INTERVERTEBRAL DISC SYNDROME

Summary

The veteran, who served in the United States Marine Corps from June 1995 to June 2001, appeals the denial of service connection for a lower back condition and a cervical spine condition. The Board reviewed the case based on the evidence of record at the time of the March 2025 rating decision. The veteran had previously received a remand for inadequate VA opinions on these claims. For the lower back condition, the Board acknowledged a current diagnosis of lumbosacral strain and an in-service event noted in October 1999 for acute lower back pain. However, the Board found the nexus element lacking. Two VA addendum opinions from November 2024 and February 2025 concluded that the in-service back pain was likely an acute, self-limiting incident that resolved in service, and any current symptoms were more likely due to post-service occupational overuse. These opinions found the evidence insufficient to show chronicity or continuity of symptoms related to service, ultimately opining the condition was less likely than not related to service. A private medical opinion from January 2023 found the condition more likely than not related to service, but the Board found it inadequate due to lack of examination, reliance on subjective complaints, and conclusory reasoning. For the cervical spine condition, the Board acknowledged a current diagnosis of cervical strain and an in-service event noted in July 1998 for neck pain. Similar to the back claim, the VA addendum opinions concluded the in-service neck pain was acute and resolved, with current symptoms likely due to occupational overuse and insufficient evidence of chronicity. The private medical opinion was also found inadequate for similar reasons. The Board found the VA opinions adequate and persuasive, concluding no nexus was established for either condition. Consequently, the evidence persuasively weighed against service connection for both the lower back and cervical spine conditions, and the benefit of the doubt doctrine was not applied. Service connection for both conditions was denied.

Rationale

Current diagnosis of lumbosacral strain acknowledged.; In-service event of acute lower back pain in October 1999 acknowledged.; VA addendum opinions found in-service condition acute and resolved.; Current symptoms attributed to post-service occupational overuse.; Evidence insufficient to show chronicity or continuity related to service.; VA examiner opined condition less likely than not related to service.; Private opinion found inadequate due to lack of examination and conclusory reasoning.; Evidence persuasively weighs against service connection.

Full Decision Text

Citation Nr: A26039979
Decision Date: 04/29/26	Archive Date: 04/29/26

DOCKET NO. 250513-543123
DATE: April 29, 2026

ORDER

Entitlement to service connection for a lower back condition is denied.

Entitlement to service connection for a cervical spine condition is denied. 

FINDINGS OF FACT

1. The evidence of record persuasively weighs against finding that a lower back condition began during active service or is otherwise related to an in-service injury or disease.

2. The evidence of record persuasively weighs against finding that a cervical spine condition began during active service or is otherwise related to an in-service injury or disease.

CONCLUSIONS OF LAW

1. The criteria for service connection for a lower back condition are not met.  38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303.

2. The criteria for service connection for a cervical spine condition are not met.  38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303.

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Veteran served in the United States Marine Corps from June 1995 to June 2001. 

This matter comes to the Board of Veterans' Appeals (Board) from a March 2025 rating decision issued by a Department of Veterans Affairs (VA) Regional Office (RO).

In the May 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 March 2025 agency of original jurisdiction (AOJ) decision on appeal. 38 C.F.R. § 20.301. Any evidence submitted after the AOJ decision on appeal cannot be considered by the Board. 38 C.F.R. §§ 20.300, 20.301, 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 claims, considering the new evidence in addition to the evidence previously considered. Id. Specific instructions for filing a Supplemental Claim are included with this decision. 

The Board acknowledges the decision by the United States Court of Appeals for Veterans Claims (Court) in Williams v. McDonough, 37 Vet. App. 305 (2024). In Williams, the Court held the Board must refrain from deciding a case until the case proceeds to the point where a docket switch is no longer permitted under the terms of 38 C.F.R. § 20.202(c)(2). The deadline to request an AMA docket switch is one year from the date of notice of the AOJ decision or 60 days from the date the VA Form 10182 was received by the Board, whichever is later. See generally Williams, 37 Vet. App. 305. The notice of the rating decision on appeal is dated March 5, 2025. The Board interprets the Veteran's statements as reflecting an intent to have this matter reviewed in an expeditious manner, which the Board finds to be an implicit waiver of the Veteran's right to change Board dockets under Williams v. McDonough, 37?Vet. App.?305 (2024). Thus, the Board will proceed with adjudication.

