomatology and the Veteran's credibility issues. The evidence was found to weigh against the claim, making the benefit-of-the-doubt doctrine inapplicable. Service connection for the lumbar spine disability was denied.

Rationale

Veteran's account of June 1967 combat injury rebutted by clear and convincing evidence.; Contemporaneous treatment record noted no history of previous injury and inconsistent medication.; Credibility issues and inconsistencies in post-service injury reports and continuity of symptoms.

Special Benefit

NO SPECIAL BENEFIT

Docket No.

250721-565411

Full Decision Text

Citation Nr: A26039807
Decision Date: 04/28/26 Archive Date: 04/28/26

DOCKET NO. 250721-565411
DATE: April 28, 2026

ORDER

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

FINDING OF FACT

The evidence fails to probatively demonstrate that the Veteran's current low back disability was incurred in or is otherwise etiologically or presumptively linked to his active duty service.

CONCLUSION OF LAW

The criteria for entitlement to service connection for a lumbar spine disability have not been met. 38 U.S.C. §§ 1110, 1112, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.304, 3.307, 3.309.

REASONS AND BASES FOR FINDING AND CONCLUSION

The Veteran served on active duty from October 1965 to October 1969.

On August 23, 2017, the President signed into law the Veterans Appeals Improvement and Modernization Act, Pub. L. No. 115-55 (codified as amended in scattered sections of 38 U.S.C.), 131 Stat. 1105 (2017), also known as the Appeals Modernization Act (AMA). The law creates a new framework for veterans dissatisfied with the United States Department of Veterans Affairs' (VA) decision on their claims to seek review, and this decision has been written consistent with the new AMA framework.

In the July 21, 2025 VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement), the Veteran elected the Board of Veterans' Appeals' (Board) Hearing docket. On October 29, 2025, the Veteran withdrew the hearing request. Therefore, the Board may only consider the evidence of record at the time of the July 2025 agency of original jurisdiction (AOJ) decision on appeal, as well as any evidence submitted by the Veteran or his representative within 90 days following receipt of the withdrawal of the hearing request. 38 C.F.R. § 20.302(b). If evidence was submitted either (1) during the period after the AOJ issued the decision on appeal and prior to receipt of the withdrawal, or (2) more than 90 days following receipt of the withdrawal, the Board cannot consider it in its decision. 38 C.F.R. §§ 20.300, 20.302(b), 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 October 29, 2025 notification that the Veteran would not be attending the scheduled Board hearing, it was noted that a withdrawal of the appeal may be forthcoming as the Veteran was satisfied with his 100 percent schedular combined rating. Since that time, no withdrawal of the appeal has been received. Accordingly, the Board shall proceed with its merits review.

The July 2025 AOJ rating decision favorably determined that new and relevant evidence had been received since the prior disallowance of the claim. With this threshold issue resolved, the Board's analysis shall focus on the merits of the claim.

1. Entitlement to service connection for a lumbar spine disability is denied.

Service connection will be granted if it is shown that a veteran has a disability resulting from an injury or disease contracted in the line of duty, or for aggravation of a preexisting injury or disease contracted in the line of duty, in the active military, naval, air, or space service. 38?U.S.C. §?1110; 38?C.F.R. §?3.303.

Generally, to establish service connection, a veteran must show: (1) a current disability; (2) an in-service incurrence of a disease or injury; and (3) a causal relationship between the current disability and the disease or injury incurred during service, the so-called "nexus" requirement. See 38 U.S.C. § 1110; 38 C.F.R. § 3.303; see also Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004). All elements must be
. 38?U.S.C. §?1110; 38?C.F.R. §?3.303.

Additionally, service connection may be achieved if any applicable presumptive service connection regulations apply to the Veteran's circumstances or when a claimed disability is shown to be proximately due to, the result of, or aggravated by a service-connected disability.

The Veteran asserts that his current low back disability developed as a result of a fall from a truck in June 1967 while serving in the Republic of Vietnam during combat, and he has experienced chronic low back symptoms persistently since that time. See February 2023 lay statement; February 2023 VA Form 21-0781.

