Veterans Medical Advisor

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                         Case from Bureau of Veterans Appeals

Dr. Bash is a veteran of


Citation Nr: 9909193

Decision Date: 03/31/99 | Archive Date: 04/06/99

DOCKET NO. 95-24 277

On appeal from the Department of Veterans Affairs (VA) Regional Office in Baltimore, Maryland

THE ISSUE

Entitlement to service connection for a low back disorder.

REPRESENTATION

Appellant represented by: Paralyzed Veterans of America, Inc.

WITNESS AT HEARING ON APPEAL

The veteran

ATTORNEY FOR THE BOARD

Julie L. Salas, Associate Counsel

INTRODUCTION

The veteran served on active duty from December 1979 to July 1985.

This matter initially came to the Board of Veteran's Appeals (Board) on appeal of an April 1995 rating decision of the RO.

In May 1997, the Board remanded this case for additional development of the record.

FINDINGS OF FACT

1. All relevant evidence necessary for an equitable disposition of the veteran's appeal has been obtained.

2. The veteran is shown to have sustained an injury to his back in connection with a parachute jump during service.

3. The veteran's currently demonstrated low back disability manifested by lumbosacral strain, lumbar disc disease and arthritis of the lumbar spine is the likely result of injuries suffered in service.

CONCLUSION OF LAW

The veteran's low back disability manifested by lumbosacral strain, lumbar disc disease and arthritis of the lumbar spine is due to injuries which were incurred in service. 38 U.S.C.A. §§ 1131, 5107, 7104 (West 1991 & Supp. 1998); 38 C.F.R. § 3.303 (1998).

REASONS AND BASES FOR FINDINGS AND CONCLUSION

As a preliminary matter, the Board finds that the veteran's claim is plausible and capable of substantiation, and thus well grounded within the meaning of 38 U.S.C.A. § 5107(a). When a veteran submits a well-grounded claim, VA must assist him in developing facts pertinent to the claim. 38 U.S.C.A. § 5107(a). The Board is satisfied that all available relevant evidence has been obtained regarding the claim, and that no further assistance to the appellant is required to comply with 38 U.S.C.A. § 5107(a).

Service connection may be established for disability resulting from personal injury suffered or disease contracted in line of duty, or for aggravation of a pre-existing injury suffered or disease contracted in line of duty. 38 U.S.C.A. § 1131; 38 C.F.R. § 3.303. The regulations also provide that 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). If the disorder is a chronic disease, service connection may be granted if manifest to a degree of 10 percent within the presumptive period; the presumptive period for arthritis is one year. 38 U.S.C.A. §§ 1101, 1112, 1113, 1137 (West 1991 & Supp. 1998); 38 C.F.R. §§ 3.307, 3.309 (1998).

In determining whether service connection is warranted for a disability, VA is responsible for determining whether the evidence supports the claim or is in relative equipoise, with the appellant prevailing in either event, or whether a preponderance of the evidence is against the claim, in which case the claim is denied. Gilbert v. Derwinski, 1 Vet.App. 49 (1990).

The veteran contends that he has a low back disorder as a result of an injury which was incurred in service. He testified at a hearing in May 1997, that he hit the ground hard during a parachute jump landing and experienced shooting pains in his back and down his left leg during service in 1984. He stated that, although he continued to experience some residual back pain throughout his service, primarily when he would turn or lift an object, he did not seek further treatment.

The veteran further testified that following his discharge from service, he had continued to experience sharp pains in his lower back and a loss of feeling in his left leg brought on by long periods of standing, turning and lifting. He stated that he ultimately sought treatment from a private physician, Dr. Ludwig Eglseder, in 1992 because he could not walk and was doubled over from the pain in his back. According to the veteran, his symptomatology had increased in severity to the extent that his left leg would occasionally give out on him. He noted that he had been prescribed pain medications, muscle relaxants, ibuprofen and a corset in an attempt to alleviate his condition.

A careful review of the veteran's service medical records shows that, in March 1984, he was treated for a lower back contusion/strain following a parachute jump the previous evening.

In support of his claim, the veteran has submitted medical records from his private physician, Ludwig Eglseder. A statement from Craig Bash, M.D., has also been received in support of the veteran's claim. A review of Dr. Eglseder's records shows that on June 15, 1992, the veteran reported for treatment of sudden low back pain, with some radicular pain to his testicles, after driving a crane over a bridge two days earlier. Dr. Eglseder diagnosed acute lumbar disc injury, which had improved to the extent that he could return to work, with some restrictions, as of June 22, 1992. A subsequent notation on June 30, 1992, indicated that the veteran was once again having problems with his back after riding in a cement truck. An MRI conducted for Dr. Eglseder in July 1992 was noted to be abnormal, showing desiccation of the L4 and L5 discs and apophyseal overgrowth at L4-5 resulting in a mild, lateral impression on the sac at this level. Similar, but lesser, changes were noted on the left. The diagnosis was that of lumbar disc displacement.

Based on a review of the veteran's claims folder, Dr. Bash stated that he agreed with the diagnoses of lumbosacral strain, lumbar disc disease and arthritis of the lumbar spine. In addressing the July 1992 MRI, Dr. Bash commented that the indications recorded demonstrated the presence of a chronic degenerative condition of both the discs and vertebral bodies, which predated and could not have developed coincident with the June 1992 incident. He further opined that "the injury in 1984 and the cumulative effect of many parachute jumps during his Army service very likely initiated the degenerative process of the discs and vertebrae of the lumbar spine." He also noted that "[t]he sudden onset of severe symptoms in 1992 likely represent[ed] an acute exacerbation and progression of the underlying chronic condition, which had its origins in the Army."

The Board finds that the preponderance of the evidence supports the veteran's claim of service connection for a low back disability manifested by lumbosacral strain, lumbar disc disease and arthritis of the lumbar spine.

The Board notes significantly that Dr. Bash, after review of the claims folder, specifically disputed the RO's implication that the veteran's low back disorder had its onset in June 1992 and carefully reasoned that his low back disability was, in fact, related to his military service.

Thus, the Board finds that service connection for a low back disability, manifested by lumbosacral strain, lumbar disc disease and arthritis of the lumbar spine, is warranted.

ORDER

Service connection for a low back disability manifested by lumbosacral strain, lumbar disc disease and arthritis of the lumbar spine is granted.




STEPHEN L. WILKINS

Member, Board of Veterans' Appeals



Department of Veterans Affairs

drbash@doctor.com

______________________

Craig N. Bash M.D., M.B.A.

Neuro-Radiologist and Associate Professor

Uniformed Services School of Medicine

NPI/UPIN-1225123318

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Bethesda, Md 20814

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