INTERVERTEBRAL DISC SYNDROME

STEVEN D. REISS · 2026 · Case ID: A26040118

GRANTED

Summary

The veteran, who served in the United States Air Force from August 1971 to October 1978, appeals the denial of service connection for lumbosacral strain with degenerative disc disease, headaches, an acquired psychiatric disorder (other specified trauma and stressor related disorder and PTSD), and Parkinson's disease. The veteran claims these conditions are related to his service, particularly his exposure to aircraft exhaust and aviation fuel (TERA) as a KC-135 Navigator, and his experiences in flight school. The Board found the evidence in approximate balance for lumbosacral strain, headaches, and the psychiatric disorder, applying the benefit of the doubt doctrine to grant service connection for these conditions, noting competent and credible lay testimony and favorable VA opinions, despite some negative VA examinations. For Parkinson's disease, the Board acknowledged a favorable July 2025 VA opinion linking it to TERA, but also noted a subsequent negative opinion from a different examiner. Ultimately, the Board found the evidence in approximate balance and applied the benefit of the doubt to grant service connection for Parkinson's disease, despite the conflicting medical opinions.

Rationale

Current disability and in-service event established; Competent and credible lay testimony regarding onset and continuity; Favorable VA examiner assessment of commonality for pilots; Benefit of the doubt applied due to approximate balance of evidence

Service Branch

AIR FORCE

Special Benefit

NO SPECIAL BENEFIT

Docket No.

260205-630277

Full Decision Text

Citation Nr: A26040118
Decision Date: 04/29/26 Archive Date: 04/29/26

DOCKET NO. 260205-630277
DATE: April 29, 2026

ORDER

Service connection for lumbosacral strain with degenerative disc disease is granted.

Service connection for headaches is granted.

Service connection for an acquired psychiatric disorder, diagnosed as other specified trauma and stressor related disorder and PTSD, is granted.

Service connection for Parkinson's disease is granted.

FINDINGS OF FACT

1. The evidence is at least in approximate balance regarding whether the Veteran's lumbosacral strain with degenerative disc disease had its onset during service.

2. The evidence is at least in approximate balance regarding whether the Veteran's headaches had their onset during service.

3. The evidence is at least in approximate balance regarding whether the Veteran's acquired psychiatric disorder, diagnosed other specified trauma and stressor related disorder and PTSD, had its onset during service.

4. The evidence is at least in approximate balance regarding whether the Veteran's Parkinson's disease is due to in-service TERA.

CONCLUSIONS OF LAW

1. The criteria for service connection for lumbosacral strain with degenerative disc disease have been met. 38 U.S.C. §§ 1110, 1154(a), 5107(b); 38 C.F.R. §§ 3.102, 3.159, 3.303, 3.309.

2. The criteria for service connection for headaches have been met. 38 U.S.C. §§ 1110, 1154(a), 5107(b); 38 C.F.R. §§ 3.102, 3.303, 3.309.

3. The criteria for service connection for the acquired psychiatric disorder, diagnosed other specified trauma and stressor related disorder and PTSD have been met. 38 U.S.C. §§ 1110, 1154(a), 5107(b); 38 C.F.R. §§ 3.102, 3.159, 3.303.

4. The criteria for service connection for the Parkinson's disease have been met. 38 U.S.C. §§ 1110, 1154(a), 5107(b); 38 C.F.R. §§ 3.102, 3.159, 3.303.

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Veteran served on active duty in the United States Air Force from August 1971 to October 1978.

This matter comes before the Board of Veterans' Appeals (Board) on appeal from September and December 2025 rating decisions by the Department of Veterans Affairs (VA) Regional Office (RO) arising from February 2025 claims.

In February 2026, the Veteran submitted a VA Form 10182 Notice of Disagreement (NOD) with the September and December 2025 rating decisions under the Appeals Modernization Act (AMA) framework, electing the Board's Hearing docket.