A January 2019 AOJ rating decision contained the following favorable findings. It noted that the Veteran's current low back disability has been variably diagnosed with degenerative disc disease, lumbar canal stenosis, lumbar facet arthrosis, and lumbar strain with arthritis. The rating decision also cited the Veteran's service treatment records which document a report of a lumbar strain on February 9, 1968, and a complaint of back pain on March 21, 1969. The reference to March 21, 1969, appears to be a clerical error as the service treatment records show that the complaint of back pain actually occurred on March 21, 1968. The Board is bound by these favorable findings, and the current disability and in-service incurrence elements of the Veteran's service connection claim have been met.

The Veteran has also reported that he injured his low back in June 1967 while serving in combat in the Republic of Vietnam. He alleges that his unit was traveling down a road, when an explosive blew up the vehicle. He was sitting at the rear of the truck, and the explosion caused him to fall off the vehicle. He claims to have injured his lower back, and his rectum was bleeding from the fall. He states that the unit was ambushed, and after it was safe, he was sent to medical, who gave him a bottle of Percocet for his back spasms, and sent him back to the field. He cites this claimed accident as the origins of his back pain and has alleged that his symptoms have remained present ever since this incident. This alleged injury is not documented in the Veteran's service department records.

When a veteran has engaged in combat with the enemy during active duty service, VA must accept satisfactory lay or other evidence that an injury or disease was incurred or aggravated in combat, if such evidence is "consistent with the circumstances, conditions, or hardships of such service." 38 U.S.C. § 1154(b); see also 38 C.F.R. § 3.304(d); see Reeves v Shinseki, 682 F.3d 988, 998 (Fed. Cir. 2012) (citing H. R. Rep. No. 1157, at 3 (1941) (noting that Congress enacted the predecessor statute to section 1154(b) because of its concern that combat veterans faced "major obstacle[s]" when seeking to assemble the medical records necessary to establish that they suffered an injury or disease while in service, that in many instances, medical records do not survive combat conditions, and that due to the exigencies of battle, soldiers may not immediately seek medical treatment for combat-related injuries). An allegation of combat-related injury or disease may be rebutted by clear and convincing evidence to the contrary. 38 U.S.C. § 1154(b). "Clear and convincing" evidence has been defined as "more than a preponderance" of the evidence. Arms v. West, 12 Vet. App. 188, 196 (1999). VA General Counsel has held that "[t]he ordinary meaning of the phrase 'engaged in combat with the enemy,' as used in 38 U.S.C. § 1154(b), requires that a veteran have participated in events constituting an actual fight or encounter with a military foe or hostile unit or instrumentality." VAOGCPREC. No. 12-
injury or disease may be rebutted by clear and convincing evidence to the contrary. 38 U.S.C. § 1154(b). "Clear and convincing" evidence has been defined as "more than a preponderance" of the evidence. Arms v. West, 12 Vet. App. 188, 196 (1999). VA General Counsel has held that "[t]he ordinary meaning of the phrase 'engaged in combat with the enemy,' as used in 38 U.S.C. § 1154(b), requires that a veteran have participated in events constituting an actual fight or encounter with a military foe or hostile unit or instrumentality." VAOGCPREC. No. 12-99, 65 Fed. Reg. 6,256-58 (2000).

The record adequately demonstrates that the Veteran's service in the Republic of Vietnam constitutes combat. The Veteran's DD Form 214 lists the Veteran's military occupational specialty (MOS) as code 1341, which equates to engineer equipment mechanic. Given this MOS, it is highly plausible that the Veteran would have been on unit convoys in the event that field repairs were required for the transport vehicles. The Veteran's service department records confirm that the Veteran served in the Republic of Vietnam from January 1967 to September 1968. The Veteran participated in the Defense of Danang Taor during the Tet-Holiday Offensive from January 29, 1968 to February 11, 1968. He also participated in operation "COCHISE" from March 18, 1968 to March 30, 1968." The Veteran's service during these operations likely involved direct exposure to large-scale, coordinated attacks from the enemy, including sustained firefights and hostile engagement, which is consistent with the definition of "engaged in combat with the enemy" provided by the VA General Counsel.

