Citation Nr: 18149529 Decision Date: 11/09/18 Archive Date: 11/09/18 DOCKET NO. 16-41 792 DATE: November 9, 2018 ORDER Service connection for a right knee disability is denied. Service connection for a right ankle disability is denied. FINDINGS OF FACT 1. The preponderance of the evidence is against finding that the Veteran has a right knee disability due to a disease or injury in service. 2. The preponderance of the evidence is against finding that the Veteran has a right ankle disability due to a disease or injury in service. CONCLUSIONS OF LAW 1. The criteria for service connection for a right knee disability are not met. 38 U.S.C. §§ 1111, 1131, 5107(b); 38 C.F.R. §§ 3.102, 3.303. 2. The criteria for service connection for a right ankle disability are not met. 38 U.S.C. §§ 1111, 1131, 5107(b); 38 C.F.R. §§ 3.102, 3.303. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran had active service in the United States Army from October 1978 to November 1982. This matter is before the Board of Veterans’ Appeals (Board) on appeal from an April 2014 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO). Service Connection Service connection may be granted for a disability resulting from a disease or injury incurred in or aggravated by active service. 38 U.S.C. §§ 1131; 38 C.F.R. § 3.303. In order to establish entitlement to service connection, there must be 1) evidence of a current disability; 2) medical, or in certain circumstances, lay evidence of in-service incurrence or aggravation of a disease or injury; and 3) causal connection between the claimed in-service disease or injury and the current disability. Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004). Service connection may also be granted for a disability, which is proximately due to, or aggravated by, a service-connected disease or injury. 38 C.F.R. § 3.310. Establishing service connection on a secondary basis requires evidence sufficient to show (1) that a current disability exists and (2) that the current disability was either caused or aggravated by a service-connected disease or injury. Allen v. Brown, 7 Vet. App. 439, 448-49 (1995). The Veteran is competent to report symptoms and experiences observable by his senses. See Jandreau v. Nicholson, 492 F.3d 1372, 1377 (Fed. Cir. 2007); 38 C.F.R. § 3.159(a). VA is required to give due consideration to all pertinent medical and lay evidence in evaluating a claim for disability benefits. Davidson v. Shinseki, 581 F.3d 1313, 1316 (Fed Cir. 2009). When there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, VA shall give the benefit of the doubt to the claimant. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102; Gilbert v. Derwinski, 1 Vet. App. 49, 57–58 (1990). 1. Entitlement to service connection for a right knee disability. The Veteran asserts service connection for a right knee disability. The question for the Board is whether the Veteran has a current disability that began during service or is at least as likely as not related to an in-service injury, event or disease. The Board finds that the Veteran has a current diagnosis of a right knee disability per an April 2014 VA examination report noting degenerative joint disease. The evidence also shows that the Veteran had knee complaints in service; however, the preponderance of the evidence weighs against finding that the Veteran’s diagnosis of right knee degenerative joint disease began during service or is otherwise related to an in-service injury, event, or disease. 38 U.S.C. §§ 1131, 5107(b); Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009); 38 C.F.R. § 3.303(a), (d). The Board acknowledges the Veteran’s belief that his right knee disability is related to his documented complaints in service, in addition to lay statements received in April 2016 from his family and friends that describe the Veteran’s pain. While the Veteran and others are competent to describe pain, they are not competent to determine that these symptoms were manifestations of his in-service complaints or are otherwise related to his service. The issue is medically complex as it involves the orthopedic system and requires expertise. Jandreau v. Nicholson, 492 F.3d 1372, 1377, 1377 n.4 (Fed. Cir. 2007). The Veteran and his friends and family have not been shown to have such expertise via training, eduction, and/or experience to provide an etiological opinion. As such, the Board finds such statements as to nexus are not competent and lack weight. The Veteran underwent a VA examination in April 2014. The examiner concluded that the Veteran’s right knee disability was not related to his in-service complaints. In support, the examiner concluded that the mild arthritic changes were more likely related to aging. Additionally, the examiner explained that the Veteran had no noted specific injury during his service, but he had soreness without such complaints or knee abnormality on discharge examination. In this regard, the September 1982 report of medical examination for separation reflects a normal evaluation of the lower extremities. The Board finds the 2014 VA examination report to have much probative weight as the examiner conducted an in-person examination, accurately and thoroughly reviewed the Veteran’s medical records, and supported the opinion with a rationale. Moreover, the Board notes that there is no competent and probative evidence that shows that the Veteran’s disability is at least as likely as not related to service. After review of the competent and probative evidence, the Board finds that the preponderance of the evidence is against service connection for a right knee disability. The Board acknowledges the Veteran’s belief that his right knee disability is related to service. However, the competent and probative evidence from the April 2014 VA examination found that the Veteran’s disability was less likely than not related to service. For the above reasons, reasonable doubt does not arise, and the claim is denied. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102. 2. Entitlement to service connection for a right ankle disability. The Veteran asserts service connection for a right ankle disability. The Board finds that the Veteran has a current diagnosis of a right ankle disability per the April 2014 VA examination report noting degenerative joint disease. The evidence also shows that the Veteran had ankle complaints in service due to an injury while playing football; however, the Board finds that the preponderance of the evidence weighs against finding that the Veteran’s diagnosis of right ankle degenerative joint disease began during service or is otherwise related to an in-service injury, event, or disease. 38 U.S.C. §§ 1131, 5107(b); Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009); 38 C.F.R. § 3.303(a), (d). The Board acknowledges the Veteran’s belief that his right ankle disability is related to his documented complaints in service, in addition to the several lay statements from family and friends that describe the Veteran’s pain. While the Veteran and others are competent to describe pain, they are not competent to determine that these symptoms were manifestations of his in-service complaints or are otherwise related to his service. The issue is medically complex as it involves the orthopedic system and requires expertise. Jandreau v. Nicholson, 492 F.3d 1372, 1377, 1377 n.4 (Fed. Cir. 2007). The Veteran and his friends and family have not been shown to have such expertise via training, eduction, and/or experience to provide an etiological opinion. As such, the Board finds such statements as to nexus are not competent and lack weight. The Veteran underwent a VA examination in April 2014. The examiner noted that in service, the Veteran had a right ankle inversion injury that healed without sequela. The examiner also noted that the Veteran’s Achilles tendonitis that occurred during outside employment overseas was unrelated to his service. The Board finds this examination to have much probative weight as the examiner conducted an in-person examination, accurately and thoroughly reviewed the Veteran’s medical records, and supported the opinion with appropriate rationale. Moreover, the Board notes that there is no competent and probative evidence that shows that the Veteran’s disability is at least as likely as not related to service. (Continued on the next page)   After review of the competent and probative evidence, the Board finds that the preponderance of the evidence is against service connection for a right ankle disability. The Board acknowledges the Veteran’s belief that his right ankle disability is related to service. However, the competent and probative evidence from the April 2014 VA examination found that the Veteran’s disability was less likely than not related to service. For the above reasons, reasonable doubt does not arise, and the claim is denied. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102. Paul Sorisio Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD G. Morales, Associate Counsel