By way of background, in October 2024, the Board issued a decision remanding the claims of the lower back and cervical spine conditions, finding that the previously procured VA opinions were inadequate.  On remand, the VA examiner was instructed to identify all current lower back and cervical spine diagnoses and for each, to opine as to whether the condition is due to the Veteran's service, to include the Veteran's report of cervical spine and lower back injuries sustained during service. In opining on these issues, the VA examiner was instructed to consider a July 22, 1998 service treatment record indicating that the Veteran experienced a cervical muscle strain after a fall, an October 4, 1999 service treatment record indicating that the Veteran experienced acute lower back pain due to heavy lifting, lay statements from the Veteran to include the Veteran's report of worsening neck and back since service and being struck in the neck while working in an aircraft, and a January 2023 private nexus opinion regarding cervical and lumbosacral strain. 

Service Connection

Service connection may be granted
 to whether the condition is due to the Veteran's service, to include the Veteran's report of cervical spine and lower back injuries sustained during service. In opining on these issues, the VA examiner was instructed to consider a July 22, 1998 service treatment record indicating that the Veteran experienced a cervical muscle strain after a fall, an October 4, 1999 service treatment record indicating that the Veteran experienced acute lower back pain due to heavy lifting, lay statements from the Veteran to include the Veteran's report of worsening neck and back since service and being struck in the neck while working in an aircraft, and a January 2023 private nexus opinion regarding cervical and lumbosacral strain. 

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, 5107; 38 C.F.R. § 3.303.  The three-element test for 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).

1. Entitlement to service connection for a lower back condition is denied. 

The Veteran states that he is entitled to service connection for a lower back condition. After a careful review of the record, the Board determines that the matter must be denied. The reasons follow. 

The first element for direct service connection requires that there be a current disability. In a March 2025 rating decision, the RO made the favorable finding that in August 2022, the Veteran was diagnosed with a lumbosacral strain. The Board will not disturb this favorable finding.  38 C.F.R. § 3.104(c). As there is a current diagnosis, the first element for direct service connection has been satisfied. 

Next, there must be an in-service event or incurrence. In a March 2025 rating decision, the RO made the favorable finding that the Veteran's October 4, 1999 service treatment records noted that the Veteran was seen for lower back pain while in service. As there is a finding that there was an in-service event, the second element for direct service connection has been satisfied. 

The final element for direct service connection is that there is a nexus between the current disability and the in-service event or incurrence. 

In November 2024, an addendum opinion was obtained. The VA examiner stated that the August 2022 VA back examination reports physical examination findings that were consistent with a lumbosacral strain. The VA examiner stated that based on a review of the Veteran's medical records and October 4, 1999 service treatment records, there was a single report of back pain after heavy lifting. The Veteran was diagnosed with acute lower back pain. The VA examiner stated that the condition was treated conservatively which was likely resolved in service as a March 6, 2001 separation report of medical history indicated "no" for recurrent back pain. She went on to state that there was no follow-up clinic visit for the back pain one year after active duty. The VA examiner stated that post-service the Veteran was able to gain employment in electrical instrumentation without chronic pain or limitation of motion related to back pain.  

The VA examiner reported that lumbar muscle strain is caused when muscle fibers are abnormally stretched or torn. She stated that in the acute phase of lower back pain, bed rest may be considered for a short period of time. However, she stated that most studies now support that the individual maintain some activity, even in the acute phase, as this promotes a more rapid recovery. Most patients were noted to feel relief using anti-inflammatory medications, such as Ibuprofen or ice. She stated that physical therapy, massage, and stretching can also be effective. The VA examiner stated that generally symptoms resolve in a few days to a few weeks. The VA examiner acknowledged that there was a private medical opinion; however, stated that there is limited evidence to show progression of pain, chronicity, and continuity as well as limitation of motion of the back affecting employment or daily activities to support a relationship with service. The VA examiner stated that the claimed condition was less likely than not related to service.

In February 2025, the VA examiner issued a second addendum opinion. The VA examiner stated that in an August 2022 VA examination for the back, the findings reported were consistent with a lumbosacral strain. She stated that based on her review of the Veteran's medical records and service treatment records, there was a single October 4, 1999 report of back pain after heavy lifting. She stated
 there was a private medical opinion; however, stated that there is limited evidence to show progression of pain, chronicity, and continuity as well as limitation of motion of the back affecting employment or daily activities to support a relationship with service. The VA examiner stated that the claimed condition was less likely than not related to service.