Based on the above, the Board finds the Veteran's allegation of injuring his low back in June 1967 during a combat envoy is entitled to consideration under the combat presumption in 38 C.F.R. § 3.304(d). However, the Veteran's allegation of such an injury in June 1967 is rebutted by clear and convincing evidence to the contrary. As noted above, the Veteran was seen for low back pain in February 1968. He described pain in the right lower back, radiating to the left part of the lower back only, with no sciatic radiation. It was specifically noted that the Veteran had "no hx [history] of previous injury." This contemporaneous notation rebuts the Veteran's present-day allegation that he injured his low back during combat action in June 1967, more than six months prior to this treatment record. Given the proximity of this notation to the events in question, it is provided far greater evidentiary weight than the Veteran's later allegations first rendered decades after service, which may have been influenced by hindsight bias, memory degradation, or pecuniary interest. The Board finds this contemporaneous evidence to meet the clear and convincing evidence standard, and this conclusion is bolstered by other instances in the record where the Veteran has been an unreliable and noncredible medical historian.

At the August 2018 Decision Review Officer (DRO) hearing, the Veteran "reported no separate back injuries following military service," but such a statement is untrue. The record reflects that the Veteran injured his low back in an on-the-job motor vehicle accident while employed as a police officer in 1975. The record contains another account where the Veteran reported low back pain associated with a recent motor vehicle accident in March 1999. The record establishes that the Veteran experienced at least two intercurrent injuries to his low back in motor vehicle accidents that occurred after his military service, and his lay reports to the DRO disavowing any injuries to the low back after service are not credible.

The Board has considered whether the Veteran may have misremembered the June 1967 date and was actually referring to the February 1968 or March 1968 treatment records which document complaints of back pain. However, this contention is not supported because these treatment records do not indicate that the Veteran was also treated for rectal bleeding (alleged to have occurred at the same time as the June 1967 accident in the February 2023 lay account). More importantly, the records indicate that the Veteran was prescribed Rolaxin at each visit, which is inconsistent with his reports of being prescribed Percocet in the alleged combat-related injury. There is no evidence or allegation from the Veteran that the back pain referenced in the February 1968 and March 1968 service treatment records was incurred during combat.

Taken as a whole, the inconsistencies described above constitute clear and convincing evidence sufficient to rebut the Veteran's account
complaints of back pain. However, this contention is not supported because these treatment records do not indicate that the Veteran was also treated for rectal bleeding (alleged to have occurred at the same time as the June 1967 accident in the February 2023 lay account). More importantly, the records indicate that the Veteran was prescribed Rolaxin at each visit, which is inconsistent with his reports of being prescribed Percocet in the alleged combat-related injury. There is no evidence or allegation from the Veteran that the back pain referenced in the February 1968 and March 1968 service treatment records was incurred during combat.

Taken as a whole, the inconsistencies described above constitute clear and convincing evidence sufficient to rebut the Veteran's account of having injured his low back in combat during June 1967. Accordingly, the Board may not rely on the Veteran's lay reports, alone, to support the claimed injury, and it is not documented anywhere else in the service department records. As the Veteran has been determined to be an unreliable medical historian since the filing of his service connection claims for a back disability, this also calls into question his allegations of continuous low back pain stemming from the June 1967 combat-related injury that is not adequately supported in the record. Consequently, the Board cannot find the Veteran's reports of chronic and continuous pain since service to be probative, as the claimed inciting injury has not been sufficiently proven, and he has not been forthright regarding intervening injuries to the low back.

The service treatment records indicate that the Veteran was treated for an abrasion to the left forearm in July 1969 as a result of an automobile accident. However, the notations in this record do not match the Veteran's description of his claimed combat-related injury, the treatment record does not reference any injuries sustained to the lower back, and the accident occurred after the Veteran's return from the Republic of Vietnam. This record cannot be viewed as evidence of the Veteran's claimed combat-related injury.

The Veteran's service separation examination in October 1969 listed the Veteran's spine as normal, and no diseases or injuries to the spine or the lower back were listed in the summary of defects and diagnoses section of the report. Contrary to the Veteran's present-day allegations, the records dated after the Veteran's service do not convincingly show chronic and persistent complaints or treatment for low back issues. The first reports of post-service back pain are from 1975 and 1999 and are in relation to post-service intercurrent motor vehicle accidents. The Veteran did not begin attributing his present low back disability to service until after he began seeking service connection for such a disability. The records dated prior to the Veteran's initial service connection claim for a low back disability in 2007 make no reference to any service-related back injuries.

