Citation Nr: 18132383
Decision Date: 09/06/18	Archive Date: 09/06/18

DOCKET NO. 16-41 237
DATE:	September 6, 2018
ORDER
Entitlement to service connection for a neck injury is granted.
Entitlement to service connection for a low back condition is granted.
Entitlement to service connection for a left foot injury is granted.
FINDINGS OF FACT
1. The Veteran’s neck injury is etiologically related to his period of active military service. 
2. The Veteran’s low back condition is etiologically related to his period of active military service. 
3.  The Veteran’s left foot injury is etiologically related to his period of active military service. 

CONCLUSIONS OF LAW
1. The criteria for entitlement to service connection for a neck injury have been met.  38 U.S.C. §§ 1110, 5103A, 5107 (2012); 38 C.F.R. §§ 3.102, 3.303 (2017).
2. The criteria for entitlement to service connection for a low back condition have been met.  38 U.S.C. §§ 1110, 5103A, 5107 (2012); 38 C.F.R. §§ 3.102, 3.303 (2017).
3. The criteria for entitlement to service connection for a left foot injury have been met.  38 U.S.C. §§ 1110, 5103A, 5107 (2012); 38 C.F.R. §§ 3.102, 3.303 (2017).
REASONS AND BASES FOR FINDINGS AND CONCLUSIONS
The Veteran had active military service in the U.S. Army from August 1984 to July 1988.
Service Connection
Service connection may be granted for a disability resulting from disease or injury incurred in or aggravated by active military, naval, or air service.  38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303(a).  Service connection may 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).  As a general matter, service connection for a disability requires evidence of: (1) the existence of a current disability; (2) the existence of the disease or injury in service, and; (3) a relationship or nexus between the current disability and any injury or disease during service.  Shedden v. Principi, 381 F.3d 1163 (Fed. Cir. 2004); see Hickson v. West, 12 Vet. App. 247, 253 (1999), citing Caluza v. Brown, 7 Vet. App. 498, 506 (1995), aff’d, 78 F.3d 604 (Fed. Cir. 1996).  
For some “chronic diseases,” presumptive service connection is available.  38 U.S.C. §§ 1101, 1112, 1113, 1137; 38 C.F.R. §§ 3.307, 3.309.  With “chronic disease” shown as such in service (or within the presumptive period under § 3.307), so as to permit a finding of service connection, subsequent manifestations of the same chronic disease at any later date, however remote, are service connected, unless clearly attributable to intercurrent causes.  38 C.F.R. § 3.303(b).  For the showing of a ‘chronic disease’ in service there is required a combination of manifestations sufficient to identify the disease entity, and sufficient observation to establish chronicity at the time.  38 C.F.R. § 3.303(b).  If chronicity in service is not established, a showing of continuity of symptoms after discharge is required to support the claim.  Id.  If not manifest during service, where a Veteran served continuously for 90 days or more during a period of war, or during peacetime service after December 31, 1946, and the ‘chronic disease’ became manifest to a degree of 10 percent within 1 year from date of termination of such service, such disease shall be presumed to have been incurred in service, even though there is no evidence of such disease during the period of service.  38 C.F.R. § 3.307. 
The term “chronic disease,” whether as shown during service or manifest to a compensable degree within a presumptive window following service, applies only to those disabilities listed in 38 C.F.R. § 3.309(a).  Walker v. Shinseki, 708 F.3d 1331 (Fed. Cir. 2013). 
In each case where service connection for any disability is being sought, due consideration shall be given to the places, types, and circumstances of such Veteran’s service as shown by such Veteran’s service record, the official history of each organization in which such Veteran served, such Veteran’s medical records, and all pertinent medical and lay evidence.  38 U.S.C. § 1154(a). 


1. Entitlement to service connection for a neck injury
2. Entitlement to service connection for a low back condition
3. Entitlement to service connection for a left foot injury
In the instant matter, the Veteran claims that the aforementioned conditions are all due to an in-service injury.  Pertinently, at the May 2018 Board hearing, the Veteran testified that while wearing full gear, he fell and hit his head, neck, and the front of his shoulder.  He described the full-body pain as one that sent a shockwave through his body.  The Veteran reported that post-injury he was given an ice pack, neck brace, and was placed on quarters or an excused absence for approximately one week.
At entry and exit of service in 1983 and 1988, respectively, the Veteran was examined as normal, and denied a head injury, painful joints, bone/joint deformity, cramps in the legs, foot trouble or neuritis on both medical history forms.  At both entry and exit, the Veteran did report having previous double hernia surgery.
The Veteran complained of constant low back pain radiating down is left leg and foot in July 2002, and was diagnosed with sciatica of the left leg and back in August 2002. 
VA treatment records from September 2015 note that the Veteran reported chronic neck and low back pain which he believed was related to field activities, repetitive jumping maneuvers, with progression over the years. The Veteran also reported occasional pain along his lateral left calf and foot.  The Veteran underwent VA examination in September 2016 for his claimed back, neck and left foot conditions.  The examiner overwhelming concluded that the Veteran did not have a current diagnosis for any of the claimed conditions, but rather the Veteran was exaggerating his symptoms on examination. The examiner did concede that the Veteran possessed signs or symptoms of radiculopathy as he described pain that goes down his back into both arms, down the inner thighs bilaterally, and into his foot.
Since then, private treatment records from October 2014 have been associated with the claims file which note that the Veteran had low back pain with radiation to the hip, left lower leg and left foot.  The physician diagnosed systematic lumbar radiculopathy with S1 dermatome left sided dysfunction, chronic low back pain syndrome, and tension cephalgia.
Thus, the Veteran presently has diagnoses of a back, neck, and a left foot condition.  Accordingly, the sole question remaining before the Board is whether those conditions are due to active military service.  To this end, the Board sought an advisory medical opinion in June 2018.  The specialist report noted that it is at least as likely as not that the Veteran’s diagnosed back, neck and left food conditions had an in-service onset, or a causally elated to the Veteran’s reported in-service fall.  Specifically, the examiner noted that the July 2017 MRI results showed multilevel degenerative change most severe at C3-4, stenosis and myelomalacia, as well as lumbar spondylosis and stenosis.  Medical findings also revealed left lumbar radiculopathy with pain radiating to the left lower extremity and left foot.  The examiner concluded stating that the Veteran’s unwavering report of back, neck, and left foot pain since service is consistent with the cumulative effects of his service, including heavy lifting in a warehouse, field activities, and repetitive jumping maneuvers. Consequently, as the competent medical evidence of record associates the Veteran’s back, neck, and left foot disabilities with his period of active military service, the Board finds that entitlement to service connection for a neck, low back, and left foot condition is granted.   38 U.S.C. §§ 1110, 5103A, 5107 (2012); 38 C.F.R. §§ 3.102, 3.303(b) (2017).  

 
T. MAINELLI
Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD	J.L. Reid, Associate Counsel 

For A Complete Guide To VA Disability Claims and to find out more about your potential VA disability case and how to obtain favorable VA Rating Decision! Visit: VA-Claims.org

For More Information on Veterans Disability Compensation Benefits! Visit: DisableVeteran.org ~ A Non-Profit Non Governmental Agency

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