In February 2025, the VA examiner issued a second addendum opinion. The VA examiner stated that in an August 2022 VA examination for the back, the findings reported were consistent with a lumbosacral strain. She stated that based on her review of the Veteran's medical records and service treatment records, there was a single October 4, 1999 report of back pain after heavy lifting. She stated that the Veteran was diagnosed with acute low back pain, and that the condition was conservatively treated. She stated that the condition in service likely resolved in service as the March 6, 2001 report of medical history marked "no" for recurrent back pain. The VA examiner stated that the Veteran's acute low back pain reported on October 4, 1999 was self-limiting and transient. The VA examiner stated that as shown in the Veteran's medical records, his in-service back pain likely resolved. She stated that post-service, the Veteran was able to gain employment in electrical implementation without chronic pain or limitation of motion related to either back or neck pain. 

The VA examiner acknowledged that the Veteran stated that there was a worsening of neck and back pain since service and being struck in the neck while working on an aircraft. However, the VA examiner found that the evidence was insufficient to show chronic progressive pain, limitation of motion, or early degenerative disease to show its continuity. She stated that the clinical course of a muscle strain to include back and neck strain usually lasts for 8-10 weeks and resolves spontaneously without chronic complication or long term sequalae. The VA examiner stated that the Veteran's post-service employment, as to which there is mechanical overuse, can explain the strain and make it less likely that it was incurred from service. She stated that records were also insufficient to show chronicity and continuity of symptomatology to support a nexus. The VA examiner stated that all evidence considered showed a new and separate back strain unrelated to service. Therefore, she opined that it is less likely than not that the Veteran's back strain was related to service, to specifically include the Veteran's report of low back injuries sustained during service.

The Board finds that these two addendum opinions taken together form an adequate opinion in support of denying service connection and address the issues that required the previous Board remand. The VA examiner's opinion was probative and supported by the evidence of record. She considered the Veteran's October 4, 1999 report of a lower back injury due to heavy lifting, finding it to be an acute incident, with the Veteran's current condition the more likely result of his occupation. The VA examiner considered the Veteran's lay statements on worsening symptoms; however, she found that the records were insufficient to support chronicity and continuity. She also considered the Veteran's January 2023 private opinion but found that there was limited evidence to support chronicity of symptoms. 

As the November 2024 and February 2025 VA addendum opinions opining that service connection is not warranted to be adequate, the Board finds that a nexus has not been established. 

The Board notes that in January 2023, the Veteran submitted a private medical opinion regarding his back condition. Dr. C.M. Bucci opined that it was more likely than not that the Veteran's condition was related to service. He stated that there were documented complaints of lumbar spine injury, and a statement establishing chronicity of symptoms from his initial complaint and complaints of pain in active duty to the present. He further stated that the lumbosacral condition was a progression or continuation of the lumbar spine injury and complaints of pain during active-duty military service. 

The Board finds the private January 2023 VA opinion to be inadequate. The private provider made his conclusions regarding the Veteran's condition without ever examining the Veteran. The private provider does not note that he reviewed the Veteran's full claims file, just that he reviewed the service treatment record showing pain in service along with the Veteran's own statement stating that his condition had worsened since service. He notes no pertinent records upon which he relied. A review of the Veteran's July 2022 VA Form 21-526 and January 2023 supplemental claim form do not list records applicable to the Veteran's condition. Therefore, the private provider's opinion was based solely on the Veteran's reports and subjective complaints.  Furthermore, the opinion is largely conclusory, lacking a clear explanation for the conclusions rendered.

As such, the Board finds that there is no nexus between the Veteran's current disability and the in-service injury. Therefore, the final element of direct service connection is not
 full claims file, just that he reviewed the service treatment record showing pain in service along with the Veteran's own statement stating that his condition had worsened since service. He notes no pertinent records upon which he relied. A review of the Veteran's July 2022 VA Form 21-526 and January 2023 supplemental claim form do not list records applicable to the Veteran's condition. Therefore, the private provider's opinion was based solely on the Veteran's reports and subjective complaints.  Furthermore, the opinion is largely conclusory, lacking a clear explanation for the conclusions rendered.

