190819-24524
190819-24524
| Board of Vet. App. | May 28, 2021Background
- Veteran served on active duty July 1980–January 1986 and seeks service connection for lumbar spine and right elbow disabilities.
- Original VA rating decision (Nov 2016) prompted an NOD; Veteran opted into AMA/RAMP in June 2018 and selected higher-level review; AOJ later re-adjudicated as a RAMP supplemental claim (July 2019).
- Veteran asserts nexus to service based on in-service low back pain complaints and an in-service assessment of "sling palsy" for the right elbow.
- The AOJ obtained VA medical opinions (Jan and Mar 2019) that concluded the disabilities were less likely than not related to service, but those opinions lacked adequate rationale and failed to meaningfully address the Veteran’s lay contentions.
- The Board found the VA opinions inadequate under controlling precedent and remanded both claims for addendum opinions that review the entire file, consider the Veteran’s reports, and address specific nexus and arthritis-manifestation questions.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Service connection — lumbar spine | Lumbar condition began in or is related to service; in-service low back pain reported | VA opinions: less likely than not related; rely on lack of documented in-service diagnosis | Remanded — VA exams inadequate; obtain addendum addressing onset, nexus, and arthritis manifestation/continuity |
| Service connection — right elbow | Right elbow disability related to in-service sling palsy | VA opinions: less likely than not related; rely on absence of in-service documentation | Remanded — VA exam failed to address Veteran’s sling palsy contention; obtain addendum addressing onset, nexus, and arthritis manifestation/continuity |
Key Cases Cited
- Monzingo v. Shinseki, 26 Vet. App. 97 (Vet. App. 2012) (examiner must provide sufficient rationale so Board can assess and weigh opinion)
- Stefl v. Nicholson, 21 Vet. App. 120 (Vet. App. 2007) (medical opinion must support conclusions with analysis)
- McKinney v. McDonald, 28 Vet. App. 15 (Vet. App. 2016) (examiner must consider veteran’s lay testimony/theories of causation)
- Barr v. Nicholson, 21 Vet. App. 303 (Vet. App. 2007) (duty to assist requires adequate medical examinations/opinions)