In April 2026, a hearing was held before the undersigned Veterans Law Judge at which the Veteran testified. At the hearing, the Veteran waived the 90-day period following the proceeding during which he could submit additional evidence in support of his appeal. 38 C.F.R. § 20.300(b). As such, and because in this decision the Board grants in full the benefits sought on appeal, the Board will proceed to adjudicate this matter.

A July 2025 VA toxic risk exposure activity (TERA) Memo reflects there was non-deployment related exposure consistent with his AFSC of 1353 KC-135 Navigator, and he was exposed to aircraft exhaust and aviation fuel consistent with the AFSC. The memo reflects that Herbicide Agents exposure is not shown.

Under the AMA, the Board is bound by favorable findings of the AOJ in the absence of evidence of clear and unmistakable error. See 38 C.F.R. §3.104. Favorable findings as to other specified trauma and stressor related disorder in the September 9, 2025, rating decision include that TERA is conceded based on his AFSC of Navigator, a qualifying event, injury, or disease had its onset during service, as personnel records show that he attended pilot training school, and he has been diagnosed with a disability in a June 2025 VA examination showing a diagnosis of other specified trauma and stressor related disorder.

As to lumbosacral strain with degenerative disc disease, a September 26, 2025, rating decision reflects TERA is conceded based on his AFSC of Navigator, the evidence shows that a qualifying event, injury, or disease had its onset during service inasmuch as service treatment records show
trauma and stressor related disorder in the September 9, 2025, rating decision include that TERA is conceded based on his AFSC of Navigator, a qualifying event, injury, or disease had its onset during service, as personnel records show that he attended pilot training school, and he has been diagnosed with a disability in a June 2025 VA examination showing a diagnosis of other specified trauma and stressor related disorder.

As to headaches, this rating decision notes the evidence shows that a qualifying event, injury, or disease had its onset during service, with STRs showing complaints of acute headaches; also, it was noted that TERA is conceded based on his AFSC of Navigator.

As to Parkinsons' disease, the December 2025 decision on appeal include that there is current disability inasmuch as the Veteran has been diagnosed with Parkinson's disease at a July 2024 VA examination, participation in TERA is conceded based on his AFSC of Navigator (1520), and the diagnosed disability is a condition that has been presumptively linked to exposure inasmuch as VA recognizes Parkinson's disease as a presumptive condition due to exposure to Agent Orange.

Service Connection

Establishing service connection generally requires medical or, in certain circumstances, lay evidence of (1) a current disability; (2) an in-service incurrence or aggravation of a disease or injury; and (3) a nexus between the claimed in-service disease or injury and the present disability). See Davidson v. Shinseki, 581 F.3d 1313 (Fed. Cir. 2009); Hickson v. West, 12 Vet. App. 247, 253 (1999); 38 C.F.R. § 3.303 (a).

Certain chronic diseases, to include arthritis, and 'other organic disease of the nervous system', to specifically include migraines, will be presumed related to service if they were noted as chronic in service; or, if they manifested to a compensable degree within a presumptive period following separation from service; or, if continuity of the same symptomatology has existed since service, with no intervening cause. 38 U.S.C. §§ 1101, 1112, 1113, 1137; Walker v. Shinseki, 708 F.3d 1331, 1338 (Fed. Cir. 2012); Fountain v. McDonald, 27 Vet. App. 258 (2015); 38 C.F.R. §§ 3.303 (b), 3.307, 3.309(a).

Service connection may be granted on a secondary basis for a disability which is aggravated by, proximately due to, or the result of a service-connected disease or injury under 38 C.F.R. § 3.310. Allen v. Brown, 7 Vet. App. 439 (1995); Cf. Spicer v. McDonough, 61 F.4th 1360 (Fed. Cir. 2023) (invalidating 3.310(b) for the use of the phrase "proximately due to" in the context of aggravation). Specifically, in Spicer, the Court held that 38 U.S.C. § 1110 plainly requires compensation when a service-connected disease or injury is a but-for cause of a present-day disability.

