Citation Nr: 1320501	
Decision Date: 06/26/13    Archive Date: 07/05/13

DOCKET NO.  09-28 494	)	DATE
	)
	)

On appeal from the
Department of Veterans Affairs Regional Office in New Orleans, Louisiana


THE ISSUE

Entitlement to service connection for a left knee disability.


REPRESENTATION

Veteran represented by:	Disabled American Veterans


WITNESS AT HEARING ON APPEAL

The Veteran


ATTORNEY FOR THE BOARD

N. Kroes, Counsel


INTRODUCTION

The Veteran served on active duty from October 1970 to July 1990.  

This matter is before the Board of Veterans' Appeals (Board) on appeal from a December 2006 decision of the New Orleans, Louisiana, Department of Veterans Affairs (VA) Regional Office (RO).  

In July 2010, the Veteran testified at a Board hearing before the undersigned Veterans Law Judge.  A transcript of this hearing is associated with the claims file.  The record was held open for 60 days so that the Veteran could submit additional evidence.  The Veteran submitted additional evidence in September 2010 with a waiver of Agency of Original Jurisdiction review.


FINDING OF FACT

The evidence indicates that the Veteran's current left knee disability, diagnosed as left knee meniscus tear and patellofemoral chondromalacia, is causally related to his military service.


CONCLUSION OF LAW

The criteria for establishing service connection for a left knee disability (diagnosed as left knee meniscus tear and patellofemoral chondromalacia) have been met.  38 U.S.C.A. §§ 1110, 1131, 5107 (West 2002); 38 C.F.R. §§ 3.102, 3.303 (2012).


REASONS AND BASES FOR FINDING AND CONCLUSION

In light of the fully favorable determination in this case, no further discussion of compliance with VA's duty to notify and assist is necessary.

The Veteran asserts that he has a current left knee disability as a result of a left knee injury while skiing during service.  He reports having problems with his knee off and on since this injury.  Board Hearing Tr. at 4, 7, 8.

Generally, in order to establish direct service connection, three elements must be established.  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.  See 38 C.F.R. § 3.303 (2012); see also Hickson v. West, 12 Vet. App. 247, 253 (1999).

Medical records establish that the Veteran has a current left knee disability.  For example, after review of a magnetic resonance imaging (MRI) in June 2006, a private orthopedic surgeon diagnosed left medial meniscus tear.  That same month, the surgeon performed a left knee video arthroscopy with partial medial meniscectomy and a left knee patellofemoral chondroplasty.  The postoperative diagnoses were left knee posterior horn medial meniscus tear and left knee patellofemoral chondromalacia grade 3.  

There is also evidence suggesting in-service incurrence of a left knee injury.  In December 1979, the Veteran reported to a military aid station complaining of acute left knee pain secondary to a fall during training.  After an initial examination the assessment was "MCL strain?".   The Veteran was then examined by another medical practitioner who entered an assessment of "Probable MCL strain".  X-ray was negative.  During a follow up appointment it was noted that the Veteran injured the ligaments in his left knee while skiing.  Although no diagnostic procedures were performed, the Veteran was assessed with strained medial collateral ligament, left knee.  

Finally, there is persuasive medical evidence that the Veteran's current left knee disability is related to the left knee injury described above.  In a July 2010 letter, the surgeon who performed the Veteran's 2006 knee surgery submitted a medical opinion on his behalf.  The surgeon noted the Veteran's complaints of knee pain since an injury in the military in 1979.  The Veteran's service records were reviewed by the surgeon, who observed that during service the Veteran was seen on multiple occasions for left knee problems although no MRI was performed.  The surgeon opined that the Veteran clearly has left knee pain which is causally related to his military service accident many years ago.  He explained that the Veteran had continued complaints throughout his military service and did not have the appropriate diagnostic study performed to show a meniscus tear.  Once an MRI was performed, it revealed the meniscus tear.  

The surgeon's opinion is afforded high probative value as it was made after a review of the relevant evidence, including past examinations of the Veteran, and contains a rationale for the conclusion reached.  There is no evidence of record in conflict with the surgeon's opinion.  As such, service connection for a left knee disability (diagnosed as left knee meniscus tear and patellofemoral chondromalacia) is warranted.  


ORDER

Service connection for a left knee disability (diagnosed as left knee meniscus tear and patellofemoral chondromalacia) is granted.




____________________________________________
Laura H. Eskenazi
Veterans Law Judge, Board of Veterans' Appeals



Department of Veterans Affairs