DEGENERATIVE ARTHRITIS OF THE SPINE (SPONDYLOSIS)

T. V. CASEY · 2026 · Case ID: A26040325

GRANTED

Summary

The Veteran, an Army veteran who served from November 1982 to November 2002, appeals the denial of service connection for cervical strain with cervical spondylosis, right sciatic nerve disability, and left sciatic nerve disability, all claimed as secondary to a service-connected lumbar spine disability. The Board reviewed the evidence, including a August 2020 VA examination and a December 2023 private nurse practitioner's opinion. The VA examiner opined that the cervical spondylosis was age-related and not medically related to the lumbar spine disability. However, the private nurse practitioner, M.M., provided a nexus opinion, likening the spine to a chain and stating that the lumbar spine's impact would affect the cervical spine, also noting that wear and tear from service could accelerate spondylosis. M.M. concluded the neck and lumbar spine disabilities were "definitely medically and physiologically related." The Board found both opinions adequate but determined the evidence was in equipoise regarding the cervical spine claim. Applying the benefit of the doubt, the Board granted service connection for cervical strain with cervical spondylosis secondary to the lumbar spine disability. For the right and left sciatic nerve disabilities, the Board noted that the AOJ had already made favorable findings in a December 2023 rating decision, establishing all three elements for secondary service connection, and therefore granted these claims as well.

Rationale

Evidence in equipoise regarding secondary nexus; Benefit of the doubt applied; Private opinion found cervical and lumbar spine disabilities related

Service Branch

ARMY

Special Benefit

NO SPECIAL BENEFIT

Docket No.

210729-175540

Full Decision Text

Citation Nr: A26040325
Decision Date: 04/29/26 Archive Date: 04/29/26

DOCKET NO. 210729-175540
DATE: April 29, 2026

ORDER

Entitlement to service connection for cervical strain with cervical spondylosis, secondary to service-connected lumbar spine disability, is granted.

Entitlement to service connection for right sciatic nerve disability, secondary to service-connected lumbar spine disability, is granted.

Entitlement to service connection for left sciatic nerve disability, secondary to service-connected lumbar spine disability, is granted.

FINDINGS OF FACT

1. Resolving doubt in the Veteran's favor, it is at least as likely as not that the Veteran's cervical strain with cervical spondylosis is caused by, or otherwise due to, his service-connected lumbar spine disability.

2. In December 2023, the AOJ made the favorable finding that the Veteran's right and left sciatic nerve disabilities are caused by, or otherwise due to, his service-connected lumbar spine disability.

CONCLUSIONS OF LAW

1. The criteria for service connection for cervical strain with cervical spondylosis, secondary to service-connected lumbar spine disability, have been met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.310.

2. The criteria for service connection for right sciatic nerve disability, secondary to service-connected lumbar spine disability, have been met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.310.

3. The criteria for service connection for left sciatic nerve disability, secondary to service-connected lumbar spine disability, have been met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.310.

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Veteran served in the United States Army from November 1982 to November 2002.

This matter comes before the Board of Veterans' Appeals (Board) on appeal from an August 2020 rating decision by a Department of Veterans Affairs (VA) regional office, which is the Agency of Original Jurisdiction (AOJ).

The Veteran elected the Board's Hearing docket. See July 2021 VA Form 10182. In correspondence received on March 18, 2025, the Veteran withdrew the request for a hearing. This restricts the Board's review to the evidence of record at the time of the August 2020 rating decision and any evidence submitted by the Veteran or his representative within 90 days following the receipt of the withdrawal. 38 C.F.R. § 20.302(b).

If the Veteran would like VA to consider the additional evidence that the Board could not consider, the Veteran may file a supplemental claim (VA Form 20-0995) and identify the evidence for the AOJ's consideration. 38 C.F.R. § 3.2501. Specific instructions for filing a supplemental claim are included with this decision.

Service Connection

Service connection may be granted for disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. §§ 1110, 1131; 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).

Secondary service connection is warranted if there is (1) evidence of a current disability; (2) evidence of a service-connected disability; and (3) medical evidence establishing a nexus (i.e., link) between the current disability and the service-connected disability. Wallin v. West, 11 Vet. App. 509, 512 (1998). A nexus is established when medical evidence shows that the current disability was either caused or aggravated by a service-connected disability. Allen v. Brown, 7 Vet. App. 439, 448 (1995) (en banc); El-Amin v. Shinseki, 26 Vet. App. 136, 140 (2013).

Service connection may also be granted for a disability that is functionally worsened by a service-connected disability. Spicer v. McDonough,
a service-connected disability; and (3) medical evidence establishing a nexus (i.e., link) between the current disability and the service-connected disability. Wallin v. West, 11 Vet. App. 509, 512 (1998). A nexus is established when medical evidence shows that the current disability was either caused or aggravated by a service-connected disability. Allen v. Brown, 7 Vet. App. 439, 448 (1995) (en banc); El-Amin v. Shinseki, 26 Vet. App. 136, 140 (2013).

Service connection may also be granted for a disability that is functionally worsened by a service-connected disability. Spicer v. McDonough, 61 F.4th 1360, 1364 (Fed. Cir. 2023) (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. 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. Nothing in the statute limits § 1110 to onset or etiological causes of a worsening in functionality.")

Generally, when there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, the benefit of the doubt shall be given to the claimant. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102. An approximate balance of the evidence includes, but is not limited to, equipoise. Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021).

1. Entitlement to service connection for cervical strain with cervical spondylosis, secondary to service-connected lumbar spine disability, is granted.

The Veteran contends that his cervical spine (neck) disability is caused by, or otherwise due to, his service-connected lumbar spine disability. See April 2020 VA Form 21-526EZ. For the reasons below, the Board agrees and finds that service connection is warranted.