The Board notes that this broad language applies to the natural progression of a condition not caused by a service-connected injury or disease, but that nonetheless would have been less severe were it not for the service-connected disability. Stated another way, § 1110 provides for compensation for a worsening of functionality-whether through an inability to treat or a more direct, etiological cause. The Federal Circuit noted that nothing in the statute limits § 1110 to onset or etiological causes of a worsening in functionality. Thus, the Court in Spicer found the phrase "proximately due to" under 3.310(b) inconsistent with § 1110 and, therefore "unlawful," consequently, for "aggravation of non-service-connected disabilities" it is enough to show that "but for" the service-connected disability the incremental-increase in severity of a nonservice-connected disease or injury would not have occurred. Id.

When there is an approximate
another way, § 1110 provides for compensation for a worsening of functionality-whether through an inability to treat or a more direct, etiological cause. The Federal Circuit noted that nothing in the statute limits § 1110 to onset or etiological causes of a worsening in functionality. Thus, the Court in Spicer found the phrase "proximately due to" under 3.310(b) inconsistent with § 1110 and, therefore "unlawful," consequently, for "aggravation of non-service-connected disabilities" it is enough to show that "but for" the service-connected disability the incremental-increase in severity of a nonservice-connected disease or injury would not have occurred. Id.

When there is an approximate balance of positive and negative evidence regarding any issue material to the determination, the benefit of the doubt is afforded the claimant. To deny a claim on its merits, the weight of the evidence must persuasively stand against a finding that the evidence is in "approximate balance" or "nearly equal" to the evidence that supports the claim. Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021) (en banc).

The Board must determine the value of all evidence submitted, including lay and medical evidence. Buchanan v. Nicholson, 451 F.3d 1331 (Fed. Cir. 2006). The evaluation of evidence generally involves a 3-step inquiry. First, the Board must determine whether the evidence comes from a "competent" source.

The Board must then determine if the evidence is credible, or worthy of belief. Barr v. Nicholson, 21 Vet. App. 303 (2007) (Observing that once evidence is determined to be competent, the Board must determine whether such evidence is also credible).

The third step of this inquiry requires the Board to weigh the probative value of the proffered evidence in light of the entirety of the record. The Board also notes that under certain circumstances, lay evidence may be sufficient to establish a nexus. See Davidson v. Shinseki, 581 F.3d 1313, 1316 (Fed. Cir. 2009); see also Layno v. Brown, 6 Vet. App. 465, 469 (1994).

Lay evidence may be competent with regard to a disease that has "unique and readily identifiable features" that are "capable of lay observation." See Barr v. Nicholson, 21 Vet. App. 303, 308-09 (2007).

Contentions

The Veteran testified that his diagnosed other specified trauma and stressor related disorder is due to his traumatic experiences in flight school, beginning at that time and continuing to the present time. Service records show that a board was convened to consider discontinuance in pilot training, but there was no diagnosis at the time. The proceedings were conducted and finalized in 1972, and he continued to serve in the role of navigator until 1978, with no complaints made or treatment sought and/or recorded between those dates. However, he testified and provided extensive written statements discussing how the unfair treatment of being failed on a single training ride and being penalized for taking a prescribed medication effectively ended his pilot career and has traumatized him to this day.

As to his back problems, he notes he hurt his back in the rides he did complete, noting he achieved many "Gs" during the rides. The G load coupled with flying many hours caused recurrent pain in his lower back, and the back hurt from the time of the rides to this day. He needed a pad under his parachutes throughout his service. He gets shots for his back pain which impacts his mobility. He can only walk for exercise.

As to his headaches, he reports these began in service and continued to the present. He has headaches when he wakes up from nightmares.

As to his Parkinsons' disease, he feels this is due to the TERA in service discussed above to include specifically jet fumes, related toxins and weed killer.

He testified that he wanted to serve 30 years but was precluded from doing so due to these problems, particularly his back and headaches.

It was noted at the hearing that a June 2025 VA examiner opined that neck and low back pain are common for military pilots.

