Citation Nr: 18142767 Decision Date: 10/17/18 Archive Date: 10/16/18 DOCKET NO. 16-36 178 DATE: October 17, 2018 ORDER Entitlement to service connection for left knee degenerative arthritis is granted. Entitlement to service connection for right knee disability degenerative arthritis is granted. FINDINGS OF FACT 1. The competent and probative evidence is in equipoise as to whether the Veteran’s degenerative arthritis of the left knee is related to service. 2. The competent and probative evidence is in equipoise as to whether the Veteran’s degenerative arthritis of the right knee is related to service. CONCLUSIONS OF LAW 1. The criteria for service connection for a left knee disability have been met. 38 U.S.C. §§ 1110, 5107(b) (2012); 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309 (2018). 2. The criteria for service connection for a right knee disability have been met. 38 U.S.C. §§ 1110, 5107(b) (2012); 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309 (2018). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran had active military service from July 1979 to July 1982. This matter comes before the Board of Veterans’ Appeals (Board) on appeal of a June 2014 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO). Service Connection Service connection may be established for a disability resulting from disease or injury incurred in or aggravated by service. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303. Regulations also provide that service connection may be granted for any disease diagnosed after discharge, when all the evidence, including that pertinent to service, establishes that the disability was incurred in service. 38 C.F.R. § 3.303(d). Generally, in order to prove service connection, there must be 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. See, e.g., Davidson v. Shinseki, 581 F.3d 1313 (Fed. Cir. 2009); Pond v. West, 12 Vet. App. 341 (1999). 1. Entitlement to service connection for a left knee disability 2. Entitlement to service connection for a right knee disability The Veteran contends that his left and right knee disabilities were incurred in or caused by service; more specifically, his training as a parachutist. As an initial matter, the Board notes the Veteran has been diagnosed during the course of the appeal with degenerative arthritis of both knees. In addition, the Veteran’s military personnel records (MPRs) confirm completion of Airborne training and receipt of a Parachute Badge; thus, evidence of in-service jumps is conceded. Accordingly, the question becomes whether the bilateral knee disabilities are related to service. The service treatment records (STRs) are silent for complaints of, treatment for, or a diagnosis of any left or right knee disability. On the Veteran’s December 1982 separation report of medical history, he denied a history of trick or locked knee and documented that he was otherwise in good health. Private post service treatment records indicate the Veteran was first seen for knee pain in November 2011. At the time, the diagnosis rendered was degenerative arthritis of the bilateral knees. As there is no competent evidence showing a chronic left or right knee disability during service or for many years thereafter, competent evidence linking the current bilateral knee disability to service is needed to support the claim. On this question there are opinions in favor of and against the claim. The Veteran appeared for a VA examination in February 2015. Arthritis in the bilateral knees was noted as a diagnosis. The VA examiner found the bilateral knee arthritis was less likely as not related to service, citing the absence of a diagnosis, treatment or symptoms in service, and the lack of evidence of treatment post service until 2011. Conversely, the evidence of record also includes on-going private treatment records from Dr. P.R., an orthopedic specialist who had been treating the Veteran for three years. At a visit in March 2014, the provider documented the Veteran’s significant history as a paratrooper, with pain which has worsened over time. In addition, the provider specifically documented that the Veteran’s history was absent for any other injury to his knees other than repeatedly “jumping out of airplanes.” The provider confirmed the diagnosis of bilateral degenerative arthritis and concluded that the Veteran’s history as a paratrooper with multiple jumps contributed to injuries to his knees which he noted, in his opinion, would more likely than not have contributed to his developing knee arthritis. Thus, there are competent medical opinions in favor of and against the claim. Upon review of the record, the Board finds the medical evidence in this particular case to be in equipoise as to whether the Veteran's current bilateral knee arthritis is related to his service, specifically to parachute jumps therein. The mandate to accord the benefit of the doubt is triggered when the evidence has reached a stage of balance. In this matter, the Board believes this point has been attained. Because a state of relative equipoise has been reached in this case, the benefit of the doubt rule will therefore be applied. See Alemany v. Brown, 9 Vet. App. 518, 519 (1996). Accordingly, the Board finds that service connection for arthritis of the left and right knees is warranted. K. A. BANFIELD Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD Rachel Mamis