As a procedural matter, the Board notes that in August 2020, the AOJ made two favorable findings relating to the Veteran's claim - that he has a neck disability, diagnosed as cervical strain with cervical spondylosis, and that he has a service-connected lumbar spine disability. See August 2020 Rating Decision. The Board will not disturb these favorable findings, and notes that the first two Wallin elements necessary to establish service connection have been met. 38 C.F.R. § 3.104(c). What is left for the Board to determine is whether there is a connection, or nexus, between his cervical spine disability and his service-connected lumbar spine disability.

In August 2020, a VA examiner diagnosed the Veteran with a cervical strain and cervical spondylosis. The examiner then opined that the Veteran's neck disability is less likely than not due to his lumbar spine disability. See August 2020 C&P Exam. The examiner explained her rationale, noting that cervical spondylosis is a medical term for "age-related wear and tear affecting the spinal disks in the neck." Id. Due to aging, the disks in the neck will "dehydrate and shrink, [and] signs of osteoarthritis develop[s]." Id. In sum, according to the examiner, cervical spondylosis is "not medically related" to the Veteran's lumbar spine disability as it "is a separate entity entirely from the service connected condition and unrelated to it." Id.

In December 2023, M.M., a private nurse practitioner, provided an opinion on how the Veteran's lumbar spine degenerative disc disease (DDD) would impact his cervical spondylosis. She noted that the Veteran's cervical spine and lumbar spine act as one unit, and if part of the spine is impacted so is the rest of it. Citing a medical study, M.M. likened the spine to a chain with one or more links out of position, which would in turn cause stress and adversely affect the entire chain. See May 2025 Medical Treatment Record. M.M. also noted that the Veteran's neck would have suffered "a great deal" due to the rigors of his military service, particularly heavy lifting, sitting for extended periods of time, and having to manage the weight of gear such as helmets. Id.

She even addressed the August 2020 VA examiner's findings, noting that the examiner herself determined that the Veteran's cervical spondylosis would eventually
one unit, and if part of the spine is impacted so is the rest of it. Citing a medical study, M.M. likened the spine to a chain with one or more links out of position, which would in turn cause stress and adversely affect the entire chain. See May 2025 Medical Treatment Record. M.M. also noted that the Veteran's neck would have suffered "a great deal" due to the rigors of his military service, particularly heavy lifting, sitting for extended periods of time, and having to manage the weight of gear such as helmets. Id.

She even addressed the August 2020 VA examiner's findings, noting that the examiner herself determined that the Veteran's cervical spondylosis would eventually develop into osteoarthritis, the same condition affecting the lumbar portion of his spine. Id. She also noted that while spondylosis is generally an age-related condition, it "can be caused and accelerated" due to wear and tear such as that incurred "by the Veteran while in service and as a result of his back injuries." See June 2025 VA Examination (private opinion erroneously labeled as a VA examination). In sum, M.M. opined that the Veteran's neck disability and service-connected lumbar spine disability are "definitely medically and physiologically related." See May 2025 Medical Treatment Record.

The Board finds that both the VA examiner's August 2020 finding against the Veteran and M.M.'s findings in the Veteran's favor are both adequate and probative. Both addressed relevant portions of the Veteran's medical and military history, and what they determined to be relevant medical literature and sources. The Board has no reason to doubt the credibility of the August 2020 VA examiner or M.M. In sum, both medical opinions are supported by legally adequate rationale. Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 301 (2008).

The Board is not bound by the medical determination of a VA examination. Hayes v. Brown, 5 Vet. App. 60 (1993). Furthermore, the Board is entitled to favor one (or more) medical opinion of others. D'Aries v. Peake, 22 Vet. App. 97 (2008).

Here, the Board finds that the evidence is in equipoise as to whether the Veteran's cervical disability is secondary to his service-connected lumbar spine disability.

In such a case, the benefit of the doubt is to be resolved in the Veteran's favor. Lynch, 21 F.4th at 781. The Board therefore finds that the Veteran's cervical spine disability is at least as likely as not caused by, or otherwise due to, his service-connected lumbar spine disability. The third Wallin element necessary to establish service connection on a secondary basis has been met, and the Veteran's claim for entitlement to service connection for a cervical spine disability, as secondary to a service-connected lumbar spine disability, is granted.

2. Entitlement to service connection for right sciatic nerve disability, as secondary to service-connected lumbar spine disability, is granted.

3. Entitlement to service connection for left sciatic nerve disability, as secondary to service-connected lumbar spine disability, is granted.

The Veteran contends that his bilateral sciatic nerve conditions are caused by, or otherwise due to, his service-connected lumbar spine disability. See April 2020 VA Form 21-526EZ. For the reasons below, the Board agrees and finds that service connection is warranted.

In a December 2023 rating decision, the AOJ made the favorable finding that the Veteran's left and right sciatic nerve disabilities are both service-connected, as secondary to the Veteran's lumbar spine disability. See December 2023 Rating Decision. In granting these claims, the AOJ has determined that the Veteran has left and right sciatic nerve disabilities, that he has a primary service-connected disability, and that his sciatic nerve disabilities are caused or aggravated by his service-connected disability.

Thus, the Wallin criteria necessary to establish service connection for left and right sciatic nerve disabilities have been satisfied by operation of the binding favorable findings of the AOJ. The Board will not disturb these favorable findings. 38 C.F.R. § 3.104(c).

(Continued on the next page)

Accordingly, service connection for left and right sciatic nerve disabilities, secondary to the Veteran's service-connected lumbar spine disability, is warranted. The Veteran's claims are granted.

T. V. Casey

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board Neville, Mikael