It was noted that there is a July 2025 VA positive nexus for Parkinsons', and it was argued that with conflicting opinions, doubt should be resolved in his favor.

1. Service connection for lumbosacral strain with degenerative disc disease is granted.

2. Service connection for headaches is granted.

The Veteran testified before the undersigned Veterans Law Judge that both low back pain and headaches were first noted in service, and it have continued to progress
He testified that he wanted to serve 30 years but was precluded from doing so due to these problems, particularly his back and headaches.

It was noted at the hearing that a June 2025 VA examiner opined that neck and low back pain are common for military pilots.

It was noted that there is a July 2025 VA positive nexus for Parkinsons', and it was argued that with conflicting opinions, doubt should be resolved in his favor.

1. Service connection for lumbosacral strain with degenerative disc disease is granted.

2. Service connection for headaches is granted.

The Veteran testified before the undersigned Veterans Law Judge that both low back pain and headaches were first noted in service, and it have continued to progress to the present. After he got kicked out of pilot school unfairly, he would have nightmares and wake up with horrible headaches which have continued to the present time.

STRs reflect significant documentation of complaints and treatment of back pain.

The Veteran also competently reported having headaches in and since service.

As to headaches, the lay evidence is competent as to current disability consistent with Barr v. Nicholson, 21 Vet. App. 303, 308-09 (2007). The Board notes a September 2025 VA examination wherein the examiner finds no current diagnosis related to headaches but also notes a history of headaches for 50 years starting in military service, as well as current headaches treated with Tylenol and herbal tea.

As to a nexus between the current conditions and service, the Board has been charged with the duty to assess the credibility and weight given to evidence. Davidson v. Shinseki, 581 F. 3d 1313 (Fed. Cir. 2009); Jandreau v. Nicholson, 492 F. 3d 1372 (Fed. Cir. 2007). Indeed, the United States Court of Appeals for Veterans Claims (Court) has declared that in adjudicating a claim, the Board has the responsibility to do so. Bryan v. West, 13 Vet. App. 482, 488-89 (2000).

Here, as to the back and headaches, there is current disability and an event in service. As to headaches, the Board finds the Veteran is competent to report regarding the symptoms he experiences, and the Board finds the testimony about current disability and onset credible. See also Layno v. Brown, 6 Vet. App. 465 (1994); Jandreau, 492 F.3d 1372. The testimony was clarifying and impactful as to the exact nature and onset of both the conditions. His reports of back pain and headaches beginning in service are consistent with the circumstances of service. 38 U.S.C. § 1154(a); 38 C.F.R. § 3.303.

The Veteran credibly testified that back and headache problems have continued and progressed to the present time.

Additionally, as to the back, the Board notes the June 2025 VA examiner's assessment that neck and back pain are commonly reported by military pilots. The examiner stated musculoskeletal disorders are considered a primary health problem among military pilots. Back pain caused by exposure to acceleration or G-force is common in military aviation. The claimant was a navigator pilot for several years and medical literature shows that this can cause back injury.

Thus, while the Board acknowledges the negative VA examinations and opinions as to the back and headaches, the evidence shows that the Veteran's current back disorder and headaches had their onset in service and thus service connection is warranted. See Flynn v. Brown, 6 Vet. App. 500, 503 (1994) (noting that "the element of cause and effect has been totally by-passed in favor of a simple temporal relationship between the incurrence of the disability and the period of active duty").

Because the competent and credible evidence is at least approximately balanced, and benefit of the doubt doctrine applies, service connection for lumbosacral strain with degenerative disc disease and headaches is warranted. 38 U.S.C. § 5107 (b), See Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021) (en banc).

3. Service connection for an acquired psychiatric disorder, diagnosed other specified trauma and stressor related disorder and PTSD is granted.

The Veteran urges that his acquired psychiatric disorder, diagnosed on VA examination in June 2025 as other specified trauma and stressor related disorder, is related to being unfairly kicked out of flight school. He reports his psychiatric problems began at that time and continued to the present.

