DEGENERATIVE ARTHRITIS OF THE SPINE (SPONDYLOSIS)

Summary

The Veteran, an Air Force AGR member who served from August 2000 to September 2005, including combat deployments to Afghanistan and Antarctica, appeals the denial of service connection for a lumbar spine disability. The Veteran claims his current lumbar spine issues, including degenerative arthritis, IVDS, disc space narrowing, and radiculopathy, are due to an in-service injury sustained in Antarctica and aggravated by his military duties. The Board found the Veteran's lay testimony credible and consistent with his service records, which documented an in-service injury and subsequent treatment for back pain. While a VA examiner provided a negative nexus opinion, deeming the pain resolved, the Board afforded it no weight due to its failure to address the Veteran's continuous symptom reports and in-service injury. In contrast, a private chiropractor's opinion, which considered the Veteran's history, imaging, and cited medical literature, found the degenerative changes and disc disease likely related to the in-service injury and subsequent spinal misalignments. Resolving all doubt in the Veteran's favor, the Board found the evidence weighed in favor of service connection, granting entitlement for a lumbar spine disability.

Rationale

Favorable finding from AOJ regarding lumbosacral strain; Veteran's credible lay testimony of in-service injury and continuous symptoms; Corroborating service treatment records and medical evidence of injury and ongoing pain; Private chiropractor's opinion finding degenerative changes likely related to in-service injury

Full Decision Text

Citation Nr: A26040970
Decision Date: 04/30/26	Archive Date: 04/30/26

DOCKET NO. 210823-181208
DATE: April 30, 2026

ORDER

Entitlement to service connection for a lumbar spine disability, to include degenerative arthritis and lumbar radiculopathy, is granted.

FINDINGS OF FACT

Resolving reasonable doubt in the Veteran's favor, his lumbar spine disability began during active service and has continued to worsen since. 

CONCLUSIONS OF LAW

The criteria for service connection for a lumbar spine disability are met.  38 U.S.C. §§ 1110, 1154(b), 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309.

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Veteran had active service from June 2009 to December 2009, March 2010 to September 2010, November 2011 to June 2012, July 2012 to January 2013, June 2013 to July 2013, with additional service in the Air National Guard and Reserves, to include periods of active service for flight training and a full-time tour of active guard and reserve duty from August 2000 to September 2005.  He earned two Air Medals for combat service in Afghanistan during Operation Enduring Freedom in May and June 2010.

This matter comes before the Board of Veterans' Appeals (Board) on appeal from a March 2021 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO).

In the August 2021 VA Form 10182, Decision Review Request: Board Appeal, under the Appeals Modernization and Improvement Act (AMA), the Veteran elected the Hearing docket. The Veteran testified before the undersigned Veterans Law Judge at a hearing in April 2025; a transcript is of record. 

Therefore, the Board may only consider evidence of record as of the March 2021 rating decision, as well as any evidence submitted by the Veteran or his representative at the April 2025 hearing or within 90 days following the hearing.  See 38 C.F.R. §?20.302(a).  The Board cannot consider (1) evidence submitted during the period after the March 2021 rating decision, and before the date of the hearing, or (2) evidence submitted more than 90 days following the hearing.  The Board has not considered evidence associated with the claims file during a period when additional evidence was not allowed that was not resubmitted within 90 days of the Board hearing, to include the October 2024 private opinion by PA-C M.D., submitted on October 29, 2024.  38 C.F.R. § 20.300.  

If the Veteran would like VA to consider any evidence that was added to the claims file 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.

The March 2021 rating decision made a specific finding of new and relevant evidence as to the matter of service connection for a lumbar spine disability.  As the?Board is bound by the favorable findings of the agency of original jurisdiction (AOJ), new and relevant evidence need not be addressed, and the Board will proceed with addressing the merits of the claim.  See 38 U.S.C. § 5104A; 38 C.F.R. §§ 3.104(c), 3.2501. 

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

The Veteran contends that he entered service without back pain, injured his back while deployed, and continued to experience chronic pain and stiffness aggravated throughout his twenty-three year career as an Air Force pilot by flying ejection seat as an Air Force pilot, marching and running in combat boots, loading and unloading heavy equipment, performing assault landings on ice and unimproved runways, and the high-G loading and corresponding tremendous weight and force on his spine.  See July 2020 VA Form 21-526EZ; August 2024 VA Form 20-10208 (resubmitted April 29, 2025).  He specifically stated that he has had ongoing issues with his back ever since he slipped and fell on the ice in Antarctica, but that he did not report his continuous lower back issues out of fear of
 and continued to experience chronic pain and stiffness aggravated throughout his twenty-three year career as an Air Force pilot by flying ejection seat as an Air Force pilot, marching and running in combat boots, loading and unloading heavy equipment, performing assault landings on ice and unimproved runways, and the high-G loading and corresponding tremendous weight and force on his spine.  See July 2020 VA Form 21-526EZ; August 2024 VA Form 20-10208 (resubmitted April 29, 2025).  He specifically stated that he has had ongoing issues with his back ever since he slipped and fell on the ice in Antarctica, but that he did not report his continuous lower back issues out of fear of losing his flight status and instead managed his pain with over-the-counter medication and chiropractic care.  See April 2025 Board Hearing Transcript.  

