12-21 885
12-21 885
| Board of Vet. App. | Jul 31, 2017Background
- Veteran served on active duty Jun 1969–Jan 1972 and appealed denials of service connection for lumbar spine and bilateral knee disabilities originally decided Sep 2009.
- Separation exam and service treatment records showed normal spine and knees; no documented complaints or treatment for back/knees in service or within one year post-discharge.
- Post-service medical records show first documentation of lumbar arthritis in 2009 and knee arthritis in 2011; SSA records show disability for back disorders effective Jun 2009.
- VA examinations (May 2015 and addenda, including Nov 2016) diagnosed degenerative joint disease/osteoarthritis and concluded it is less likely than not that the conditions began in service or within one year of discharge.
- Examiners also concluded the service‑connected neuropathy/diabetes did not cause or aggravate the back/knee conditions (no Charcot arthropathy); medical opinions were found adequate and uncontroverted.
- Board found VA satisfied duty to notify and assist, no prejudice from development, and denied service connection because preponderance of evidence is against nexus to service or to a service‑connected condition.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Service connection — lumbar spine | Lumbar spine arthritis is related to an in‑service slip and subsequent symptoms since 1970 | Separation exam normal; no diagnosis within one year; imaging and expert opinion point to age‑related degeneration, not service | Denied — no nexus to service or continuity within one year of discharge |
| Service connection — bilateral knees | Knee arthritis relates to in‑service slip and chronic post‑service symptoms (left knee fracture 1980) | Separation exam normal; arthritis first documented decades after service; imaging consistent with age; examiner opined against service nexus | Denied — no nexus to service or continuity within one year of discharge |
| Secondary service connection (to service‑connected neuropathy/diabetes) | Back/knee conditions were caused or aggravated by service‑connected neuropathy/diabetes | Medical opinions: diabetes/neuropathy do not directly affect joints absent Charcot arthropathy, which Veteran does not have; no evidence of aggravation | Denied — no adequate medical nexus showing causation or aggravation |
| Adequacy of VA development/exams | (Implicit) additional development and competent medical opinions needed | VA provided examinations, addenda, and obtained records; exams were adequate and file fully developed | Held adequate — Board proceeded; no prejudice to Veteran |
Key Cases Cited
- Shinseki v. Sanders, 556 U.S. 396 (2009) (prejudice standard for procedural errors)
- Shedden v. Principi, 381 F.3d 1163 (Fed. Cir. 2004) (elements for service connection)
- Walker v. Shinseki, 701 F.3d 1331 (Fed. Cir. 2013) (continuity of symptomatology for chronic disease claims)
- Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007) (competency limits for lay evidence on medical etiology)
- Stegall v. West, 11 Vet. App. 268 (1998) (requirement that remand directives be complied with)
- Bernard v. Brown, 4 Vet. App. 384 (1993) (duty to assist and when appellate review may proceed)
- Barr v. Nicholson, 21 Vet. App. 303 (2007) (requirements for adequate VA medical examinations)
- Sickels v. Shinseki, 643 F.3d 1362 (Fed. Cir. 2011) (challenge to adequacy of VA exams)
- Soyini v. Derwinski, 1 Vet. App. 540 (1991) (when further development is unnecessary)
- Sabonis v. Brown, 6 Vet. App. 426 (1994) (same)