Current disability and an in-service event are established. Nexus must be addressed. The Board also notes that as to diagnosis, a September 2025 VA examination also reflects
5107 (b), See Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021) (en banc).

3. Service connection for an acquired psychiatric disorder, diagnosed other specified trauma and stressor related disorder and PTSD is granted.

Current disability and an in-service event are established. Nexus must be addressed. The Board also notes that as to diagnosis, a September 2025 VA examination also reflects PTSD based on the same event.

In February 2025, he reported that being let go from pilot school ended his dream as flying had been the reason he joined the military. He worked hard and was slated to fly the F-106 upon graduation. However, he disobeyed an order to circle the runway while in the air and landed the plane. He was unaware the order came from the Brigadier General watching him fly. He was isolated from the rest of the pilots, and they were no longer allowed to talk to him. He was reassigned to a different MOS shortly after. He began to have nightmares which have persisted to present. He constantly thinks about his time in Pilot School and how his entire life changed after being kicked out. This has haunted him throughout his life since it occurred.

In pertinent part, a June 2025 VA mental disorders examination reflects the examiner's opinion that the condition is at least as likely as not related to service. His current symptoms and symptoms that he has been experiencing for many years appear to be a trauma-like reaction to a stressor event during his service. Although claimant does not currently meet full criteria for PTSD. There are no medical opinions of record that are more persuasive.

The clarifying discussion at the hearing reflects the Veteran's competent and credible report that the psychiatric problems began with the pilot school incident and continued to the present.

The evidence is at least in approximate balance as to whether the current acquired psychiatric disorder, diagnosed other specified trauma and stressor related disorder and PTSD began with the pilot school incident discussed above and continued. The evidence shows that the Veteran's current psychiatric disorder had its onset in service and thus service connection is warranted. See Flynn v. Brown, 6 Vet. App. 500, 503 (1994) (noting that "the element of cause and effect has been totally by-passed in favor of a simple temporal relationship between the incurrence of the disability and the period of active duty").

Because the competent and credible evidence is at least approximately balanced, and benefit of the doubt doctrine applies, service connection for acquired psychiatric disorder, diagnosed other specified trauma and stressor related disorder and PTSD is warranted. 38 U.S.C. § 5107 (b), See Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021) (en banc).

4. Service connection for Parkinson's disease is granted.

The Veteran urges he developed Parkinson's disease due to the verified TERA in service. There is current disability as well as TERA based on his AFSC of 1353 KC-135 Navigator, exposure to aircraft exhaust and aviation fuel exposures. Herbicide Agents exposure is not shown. Nexus must be addressed.

Critically, a July 2025 VA medical opinion is favorable to this claim with medical citations. The examiner noted that the Veteran's Parkinson's disease was at least as likely as not caused by the indicated TERA. The examiner stated that the records reviewed do not indicate any risk factors outside of military service and a neurologist noted PPE was reportedly not used. The frequency of exposure is reported as daily. The route of exposure is described as inhalation. The duration of exposure is described as 7 years. The reported activity that resulted in exposure is described as per MOS at Lacklin, Rickenbacker, Westover Air Force bases. This is based upon claimed exposure(s) to jet exhaust and fuel. The examiner explained that Parkinson's Disease is at least as likely as not caused by the indicated TERA after considering the total potential exposure through all applicable military deployments and the synergistic, combined effect of all TERA of the Veteran. The examiner stated there is nexus to prove that aircraft fuel and exhaust can cause Parkinson's Disease. Per medical literature, acute exposure to jet fuels has been associated with neurologic effects in humans, including headache, nausea, vomiting, dizziness, fatigue, in coordination, irritability, problems with attention and memory, narcosis, and gait disturbances.