Generally, to establish service connection, the evidence must show (1) a present disability, (2) an in-service incurrence or aggravation of a disease or injury, and (3) a causal relationship between the present disability and the disease or injury incurred or aggravated during service.  See Davidson v. Shinseki, 581 F.3d 1313, 1315-16 (Fed. Cir. 2009); Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004).  Service connection may also be granted for any disease diagnosed after discharge, when all the evidence, including that pertinent to service, establishes that the disease was incurred in service.  38 C.F.R. § 3.303(d).

For certain chronic disorders, to include arthritis, service connection may be granted if the disease becomes manifest to a compensable degree within one year following separation from service.  See 38 U.S.C. §§ 1101, 1112, 1113, 1137; 38 C.F.R. §§ 3.307, 3.309.  In such cases, the disease is presumed under the law to have had its onset in service even if there is no evidence of such disease during service.  38 C.F.R. § 3.307(a); see also Walker v. Shinseki, 708 F.3d 1331 (Fed. Cir. 2013).

Lay evidence may be competent evidence to establish incurrence.  See Davidson, supra.  Furthermore, a layperson is competent to report on the onset and continuity of symptomatology.  See Layno v. Brown, 6 Vet. App. 465, 470 (1994) (a Veteran is competent to report on that of which he or she has personal knowledge).  However, competent medical evidence is necessary where the determinative question is one requiring medical knowledge.  See Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007).

VA is responsible for determining whether the evidence persuasively favors one side or another. 38 C.F.R. § 4.3.  VA shall consider all information and medical and lay evidence of record.  Where there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, VA shall give the benefit of the doubt to the claimant.  38 U.S.C. § 5107; 38 C.F.R. § 3.102; see also Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021) (en banc).

The Veteran's current diagnosis of lumbosacral strain was included as a favorable finding in the March 2021 rating decision.  The Board is bound by favorable findings.  38 U.S.C. § 5104A; 38 C.F.R. § 3.104(c).  The Veteran has also been diagnosed with degenerative arthritis of the lumbar spine, intravertebral disc syndrome (IVDS), multilevel disc space narrowing, and lumbar radiculopathy.  See August 2023 Lumbar Spine Imaging; August 2023 W.W.H., Dr. M.T.; September 2023 A.P.T., Dr. R.P.  Therefore, the first element of service connection is met. 

Turning to the second element, the Board finds that the evidence shows in-service incurrence. 

The Veteran's personnel records show that he served an active guard reserve (AGR) tour from August 18, 2000, through September 11, 2005, with Title 10 status for any mission-directed OCONUS travel.  See e.g. August 2000, August Orders; 38 C.F.R. § 3.6(a), (c
ulopathy.  See August 2023 Lumbar Spine Imaging; August 2023 W.W.H., Dr. M.T.; September 2023 A.P.T., Dr. R.P.  Therefore, the first element of service connection is met. 

Turning to the second element, the Board finds that the evidence shows in-service incurrence. 

The Veteran's personnel records show that he served an active guard reserve (AGR) tour from August 18, 2000, through September 11, 2005, with Title 10 status for any mission-directed OCONUS travel.  See e.g. August 2000, August Orders; 38 C.F.R. § 3.6(a), (c)(3).  His performance reports and award citations show that he flew over 50 missions to Antarctica delivering cargo, fuel, and personnel from McMurdo to various remote science camps in "extremely hazardous conditions" on "short unimproved landing strips" and "ski ways", and over 60 combat sorties in Afghanistan during Operation Enduring Freedom.  See e.g. August 2001, August 2008, August 2011 AF Forms 707; July 2010, December 2010 Air Medal Citations.  

His service treatment records show treatment for back pain in February 2001 at the McMurdo Medical Center in Antarctica, and notations of a back injury "while on the ice" during a March 2001 deployment assessment.  See February 2001 M.M.C. Encounter Form; March 2001 Deployment Assessment.  An April 2016 dental treatment record noted that the Veteran was under chiropractic care, May 2016 health records noted that he was on profile and saw a primary care provider "for neck and back pain", and in May 2016 a flight surgeon noted that the Veteran required follow up for his neck and back.  See April 2016 AF Form 696; May 2016 Health Records. In December 2016, the Veteran sought private emergency treatment for back muscle spasms and reported that he had similar problems "2 years ago".  See December 2016 S.J. Ambulance Note; December 2016 C.H. Emergency Department Note.  

