11-21 145
11-21 145
| Board of Vet. App. | Aug 31, 2017Background
- Veteran served on active duty July 1969–April 1971 and appealed a December 2010 RO denial of service connection for a low back disability.
- Service treatment records (STRs) show a pre-service/back bruise noted on enlistment with a mild lumbar sprain described as resolved and otherwise normal spinal exams in service and at separation.
- First documented postservice back treatment in the record is chiropractic records beginning April 2009 (diagnosis of lumbosacral degenerative disc disease L5–S1 in 2013). The Veteran reported earlier chiropractic care in the 1980s but did not provide provider information or authorizations requested in 2014.
- At an October 2012 Travel Board hearing the Veteran asserted he injured his back in service (pulled into a bomb shelter) and later treated for back problems, but no contemporaneous STRs or medical records tie a current diagnosis to an in‑service event.
- VA complied with notice and development duties; the Board found no competent medical evidence of a nexus and determined further VA examination was not warranted given the absence of evidence suggesting a link.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether Veteran is entitled to service connection for a low back disability | Veteran contends back injury in service and subsequent/chronic symptoms (including chiropractic care) establish service connection | VA argues STRs show no in‑service or immediate postservice back disability, no continuous symptomatology, and no medical nexus linking current DDD to service | Denied — preponderance of evidence against service connection; no in‑service or first‑year postservice manifestation, no continuity, no nexus |
| Whether presumptive service connection for arthritis applies (manifestation within one year) | Veteran argues arthritis/degeneration is related to service events | VA notes no evidence arthritis manifested within first postservice year | Denied — no evidence of arthritis manifesting within one year postservice |
| Whether continuity of symptomatology establishes service connection | Veteran asserts earlier (1980s) treatment shows continuity from service to current condition | VA notes lack of records for 1980s treatment and long gaps (service → 1980s → 2009) that break continuity | Denied — continuity not shown; gaps and lack of corroborating records are dispositive |
| Whether VA erred by not obtaining a medical nexus opinion | Veteran asserts nexus exists based on lay statements | VA contends no competent evidence suggests a possible link that would trigger an exam requirement | Denied — Board found no competent evidence raising a nexus issue; VA not required to obtain exam |
Key Cases Cited
- Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007) (lay evidence insufficient for medical questions requiring expertise)
- McLendon v. Nicholson, 20 Vet. App. 79 (2006) (VA need not provide an examination where no competent evidence suggests possible service connection)
- Waters v. Shinseki, 601 F.3d 1274 (Fed. Cir. 2010) (conclusory lay statements insufficient to require medical examination)
- Walker v. Shinseki, 708 F.3d 1331 (Fed. Cir. 2013) (continuity of symptomatology as a method to establish service connection)
- Stegall v. West, 11 Vet. App. 268 (1998) (requirement that remand directives be followed)
- Gilbert v. Derwinski, 1 Vet. App. 49 (1990) (preponderance of the evidence and benefit of the doubt standard)