Degenerative Disc Disease
Heavy load-bearing/rucksack carriage and low back pain incidence in service members.
38 CFR diagnostic codes 5237, 5238, 5239, 5242, 5243, 5244, 5235, 5236
Peer-reviewed evidence (4)
The verified studies behind a Degenerative Disc Disease claim — each links to its real PubMed or DOI record. These are sources our nexus drafts can draw from; none are invented.
- Knapik JJ, Reynolds KL, Harman E. Soldier load carriage: historical, physiological, biomechanical, and medical aspects. Mil Med. 2004;169(1):45-56. PMID:14964502. doi:10.7205/milmed.169.1.45.
- Ernat J, Knox J, Orchowski J, Owens B. Incidence and risk factors for acute low back pain in active duty infantry. Mil Med. 2012;177(11):1348-51. PMID:23198512. doi:10.7205/milmed-d-12-00183.
- Knox JB, Orchowski JR, Scher DL, Owens BD, Burks R, Belmont PJ. Occupational driving as a risk factor for low back pain in active-duty military service members. Spine J. 2014;14(4):592-7. PMID:23992937. doi:10.1016/j.spinee.2013.06.029.
- Steelman T, Lewandowski L, Helgeson M, Wilson K, Olsen C, Gwinn D. Population-based Risk Factors for the Development of Degenerative Disk Disease. Clin Spine Surg. 2018;31(8):E409-E412. PMID:29985801. doi:10.1097/BSD.0000000000000682.
Controlling law
The CFR sections and cases the theories relevant to this condition rest on — the legal standard raters evaluate against, never a prediction about any claim.
Direct (§ 3.303)
Regulation
38 C.F.R. § 3.303
Direct service connection — a current disability linked to service. (Continuity of symptomatology under § 3.303(b) is limited by case law to the § 3.309(a) chronic diseases — Walker.)
Case law
Shedden v. Principi, 381 F.3d 1163 (Fed. Cir. 2004)
The three-element test: current disability, in-service event, and a nexus between them.
Holton v. Shinseki, 557 F.3d 1363 (Fed. Cir. 2009)
Federal Circuit restatement of the same three direct-service-connection elements.
Caluza v. Brown, 7 Vet. App. 498 (1995)
The evidentiary framework a rater weighs each element against.
Walker v. Shinseki, 708 F.3d 1331 (Fed. Cir. 2013)
Continuity of symptomatology (§ 3.303(b)) is available ONLY for a chronic disease listed in § 3.309(a); any other condition must use the medical-nexus pathway.
Davidson v. Shinseki, 581 F.3d 1313 (Fed. Cir. 2009)
A categorical 'a medical opinion is always required for nexus' is legal error — competent lay evidence can suffice.
Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007); Layno v. Brown, 6 Vet. App. 465 (1994)
A veteran is competent to report symptoms they personally observe (Layno), and lay evidence can even establish a simple diagnosis in the right case (Jandreau).
McLendon v. Nicholson, 20 Vet. App. 79 (2006)
A LOW threshold — evidence that merely indicates a nexus MAY exist obligates VA to provide a C&P exam.
38 U.S.C. § 5107(b); Gilbert v. Derwinski, 1 Vet. App. 49 (1990)
When the evidence is in relative equipoise, the tie goes to the veteran — the preponderance must be AGAINST the claim to deny it.
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