Citation Nr: 18141770 Decision Date: 10/11/18 Archive Date: 10/11/18 DOCKET NO. 13-23 561 DATE: October 11, 2018 ORDER Entitlement to service connection for a left knee condition is denied. FINDING OF FACT The preponderance of the evidence fails to show the Veteran’s left knee condition is related to service or a service connected disability. CONCLUSION OF LAW The criteria for entitlement to service connection for a left knee condition have not been met. 38 U.S.C. §§ 1110, 5107(b); 38 C.F.R. §§ 3.102, 3.303, 3.304, 3.310 (2018). REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran had active service from June 1992 to April 1996. In April 2014, the Veteran presented sworn testimony at a regional office (RO) hearing. In November 2014, the Veteran presented sworn testimony during a hearing chaired by the undersigned. Transcripts of both proceedings are of record. 1. Entitlement to service connection for a left knee condition The Veteran contends that his current left knee condition is related to his active service, and alternatively, that his left knee condition was caused or aggravated by his service-connected right knee condition. Under the relevant laws and regulations, service connection may be granted for a disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C.§ 1110. Generally, the evidence must show: (1) the existence of a present disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the present disability and the disease or injury incurred or aggravated during service. Shedden v. Principi, 381 F.3d 1163, 1166-67 (Fed. Cir. 2004). Service connection is also provided for a disability which is proximately due to, the result of, or aggravated by a service-connected disability. Allen v. Brown, 7 Vet. App. 439 (1995); 38 C.F.R. § 3.310. It is the policy of VA to administer the law under a broad interpretation, consistent with the facts in each case, with all reasonable doubt to be resolved in favor of the claimant. 38 C.F.R. § 3.102. Service treatment records indicate Veteran reported bilateral knee pain caused by rope jumping. There is also documentation that he was assessed as having a sprain of the left cruciate ligament. At the time of his appeal Veteran had been diagnosed with status post left knee meniscectomy, and therefore Shedden elements (1) and (2) have been met. What remains for the Board to determine is whether the evidence supports the finding of a nexus between the Veteran’s current left knee condition and active service, or a finding that it was caused or aggravated by his service-connected right knee condition. A December 2010 letter/note from Dr. D.B., the Veteran’s treating physician, is included in the record. After reviewing the Veteran’s records and observing that he experienced an ACL sprain while in military, Dr. D.B. stated it is unlikely that his meniscus tear occurred at that time. If this were the case, the Veteran would have had more degenerative changes in his knee, and it is unlikely that the tear seen in his knee would have been tolerable for that period of time. Dr. D.B. also did not think that his right knee condition exacerbated or made worse his left knee condition, and concluded that his left knee condition is not related to his military service. On VA examination in April 2013, the Veteran was noted to have a diagnosis of status post left knee meniscus tear and status post left knee arthroscopic meniscectomy. The examiner reviewed the Veteran’s health records, and opined that his left knee issue is less likely related to his original military knee pain, but more likely related to overuse of the left knee due to his job and playing sports. At his DRO hearing in April 2014, the Veteran testified that he was on crutches for a month during service due to his knee injuries. He also stated that he indicated he had a knee problem on his application for employment for his current job, indicating the condition pre-existed his work there. However, the Board notes that during the April 2014 hearing, it was unclear which knee the Veteran was referring to during his statements. In August 2013, VA received a letter from the Veteran’s employer stating that, at the time of his hiring, the Veteran had reported that he had a knee injury from his military service. Neither the letter, nor his attached job application indicate which knee had been injured. At the November 2014 Board hearing, the Veteran stated he feels like he has been using his left knee to overcompensate for his right knee for 20 years. He explained that he has had ongoing knee pain since jumping out of helicopters during service, and the time gap of treatment for his left knee between separation and 2009 was due to his not being aware he could apply for benefits. At the hearing, the Veteran argued that his left knee condition was secondary to his service-connected right knee condition and that the April 2013 VA medical opinion was therefore inadequate. The Veteran was afforded an additional VA examination in May 2016. Dr. C.W. recharacterized the Veteran’s left knee condition as residuals from a left medial meniscus tear surgical repair. He opined that it is less likely than not that the Veteran’s left knee condition was incurred in or was caused by service, and it is less likely than not a result of his service-connected right knee condition. Dr. C.W. explained that the Veteran’s records show no chronicity of care to link symptoms of his in-service left knee pain to his condition 10 years later. Although the Veteran claims he favored his left knee after his right knee injury, and has had chronic knee pain since separation, there is no objective evidence to substantiate this. The Board notes that the Veteran’s private medical records show treatment for his right knee beginning in 2004, and treatment or complaint of left knee pain in 2009. The Board finds the evidence is against a finding that the Veteran’s current left knee condition is directly related to service. Although the Veteran had a left knee injury during service, the medical evidence of record is compelling that his current condition is unrelated to service. Despite his statements that he experienced ongoing pain, there is no evidence of ongoing treatment for the left knee, and even when treated for the right knee in 2004, the Veteran did not complain of left knee pain, or seek treatment for his left knee until 2009. Additionally, even his own treating physician, Dr. D.B., stated that there are no degenerative changes in the left knee consistent with a previous injury from service or that is related to the right knee. Concerning service connection on a secondary basis, all of the medical evidence and opinions of record indicate the Veteran’s left knee condition was not caused or aggravated by his service-connected right knee condition. While the Board recognizes the Veteran’s reports of ongoing pain and compensating for his right knee, there is no medical evidence to support his argument. VA examiners and the Veteran’s own physician have not provided evidence to support such a correlation. Because the weight of the evidence is against the Veteran’s claim, the benefit-of-the-doubt doctrine does not apply. See 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102; See Gilbert v. Derwinski, 1 Vet. App. 49 (1990). Accordingly, entitlement to service connection for a left knee condition is denied. MICHAEL A. HERMAN Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD M.E. Lee, Associate Counsel