Citation Nr: 18140904 Decision Date: 10/09/18 Archive Date: 10/09/18 DOCKET NO. 16-29 882 DATE: October 9, 2018 ORDER Entitlement to service connection for a left knee disability is granted. Entitlement to service connection for a right knee disability is granted. FINDINGS OF FACT 1. The evidence shows that the Veteran has a current left knee disability related to his military service. 2. The evidence shows that the Veteran has a current right knee disability related to his military service. CONCLUSIONS OF LAW 1. The criteria for entitlement to service connection for a left knee disability have been met. 38 U.S.C. §§ 1131, 5107(b); 38 C.F.R. §§ 3.102, 3.303(a). 2. The criteria for entitlement to service connection for a right knee disability have been met. 38 U.S.C. §§ 1131, 5107(b); 38 C.F.R. §§ 3.102, 3.303(a). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from July 1980 to July 1984. This appeal comes to the Board of Veterans’ Appeals (Board) from an April 2014 rating decision by a Department of Veterans Affairs (VA) Regional Office (RO). Service connection is granted on a direct basis when there is competent, credible evidence of (1) a current disability, (2) in-service incurrence or aggravation of an injury or disease, and (3) a nexus, or link, between the current disability and the in-service disease or injury. 38 U.S.C. §§ 1110, 1131; Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009); 38 C.F.R. § 3.303(a), (d). Service connection for chronic diseases listed in 38 U.S.C. sections 1101(3) and 38 C.F.R. § 3.309(a) may be established on a presumptive basis if the chronic disease was shown as chronic in service; manifested to a compensable degree within a presumptive period, usually one year, after separation from service; or was noted in service with continuity of symptomatology since service. 38 U.S.C. §§ 1112, 1113; Walker v. Shinseki, 708 F.3d 1331 (Fed. Cir. 2013); 38 C.F.R. §§ 3.303(b), 3.307, 3.309(a). Such diseases include post-traumatic osteoarthritis. In Gilbert v. Derwinski, 1 Vet. App. 49, 53 (1990), the Court stated that “a veteran need only demonstrate that there is an ‘approximate balance of positive and negative evidence’ in order to prevail.” To deny a claim on its merits, the preponderance of the evidence must be against the claim. See Alemany v. Brown, 9 Vet. App. 518, 519 (1996) (citing Gilbert, 1 Vet. App. at 54). The Veteran was afforded a VA examination of his knees in April 2014. The VA examiner noted the Veteran has been diagnosed with bilateral patellofemoral syndrome, and the Board notes that the Veteran’s treating doctor has since assessed him with bilateral patellofemoral osteoarthritis. See, e.g., November 2015 statement from J.S., M.D.. Both the VA examiner and J.S., M.D. noted that the Veteran’s service treatment records show reports of knee pain. The VA examiner indicated the Veteran’s current disabilities were not related to the Veteran’s service because a knee disability was not noted upon the Veteran’s separation from service or shortly thereafter. In contrast, the Veteran’s treating doctor indicated that the current knee disabilities are related to the Veteran’s activities during service including running and lifting, which contributed to the development of arthritis. The Veteran’s treating doctor had the benefit of reviewing updated X-rays, which the doctor used to support a diagnosis of osteoarthritis of the knees. Ultimately, the Board finds there is an approximate balance of negative and positive evidence as to whether the Veteran’s current knee disabilities are related to his military service. Affording the Veteran the benefit of the doubt, entitlement to service connection for disabilities of the left knee and right knee is granted. MICHAEL LANE Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD Michael Duffy, Associate Counsel