Additional VA medical opinion was
ickenbacker, Westover Air Force bases. This is based upon claimed exposure(s) to jet exhaust and fuel. The examiner explained that Parkinson's Disease is at least as likely as not caused by the indicated TERA after considering the total potential exposure through all applicable military deployments and the synergistic, combined effect of all TERA of the Veteran. The examiner stated there is nexus to prove that aircraft fuel and exhaust can cause Parkinson's Disease. Per medical literature, acute exposure to jet fuels has been associated with neurologic effects in humans, including headache, nausea, vomiting, dizziness, fatigue, in coordination, irritability, problems with attention and memory, narcosis, and gait disturbances.

Additional VA medical opinion was sought and obtained in October 2025 wherein the examiner was asked to address how, given the current evidence, the likelihood that jet fuel exposure is more likely than not causal for Parkinson's Disease compared to well-established factors such as genetic predisposition, age, diet, lifestyle, and exposure to herbicides. They were asked to consider detailing any additional studies or evidence that may support the connection between jet fuel exposure and the neurodegenerative processes specific to Parkinson's Disease, if available. A new examiner responded with a negative opinion with medical citations.

The Veteran's TERA memo 7/15/2025 has been reviewed and notes "aircraft exhaust, aviation fuel" exposures. Clinical records reveal the Veteran's has been diagnosed with Parkinson's disease around 2023 for which he was referred to neurology. The Veteran's Parkinson's disease. Parkinson's disease is a disorder where brain cells that produce dopamine, a chemical messenger crucial for movement, die off, causing symptoms like tremors and stiffness. The exact cause is unknown, but it's believed to be a mix of genetic and environmental factors, such as exposure to pesticides or head injuries. Aging is the biggest risk factor for the disease. There is no medical or scientific evidence available that provides any indication of a relationship between the development of the condition(s) at issue and the TERA. While biological plausibility exists-air pollution and hydrocarbon exposure can induce neuroinflammation and neurotoxicity relevant to Parkinson's pathogenesis, the majority of Parkinson's disease cases cannot be attributed to environmental exposures alone, and genetic and other factors play substantial roles. A nexus cannot be established.

An addendum was requested from this examiner in November 2025 asking about the medical citations. She was asked for a comparative discussion on the relative likelihood of jet fuel exposure causing Parkinson's disease compared to genetic predisposition, age, and other well-established factors - addressing the specific mechanisms by which jet fuel exposure could potentially affect dopamine neurons, including any available scientific literature that supports such mechanisms. She stated no such study exists that studies the effects of jet fuel exposure as a causative agent of Parkinson's. She stated:

The study I cited notes hydrocarbon presence in air pollution. Hydrocarbons are also found in jet fuel. I have given a negative opinion relating jet fuel exposure to the Veteran's Parkinson's. Given the current scientific evidence, age and genetic predisposition remain the most reliably identified and quantified risk factors for Parkinson's disease. While environmental exposures can increase risk, and may be important in certain cases, there is no evidence that chronic exposure to something like jet fuel is a common or primary cause of Parkinson's. I stand behind my originally documented MO...

The Board finds the evidence at least in approximate balance as to whether the current acquired Parkinson's disease is due to the documented TERA.

The July 2025 opinion was well-supported and consistent with the record. A medical opinion is adequate when the medical expert discusses the relevant facts of a claimant's case, including any relevant lay statements about the disability picture, such that the opinion and rationale sufficiently inform the Board of the expert's judgment on the medical question. Miller v. Wilkie, 32 Vet. App. 249, 254 (2020). The July 2025 clinician discussed the relevant facts of a claimant's case, including relevant lay statements about the disability picture; the opinion and rationale sufficiently inform the Board of the expert's judgment on the medical question.

Here, in light of the Veteran's testimony, and because the competent and credible evidence is at least approximately balanced, and benefit of the doubt doctrine applies, service connection for Parkinson's disease is warranted. 38 U.S.C. § 5107 (b), See Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021) (en banc).

STEVEN D. REISS

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board Nancy Rippel

The Board's decision in this case is binding only with respect to the instant matter decided
; the opinion and rationale sufficiently inform the Board of the expert's judgment on the medical question.

STEVEN D. REISS

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board Nancy Rippel

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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