At the August 2018 DRO hearing, the Veteran's representative argued there was no continuity of treatment for back complaints following the Veteran's discharge from military service due to lack of medical insurance. This contention is facially implausible as the record establishes that the Veteran worked as a police officer for his local municipality for 32 years and rose to the rank of sergeant. See November 2023 VA PTSD examination. The Veteran would have received medical insurance as part of the benefits package for civil service employees. See Caluza v. Brown, 7 Vet. App. 498, 506 (1995) (VA adjudicators may properly consider internal inconsistency, facial plausibility and consistency with other evidence submitted on behalf of the Veteran in weighing evidence). Moreover, the Veteran's VA treatment records indicate that the Veteran had private medical insurance but lost it when his employment as a police record ended in 1999. See April 2023 VA treatment records. This inconsistency further contradicts the Veteran's account of his medical history.

The electronic claims file contains three VA medical nexus opinions. In April 2008, a VA examiner opined that the relationship of the Veteran's back disability to the remote injuries noted in 1968, 40 years prior, would be purely speculative. The August 2018 VA examiner stated the Veteran experienced a remote strain in 1968, which is a separate and distinct disability than his present degenerative disc disease and lumbar spine stenosis, which is more consistent with a natural age-related finding. The April 2023 VA examiner commented that if the Veteran's "stated history of being thrown off the back of a truck and landing on his back/buttock was confirmed, the nature of the injury would explain the diffuse severity of his lumbar degeneration." However, the examiner then noted that the Veteran denied a history of a back injury when he first presented with back pain in February 1968 (after the alleged June 1967 injury). The examiner stated that based on
2018 VA examiner stated the Veteran experienced a remote strain in 1968, which is a separate and distinct disability than his present degenerative disc disease and lumbar spine stenosis, which is more consistent with a natural age-related finding. The April 2023 VA examiner commented that if the Veteran's "stated history of being thrown off the back of a truck and landing on his back/buttock was confirmed, the nature of the injury would explain the diffuse severity of his lumbar degeneration." However, the examiner then noted that the Veteran denied a history of a back injury when he first presented with back pain in February 1968 (after the alleged June 1967 injury). The examiner stated that based on the current record (which did not corroborate the Veteran's claimed June 1967 injury), and the Veteran's advanced age, when arthritis of the spine is typically expected, she could not opine that the Veteran's current low back disability was at least as likely as not related to the Veteran's service.

The Board finds the August 2018 and April 2023 VA medical opinions to be the most probative, as their conclusions were supported by explanatory rationales based on their clinical experience and known medical principles regarding the development of arthritis and aging. The April 2023 examiner questioned the Veteran's reports regarding his claimed in-service injury, and for the reasons stated above, such an injury has not been proven through competent and credible record evidence.

The Veteran's direct service connection claim must be denied because despite the documented reports of low back pain in February 1968 and March 1968, the Veteran's account of a June 1967 inciting injury to the spine has not been proven, and his credibility issues have rendered his lay reports of chronic and continuous symptoms since service non-credible and devoid of probative value in this appeal. Likewise, the medical nexus element of the Veteran's claim has not been satisfied, as the most probative evidence on this point is the negative opinions authored by the August 2018 and April 2023 VA examiners.

The Board has considered the chronic disease presumptive service connection provisions of 38 C.F.R. § 3.303(b), 3.307(a)(3), and 3.309(a), as "arthritis" is a qualifying chronic disease. There is no probative evidence that the Veteran's lumbar arthritis manifested to a compensable degree within one year of service separation. Additionally, where chronicity of complaints in service is legitimately questioned, presumptive service connection can only be achieved through continuity of symptomatology, and the medical evidence does not support continuity of symptoms since service, and the Veteran's lay reports alleging continuity of symptoms since service have been determined to lack credibility. Chronic disease presumptive service connection is not supported under the current evidentiary record.

The evidence is not in approximate balance and persuasively weighs against the Veteran's claim under all applicable theories of entitlement. As such, the benefit-of-the-doubt doctrine is not for application. See 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102; see Lynch v. McDonough, 21 F.4th 776, 780-82 (2021). The appeal seeking entitlement to service connection for a lumbar spine disability is denied.

Cynthia M. Bruce

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board M. Galante, 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.

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