As such, the Board finds that there is no nexus between the Veteran's current disability and the in-service injury. Therefore, the final element of direct service connection is not satisfied and direct service connection must be denied. 

For the above reasons, the evidence is neither evenly balanced nor approximately so with regard to whether service connection for a lower back condition is warranted. Rather, the evidence persuasively weighs against service connection for a lower back condition. The benefit of the doubt doctrine is therefore not for application. See 38 U.S.C. §5107(b); Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021) (en banc) (only when the evidence persuasively favors one side or another is the benefit of the doubt doctrine not for application); Ortiz v. Principi, 274 F.3d 1361, 1364 (Fed. Cir. 2001). Thus, the claim for service connection for a lower back condition is denied.

2. Entitlement to service connection for a cervical spine condition is denied. 

The Veteran states that he is entitled to service connection for a cervical spine condition. After a careful review of the record, the Board determines that the matter must be denied. The reasons follow. 

The first element for service connection is that the Veteran has a current disability. In a March 2025 rating decision, the RO made the favorable finding that in August 2022, the Veteran was diagnosed with a cervical strain. The Board will not disturb this favorable finding.  38 C.F.R. § 3.104(c). As there is a current disability, the first element for direct service connection has been satisfied.

The second element of service connection requires that there was an in-service injury or incurrence. In the March 2025 rating decision, the RO made the favorable finding that the Veteran's July 22, 1998 service treatment records show that he was seen for neck pain. As there was an in-service injury, the second element of direct service connection has been satisfied. 

The final element for direct service connection is that there is a nexus between the current disability and the in-service injury. 

In November 2024, the VA examiner diagnosed the Veteran with cervical muscle strain. The VA examiner opined that the condition was less likely than not related to service. She explained that based on a review of the medical records and the Veteran's July 22, 1998 service treatment records, there was only a single report of neck pain after a fall. The VA examiner stated that a physical examination showed no TTP along the cervical spine. She noted that there was full range of motion with only mild paracervical spine muscle pain with flexion. The VA examiner noted that the Veteran's condition in service was treated conservatively and likely resolved as the March 6, 2001 separation report of medical history marked "yes" on swollen or painful joints pertaining to bilateral knees but not to the neck. The VA examiner also noted there was no followup visit for neck pain one year after active duty, and post-service records showed that the Veteran was able to gain employment in electrical instrumentation without chronic pain or limitation of motion related to the neck pain. 

The VA examiner stated that cervical strain is produced by an overload injury to the muscle-tendon unit because of excessive forces on the cervical spine. She explained that the cause is thought to be the elongation and tearing of muscles or ligaments. The VA examiner stated that most patients feel relief using antiinflammatory medications, such as Ibuprofen or ice. She stated that generally symptoms resolve in a few days to a few weeks. The VA examiner noted that a private medical opinion was received, but there is limited evidence to show progression of pain, chronicity and continuity, as well as limitation of motion in the neck, affecting employment or daily activities so as to support a relationship with service. 

The VA examiner stated that an overall review of the records showed an acute, transient, and resolved neck pain in active-duty service, which did not progress into a chronic condition. She stated that a cervical strain usually resolves in 8-10 weeks without chronic complication or long term sequalae. The VA examiner stated that although the Veteran reported worsening back and neck pain since service and being struck in the neck while
 She stated that generally symptoms resolve in a few days to a few weeks. The VA examiner noted that a private medical opinion was received, but there is limited evidence to show progression of pain, chronicity and continuity, as well as limitation of motion in the neck, affecting employment or daily activities so as to support a relationship with service. 

The VA examiner stated that an overall review of the records showed an acute, transient, and resolved neck pain in active-duty service, which did not progress into a chronic condition. She stated that a cervical strain usually resolves in 8-10 weeks without chronic complication or long term sequalae. The VA examiner stated that although the Veteran reported worsening back and neck pain since service and being struck in the neck while working on an aircraft, the records were insufficient to show chronicity and continuity of symptomatology to support a nexus. She further noted that the Veteran was also able to gain employment without chronic pain or limitation of motion of the neck, to suggest non-progressive weakening of the muscle strain. She stated that all evidence considered showed a new and separate cervical strain unrelated to service. The VA examiner opined that the condition was less likely than not related to service.