The Board notes that the Veteran is competent to report his observable symptoms, including the onset of back pain in service, with continuing symptoms since service, and finds his reports both consistent with the conditions and circumstances of his service, and credible, as they are largely corroborated by his service records and medical treatment records showing injury and back pain.  See Jandreau, supra; see also 38 U.S.C. § 1154(b).   The Veteran's spouse, T.B., who met him in May 2017, stated that he experienced a back pain flareup just after they met, and that he continued to experience flareups over the years.  See April 2025 T.B. Statement.  Therefore, the second element of service connection, an in-service injury, is met.

Turning to the third element, the Board notes that there is evidence weighing in favor of and against service connection.  

During a September 2020 VA back examination, the Veteran reported that his back pain began in 2002, after he landed on his back when he slipped and fell in Antarctica, and has continued since.  See September 2020 VA Back Conditions Examination.  He reported that he was hospitalized in 2003, his back gave out and he fell to the floor in 2017, he sought chiropractic treatment, and he continued to have tightness in his back, flareups of back pain, and difficulty sitting for long flights.  Id.  Despite noting objective evidence of pain on passive range of motion testing and acknowledging that the Veteran's service treatment records indicated low back pain, the examiner provided a negative nexus opinion with the rationale that evidence of acute low back pain in February 2001 and August 2016 "resolved without evidence of recurrence or chronicity".  See October 2020 VA Back Opinion.  The Board must be able to conclude that a medical expert has applied valid medical analysis to the significant facts of the case to reach the conclusion submitted in the medical opinion.  See Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 304 (2008).  As the October 2020 VA opinion disregarded the Veteran's statements that his back pain had been continuous in and since service, the Board affords it no probative weight.  See Reonal v. Brown, 5 Vet. App. 458, 461 (1993) (opinions based on an inaccurate factual premise carry no probative value); Miller v. Wilkie, 32 Vet. App. 249 (2020) (an examination with a medical opinion adequately
 applied valid medical analysis to the significant facts of the case to reach the conclusion submitted in the medical opinion.  See Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 304 (2008).  As the October 2020 VA opinion disregarded the Veteran's statements that his back pain had been continuous in and since service, the Board affords it no probative weight.  See Reonal v. Brown, 5 Vet. App. 458, 461 (1993) (opinions based on an inaccurate factual premise carry no probative value); Miller v. Wilkie, 32 Vet. App. 249 (2020) (an examination with a medical opinion adequately informing the Board of the Veteran's disability while considering prior medical history requires thorough consideration of the Veteran's lay reports of symptomatology).  

In contrast, in January 2016, the Veteran's treating chiropractor conducted a comprehensive review and analysis of the Veteran's lumbar spine utilizing imaging of his lumbar and (service-connected) cervical spine.  See January 2016 N.F.C. Dr. B.N. Report of Findings.  Dr. B.N. identified spinal arthritis and disc disease; explained that ligament damage is present when spina vertebra do not align properly; noted that the Veteran's narrowed disc space indicated that the disc had been injured; and stated that "while disc disease can have several causes, generally it is the result of abnormal stress (pressures) applied to the disc from abnormal spinal alignment", citing to numerous medical journals and medical literature in support of the conclusion that the Veteran's spine degeneration can generally be traced back to a past injury and his disease syndromes to spinal displacement.  Id.  Dr. B.N. identified the misalignment in the Veteran's service-connected cervical spine and explained that "when misalignments in this region occur, the effects can be full body"; that the abnormal position of the Veteran's neck put increased pressure on his spinal discs, muscles, bones, and nerves, and that this "may lead to early spinal arthritis and disc disease".  Id.  As the private clinician considered the Veteran's medical history and applied a valid medical analysis to the significant facts to reach the conclusion, including extensive citations to relevant supporting medical literature, the Board affords it high probative weight.  See Nieves-Rodriguez, supra; Stefl v. Nicholson, 21 Vet. App. 120 (2007).  

The Veteran's statements that he has experienced continuous symptoms of back pain since he initially injured his back in service, corroborated by treatment records showing evidence of a back injuries in service and continued treatment for and reports of ongoing back pain, followed by an August 2023 diagnosis of degenerative arthritis of the lumbar spine, intravertebral disc syndrome (IVDS), multilevel disc space narrowing, and lumbar radiculopathy, is the essence of continuity of symptomatology contemplated by 38 C.F.R. § 3.303(b).  See Wilson v. Derwinski, 2 Vet. App. 16, 19 (1991); see also Savage v. Gober, 10 Vet. App. 488, 496 (1997).  Therefore, the Board also finds that this evidence also weighs in favor of finding service connection.  38 C.F.R. §§ 3.307, 3.309.

After a review of the record, and resolving all doubt in the Veteran's favor, the Board finds that the evidence weighs in favor of service connection.  See Lynch, 21 F.4th at 781-82.  Accordingly, service connection for a lumbar spine disability, to include degenerative arthritis and lumbar radiculopathy, is warranted.  38 U.S.C. §§ 5107, 1154(b); 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309.

 

 

A. J. Spector

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	Zahn, C.

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.