Citation Nr: 18149852
Decision Date: 11/13/18	Archive Date: 11/13/18

DOCKET NO. 16-37 248
DATE:	November 13, 2018
ORDER
Service connection for a left knee condition, also claimed as patellofemoral crepitation, is denied.
FINDING OF FACT
The Veteran’s current left knee disorder, diagnosed as patellofemoral crepitation and patellofemoral syndrome, was not demonstrated in or related to an in-service injury, event, or disease.
CONCLUSION OF LAW
The criteria for entitlement to service connection for a left knee condition, also claimed as patellofemoral crepitation, have not been met.  38 U.S.C. §§ 1111, 5107(b) (2012); 38 C.F.R. §§ 3.102, 3.303 (2018).
REASONS AND BASES FOR FINDING AND CONCLUSION
The Veteran served in the United States Army from October 1970 until his honorable discharge in May 1972.  The Veteran was awarded the National Defense Service Medal and the M-16 Sharpshooter Badge.
Neither the Veteran nor his representative has raised any other issues with the duty to notify or duty to assist.  See Scott v. McDonald, 789 F.3d 1375, 1381 (Fed. Cir. 2015) (holding that “the Board’s obligation to read filings in a liberal manner does not require the Board... to search the record and address procedural arguments when the veteran fails to raise them before the Board.”); Dickens v. McDonald, 814 F.3d 1359, 1361 (Fed. Cir. 2016) (applying Scott to a duty to assist argument).
Entitlement to service connection for a left knee condition, also claimed as patellofemoral crepitation
The Veteran contends that his left knee condition began during service or is otherwise related to an in-service injury, event, or disease.  Specifically, that his knee condition began in October 1971 when he injured his knee during service.
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 concludes that, while the Veteran has a current diagnosis of patellofemoral crepitation and patellofemoral syndrome of the left knee during the appeal period, and evidence shows that he incurred a left knee injury during service, the preponderance of the evidence weighs against finding that the Veteran’s current left knee disorder began during service or is otherwise related to an in-service injury, event, or disease.  38 U.S.C. § 1110, 5107(b); Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009); 38 C.F.R. § 3.303(a), (d). 
Private treatment records show the Veteran was not diagnosed with patellofemoral crepitation until February 2014, multiple years after his separation from service.  While the Veteran is competent to report having experienced symptoms of pain and popping of the joint intermittently since service, he is not competent to determine that these symptoms were manifestations of patellofemoral crepitation.  The issue is medically complex, as it requires knowledge of (the interaction between multiple organ systems in the body/interpretation of complicated diagnostic medical testing).  Jandreau v. Nicholson, 492 F.3d 1372, 1377, 1377 n.4 (Fed. Cir. 2007).  Concerning the nexus opinion, the private provider did not provide an opinion concerning the etiology of the Veteran’s knee condition.
Further, the April 2014 VA examiner explained why the Veteran’s patellofemoral crepitation is less likely than not secondary to events or conditions of his military service, to include consideration of the October 1971 left knee injury.  The VA examiner’s opinion and rationale was based on an accurate medical history and provides an explanation that contains clear conclusions and supporting data.  As a result, the Board finds that the evidentiary record does not contain positive probative evidence to establish that the third criterion to establish service connection on a direct basis has been met.
In reaching this decision the Board considered the doctrine of reasonable doubt, however, as the preponderance of the evidence is against this claim, the doctrine is not for application.  Gilbert v. Derwinski, 1 Vet. App. 49 (1990).
 
T. Blake Carter
Acting Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD	G. DEEMER, ASSOCIATE COUNSEL