Citation Nr: 0720495 Decision Date: 07/10/07 Archive Date: 07/18/07 DOCKET NO. 05-29 792 ) DATE ) ) On appeal from the Department of Veterans Affairs Regional Office in Nashville, Tennessee THE ISSUE Entitlement to service connection for a low back disability. REPRESENTATION Appellant represented by: The American Legion WITNESS AT HEARING ON APPEAL Appellant ATTORNEY FOR THE BOARD N. McElwain, Associate Counsel INTRODUCTION The veteran had active service from March 1976 to March 1979 and from November 1980 to June 1995. This matter came before the Board of Veterans' Appeals (Board) on appeal from a decision of September 2004 by the Department of Veterans Affairs (VA) Nashville, Tennessee, Regional Office (RO). FINDING OF FACT The veteran's medical records indicate continuity of low back symptomatology in and after service, and the veteran's current disability has been linked to service. CONCLUSION OF LAW The criteria for service connection for a low back disability have been met. 38 U.S.C.A. §§ 1110, 1131 (West 2002); 38 C.F.R. § 3.303 (2006). REASONS AND BASES FOR FINDING AND CONCLUSION Service connection may be granted for a disability resulting from injury or disease incurred in or aggravated by active service. 38 U.S.C.A. §§ 1110, 1131; 38 C.F.R. § 3.303. To establish service connection for the claimed disorder, there must be medical evidence of a current disability; medical or, in certain circumstances, lay evidence of in-service incurrence or aggravation of a disease or injury; and medical evidence of a nexus between the claimed in-service disease or injury and the current disability. If a chronic disorder, such as arthritis, is manifest to a compensable degree within one year after separation from service, the disorder may be presumed to have been incurred in service. See 38 U.S.C.A. §§ 1101, 1112, 1113, 1137; 38 C.F.R. §§ 3.307, 3.309. Service medical records report treatment for low back pain in June 1981, June 1984, September 1986, June 1989, February 1991, and March 1995, with assessments of back strain, sacroiliac dysfunction, and low back pain. The March 1995 separation examination record reports the veteran gave a positive history of recurrent back pain, and the examiner noted the veteran's prior medical history of sacroiliac dysfunction with moderate relief, status post muscle energy manipulation. Although the March 1995 separation examination record, in addition to the previous examination records, all report normal findings for the spine, records dating subsequent to service indicate continuous treatment for a back disability. A February 1996 emergency room record reports the veteran's complaint of low back pain, and the veteran was assessed with low back pain with muscle spasm. See February 1996 Blanchfield medical record. A 1997 VA examination record reports the veteran's history of discomfort, radiating pain, and spasms in his lumbar spine. See July 1997 VA examination record. An April 1998 record reports the veteran's history of injuring his back the day before, and the veteran is diagnosed with lumbosacral strain. See April 1998 Blanchfield Medical record. In 2001, the veteran went to the emergency room 3 times for low back pain. See June 2001 Trinity Hospital emergency room record (history of straining back at work); April and August 2001 Blanchfield Medical record. The veteran also received treatment for back pain and spasms in June 2001, and an October 2001 treatment record reports the veteran's history of low back pain for "over 3 years." See April and October 2001 Blanchfield treatment record. Subsequent records indicate continuing treatment for low back pain with an assessment of degenerative disc disease and disc rupture of L4-5 with resulting right leg radiculopathy. See, e.g., November 2001, January 2002, August 2003, and November 2003 Blanchfield medical records. In January 2004, the veteran underwent a lumbar fusion, and post surgery records report improvement in the back, but that there was still pain in the sacroiliac joint. See September 2004 Berkman letter. A treating physician, Dr. Berkman, has submitted letters stating that he has treated the veteran for episodes of back and leg pain, beginning in 1996. See October 2003, January 2004 Berkman letters. A subsequent letter reports Dr. Berkman's opinion that the veteran's low back disability was from "normal wear and tear on [the veteran's] body as a result of service and work in the military." See May 2004 Berkman letter. Other records indicate the veteran's history of back pain since a 1996 motor vehicle accident. See September 2001 x-ray record; October 2003 Blanchfield treatment record. See also undated 1996 Blanchfield emergency room record (record must be dated post-June 1996 since veteran noted to be 38). The Board finds that the evidence is, at a minimum, in equipoise as to whether the veteran's current low back disability is related to service. Although some treatment records report the veteran's history of low back pain since a 1996 motor vehicle accident, this history is not as probative as the competent medical evidence of record. In general, a layperson is competent to comment on the presence or etiology of a medical disorder. Rather, medical evidence is needed to that effect. See Espiritu v. Derwinski, 2 Vet. App. 492. In this case, the medical evidence reports treatment for low back pain on several occasions during service and post- service records indicate a pattern of treatment for low back problems from separation to the present, to include a treatment record which possibly predates the 1996 motor vehicle accident. Additionally, the evidence includes a positive nexus statement from the veteran's treating physician. Although this opinion is not based on a review of the evidence, the Board finds that the evidence, as a whole, supports the positive nexus opinion. Consequently, based on the evidence of an in-service incurrence of a low back disability, the continuity of symptomatology from separation from service to the present, and the positive nexus opinion, service connection is granted. ORDER Service connection for a low back disability is granted. ____________________________________________ J. E. DAY Veterans Law Judge, Board of Veterans' Appeals Department of Veterans Affairs