Compensation under 38 U.S.C. § 1151 for worsened disability from cervical spine degenerative arthritis is granted. Compensation under 38 U.S.C. § 1151 for worsened disability from lumbar spine degenerative arthritis is…

Citation Nr: A26069992 Decision Date: 07/30/26 Archive Date: 07/30/26 DOCKET NO. 220512-242294 DATE: July 30, 2026 ORDER Compensation under 38 U.S.C. § 1151 for worsened disability from cervical spine degenerative arthritis is granted. Compensation under 38 U.S.C. § 1151 for worsened disability from lumbar spine degenerative arthritis is granted. FINDINGS OF FACT 1. The evidence is at least in equipoise showing additional cervical and lumbar spine disability resulted from the slip and fall at a VA facility on February 18, 2020. 2. The slip and fall injury was proximately caused by an event not reasonably foreseeable during inpatient treatment. CONCLUSIONS OF LAW 1. The criteria for compensation under 38 U.S.C. § 1151 for worsened disability from cervical spine degenerative arthritis have been met. 38 U.S.C. §§ 1151, 5103, 5107; 38 C.F.R. §§ 3.102, 3.159, 3.361. 2. The criteria for compensation under 38 U.S.C. § 1151 for worsened disability from lumbar spine degenerative arthritis have been met. 38 U.S.C. §§ 1151, 5103, 5107; 38 C.F.R. §§ 3.102, 3.159, 3.361. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty in the U.S. Navy from December 1973 to January 1974. In the May 2022 VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement), the Veteran elected the Hearing docket. A Board hearing was held on January 14, 2026. Therefore, the Board may only consider the evidence of record at the time of the May 2021 agency of original jurisdiction (AOJ) decision on appeal, as well as any evidence submitted by the Veteran or representative at the hearing or within 90 days following the hearing. 38 C.F.R. § 20.302(a). If evidence was submitted either (1) during the period after the AOJ issued the decision on appeal and prior to the Board hearing, or (2) more than 90 days following the hearing, the Board did not consider it in its decision. 38 C.F.R. §§ 20.300, 20.302(a), 20.801. If the Veteran would like VA to consider any evidence that was submitted that the Board could not consider, the Veteran may file a Supplemental Claim (VA Form 20-0995) and submit or identify this evidence. 38 C.F.R. § 3.2501. If the evidence is new and relevant, VA will issue another decision on the claim[s], considering the new evidence in addition to the evidence previously considered. Id. Specific instructions for filing a Supplemental Claim are included with this decision. 1. Compensation under 38 U.S.C. § 1151 for cervical spine degenerative arthritis and lumbar spine degenerative arthritis When a veteran suffers a qualifying additional disability or death as the result of hospital care, medical or surgical treatment, examination, training and rehabilitation services, or compensated work therapy program furnished by VA, compensation will be awarded in the same manner as if such additional disability or death were service connected. 38 U.S.C. § 1151; 38 C.F.R. § 3.361. For claims filed on or after October 1, 1997, the additional disability or death must have been directly caused by carelessness, negligence, lack of proper skill, error in judgment, or a similar instance of fault on the part of VA. 38 C.F.R. § 3.361(c), (d). This standard will be met if VA failed to exercise the degree of care that would be expected of a reasonable health care provider, or if VA furnished treatment, care, or examination without the informed consent of the veteran. 38 C.F.R. § 3.361(d)(1). Alternatively, compensation will be awarded if additional disability or death was directly caused by an event not reasonably foreseeable. 38 C.F.R. § 3.361(d)(2). When there is an approximate balance of positive and negative evidence regarding any material issue, all reasonable doubt will be resolved in favor of the claimant. 38 U.S.C. § 5107. The Board finds the criteria for compensation for lumbar spine and cervical spine disabilities based on 38 U.S.C. § 1151 have been met. First, the AOJ made the favorable finding of current disabilities of degenerative arthritis of the cervical and lumbar spine. Next, the evidence is at least in equipoise to find that additional cervical and lumbar spine disability was caused by a slip and fall injury that occurred at a VA facility during treatment on February 18, 2020. The Veteran testified, and VA treatment records confirm, that he slipped and fell on water on the floor of a VA domiciliary care facility. A nursing note states that the Veteran walked up to the nursing office to notify staff that he slipped on some water and hit his tailbone. The Veteran was sent to the emergency department, and water was noted to be spilled in different areas of the hallway floor. At the time of the incident, the Veteran was receiving inpatient treatment at the domiciliary unit for severe stimulant use disorder. Treatment records and the Veteran's statements establish he had lumbar and cervical spine disabilities stemming from a motor vehicle accident prior to the February 2020 fall. Yet, the Veteran reported a notable increase in neck and back pain after the fall, going from about three or four out of ten to seven or eight out of ten. The April 2021 VA examiner opined that the cervical and lumbar spine disabilities were less likely than not caused by or worsened as a result of VA treatment. However, in the January 2026 opinion, L.T., APRN concluded that the slip and fall more likely than not caused the Veteran additional disability, because the Veteran's neck and lower back pain went from mild to severe, which is not consistent with the natural progression without an intervening cause. The Board finds the evidence supports the conclusion that the Veteran experienced additional cervical and lumbar spine disability as a result of VA care. The remaining question is whether the proximate cause of the additional disability was carelessness, negligence, or similar instance of fault on the part of VA; or an event not reasonably foreseeable. 38 U.S.C. § 1151(a)(1)(A) and (B). There is very little evidence regarding carelessness or negligence, and the Veteran's attorney did not address that element of the claim in the argument presented to the Board. It is unclear how the water got on the floor (Was it caused by VA staff or facility or another patient?) or how long it had been on the floor and unaddressed when the Veteran slipped. During the Board hearing, the Veteran stated that there was no sign around the water and he did not believe anyone had been advised it was there. Nevertheless, the Board can resolve this claim in the Veteran's favor by finding a slip and fall was not an event reasonably foreseeable in the course of inpatient treatment for stimulant use disorder. There is no indication that walking in the hallway was part of the treatment plan, and slipping in water is not a reasonably foreseeable risk of the treatment for stimulant use disorder. As such, the evidence shows additional lumbar and cervical spine disability caused by VA hospital care, the proximate cause of which was an event not reasonably foreseeable. The criteria for compensation under 38 U.S.C. § 1151 have been met. A. S. CARACCIOLO Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Armstrong, Anna The Board's decision in this case is binding only with respect to the instant matter decided. This decision is not precedential and does not establish VA policies or interpretations of general applicability. 38 C.F.R. § 20.1303.