In February 2025, the VA examiner issued a second addendum opinion. Regarding the neck, she stated that post-service, the Veteran was able to gain employment in electrical implementation without chronic pain or limitation of motion related to either back or neck pain. The August 2022 VA examination for the neck showed physical examination findings consistent with a cervical strain. The VA examiner acknowledged that the Veteran stated that there was a worsening of neck and back pain since service and being struck in the neck while working on an aircraft. However, the VA examiner found that the evidence was insufficient to show chronic progressive pain, limitation of motion, or early degenerative disease to show its continuity. She stated that the clinical course of a muscle strain to include back and neck strain usually lasts for 8-10 weeks and resolves spontaneously without chronic complication or long term sequalae. The VA examiner stated that the Veteran's post-service employment, as to which there is mechanical overuse, can explain the strain and made it less likely that it was incurred from service. She stated that records were also insufficient to show chronicity and continuity of symptomatology to support a nexus. The VA examiner stated that all evidence considered showed a new and separate cervical strain unrelated to service. Therefore, she opened that it was less likely than not that the Veteran's cervical or back strain was related to service, to specifically include the Veteran's report of cervical spine sustained during service. 

The Board finds that the combination of the two VA addendum opinions rendered an adequate opinion which addressed all of the deficiencies noted in the prior opinions by the October 2024 Board remand. The VA examiner specifically considered the Veteran's report of a neck injury during service, as well as the lay statements noting a worsening of symptoms. However, the VA examiner found these statements were not supported by sufficient evidence to show chronicity of symptomatology. She relied on the evidence of record to conclude that the strain in service was more than likely acute, and any current strain would be related to the Veteran's occupational duties. She stated that after considering all of the evidence, the evidence weighed in favor of finding this to be a new cervical strain, and not the one that was treated during service. 

As the November 2024 and February 2025 VA addendum opinions that opined that service connection is not warranted are adequate, a nexus has not been established.

The Board notes that in January 2023, the Veteran submitted a private medical opinion regarding his neck condition. Dr. C.M. Bucci opined that the condition was more likely than not related to service based on the documented complaints of cervical spine injury and pain, and statements establishing chronicity of symptoms from his initial complaint during active duty to the present. He stated that the current condition was s a progression or continuation of the Veteran's cervical spine injury and pain during active-duty military service. 

The Board finds the January 2023 private opinion to be inadequate. The Board notes that it is nearly identical to the private opinion on the back from the same provider. The provider did not indicate that he examined the Veteran or reviewed the entirety of the Veteran's record. Rather, he stated that he relied on the report of injury during service and the Veteran's lay statements that the condition worsened since service. A review of the Veteran's July 2022 VA Form 21-526EZ and January 2023 supplemental claim form do not list records applicable to the Veteran's condition. The private provider's opinion was based on the Veteran's subjective complaints. Further, the provider's opinion was conclusory and did not provide a well-reasoned rationale.   

Therefore, the Board finds that there is no nexus between the Veteran's current disability and the in-service injury. The final element for direct
 the same provider. The provider did not indicate that he examined the Veteran or reviewed the entirety of the Veteran's record. Rather, he stated that he relied on the report of injury during service and the Veteran's lay statements that the condition worsened since service. A review of the Veteran's July 2022 VA Form 21-526EZ and January 2023 supplemental claim form do not list records applicable to the Veteran's condition. The private provider's opinion was based on the Veteran's subjective complaints. Further, the provider's opinion was conclusory and did not provide a well-reasoned rationale.   

Therefore, the Board finds that there is no nexus between the Veteran's current disability and the in-service injury. The final element for direct service connection is not satisfied, and direct service connection must be denied. 

For the above reasons, the evidence is neither evenly balanced nor approximately with regard to whether service connection for a neck condition is warranted. Rather, the evidence persuasively weighs against service connection for a neck condition. The benefit of the doubt doctrine is therefore not for application. See 38 U.S.C. §5107(b); Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021) (en banc) (only when the evidence persuasively favors one side or another is the benefit of the doubt doctrine not for application); Ortiz v. Principi, 274 F.3d 1361, 1364 (Fed. Cir. 2001). Thus, the claim for service connection for a cervical spine condition is denied.

 

L. CHU

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	Fleming, Shelley M.

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.