13-00 573, 13-00 573

Veteran served on active duty Aug 2002–Aug 2007 and reported a lower back injury during service (noted July 2007) after hyperextending and during physical training activities.
Post-service VA records show chronic back pain complaints; private records (July 2014) diagnose sacroiliitis and lumbar facet syndrome.
VA examinations (Mar 2011, Feb 2016) found no objective pathology and no diagnosis; veteran and a private specialist asserted objective testing may not show the condition.
Veteran provided a February 2017 private medical opinion opining greater than 50% likelihood that chronic back pain is related to service after review of records and exam.
Board resolved reasonable doubt in Veteran’s favor, found current diagnoses (sacroiliitis and lumbar facet syndrome), in-service injury, and a persuasive nexus opinion; granted service connection for chronic back pain diagnosed as sacroiliitis and lumbar facet syndrome.

Issue	Plaintiff's Argument	Defendant's Argument	Held
Entitlement to service connection for lower back disorder	Veteran argued his in-service injury and continuous post-service symptoms establish service connection; private examiner provided nexus opinion	VA examiners found no objective pathology and opined no active spine pathology or diagnosis	Granted: Board found current diagnoses, in-service injury, and gave probative weight to private nexus opinion, resolving doubt for Veteran

Shedden v. Principi, 381 F.3d 1163 (Fed. Cir. 2004) (elements for service connection include current disability, in-service event, and nexus)
Layno v. Brown, 6 Vet. App. 465 (Vet. App. 1994) (veteran competent to report onset and continuity of symptoms)
Gilbert v. Derwinski, 1 Vet. App. 49 (Vet. App. 1990) (benefit-of-the-doubt doctrine when evidence is equipoise)
McClain v. Nicholson, 21 Vet. App. 319 (Vet. App. 2007) (VA must consider competent evidence and may accept private diagnoses where probative)