Citation Nr: 18150447 Decision Date: 11/15/18 Archive Date: 11/15/18 DOCKET NO. 16-24 672A DATE: November 15, 2018 ORDER New and material evidence having been received, reopening the claim of entitlement to service connection for a left knee disability is granted. Entitlement to service connection for a left knee disability is granted. Entitlement to service connection for hypertension is granted. FINDINGS OF FACT 1. In an unappealed July 2007 rating decision, the Veteran was denied entitlement to service connection for a left knee injury. 2. Evidence added to the record since the July 2007 rating decision is not cumulative or redundant of the evidence of record at the time of the prior denial, and raises a reasonable possibility of substantiating the claim for service connection for a left knee disability. 3. Left knee injury (claimed as left knee condition) had its onset during active service. 4. Hypertension had its onset during active service. CONCLUSIONS OF LAW 1. New and material evidence has been received to reopen the claim of entitlement to service connection for a left knee disability. 38 U.S.C. § 5108 (2012); 38 C.F.R. § 3.156 (2018). 2. The criteria for service connection for a left knee disability have been met. 38 U.S.C. §§ 1110, 1112, 5107 (2012); 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309 (2018). 3. The criteria for service connection for hypertension have been met. 38 U.S.C. §§ 1110, 1112, 5107 (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 form August 1990 to November 1992, September 2004 to December 2005, July 2007 to September 2007, and March 2009 to July 2011. This case comes before the Board of Veterans’ Appeals (Board) on appeal from September 2012 and January 2015 rating decisions issued by the Department of Veterans Affairs (VA) Regional Office (RO) in Waco, Texas. The Board notes that the Veteran submitted at timely notice of disagreement with the January 2015 denial of entitlement to service connection for sleep apnea. A review of the records shows that the Veteran was granted entitlement to service connection for sleep apnea in an April 2016 Decision Review Officer (DRO) decision. There is no indication from the record that the Veteran has disagreed with the effective date or rating assigned in that decision. As such, that constitutes a full grant of the benefit sought on appeal, and the Board has limited its consideration accordingly. The Board notes that the claim to reopen service connection for a left knee disability has been identified as stemming from a July 2014 rating decision denying entitlement to service connection for a left knee disability. However, the Board finds that the Veteran submitted a statement in October 2012 which constitutes a timely notice of disagreement with the denial of entitlement to service connection for a left knee injury in a September 2012 rating decision, which was issued in response to an August 2011 claim. As such, the period on appeal is characterized accordingly. Claim to Reopen – Left Knee Disability In a July 2007 rating decision, the Veteran was denied service connection for a left knee injury based on a finding that the Veteran did not have a left knee disability that was related to his active service. The Veteran did not appeal that decision. The evidence received since the July 2007 rating decisions includes additional lay statements from the Veteran and additional medical evidence, to include a positive nexus opinion from a VA examiner. The Board finds that the additional evidence added to the record is new and material. In that regard, the evidence is new, as it was not previously considered by VA, and it raises a reasonable possibility of substantiating the claim of entitlement to service connection for a left knee disability. Therefore, reopening of the claim of entitlement to service connection for a left knee disability is warranted. Service Connection – Left Knee Disability The Veteran asserts that his left knee condition is etiologically related to a period of active service. Specifically, the Veteran has reported that he sustained a left knee injury while serving in Iraq during his September 2004 to December 2005 period of active service. Service treatment records (STRs) are silent for complaints of, treatment for, or a diagnosis of a left knee disability while the Veteran was in active service. However, medical records from June 2006, just a short time following the Veteran’s reported injury, show that the Veteran was seen for complaints of left knee pain. X-rays performed at that time revealed minimal osteoarthritic changes. Additional treatment records show that the Veteran continued to report left knee pain since that time. The Board finds that the Veteran is credible to report when he first experienced symptoms of left knee pain, and that the symptoms have continued since that time. Heuer v. Brown, 7 Vet. App. 379 (1995); Falzone v. Brown, 8 Vet. App. 398 (1995); Caldwell v. Derwinski, 1 Vet. App. 466 (1991). Moreover, the Board finds the Veteran to be credible in that respect. The Veteran was afforded a VA examination in November 2013. At that time, the Veteran reported his in-service knee injury. X-rays confirmed arthritis in the left knee and the examiner diagnosed left knee degenerative arthritis. The examiner opined that the Veteran’s current left knee injury was as likely as not related to his active service. In this regard, the examiner noted the Veteran’s current knee disability was a continuation of his reported injury in Iraq and his subsequent symptoms. The Board finds that the November 2013 VA medical opinion is adequate because the examiner thoroughly reviewed the claims file and discussed the relevant evidence, considered the contentions of the Veteran, and provided a thorough supporting rationale for the conclusions reached. Barr v. Nicholson, 21 Vet. App. 303 (2007); Stefl v. Nicholson, 21 Vet. App. 120 (2007); Nieves-Rodriguez v. Peake, 22 Vet. App. 295 (2008). The Board acknowledges that there are additional medical opinions against the claim of record. However, the Board finds that those opinions are not adequate as they do not fully consider the Veteran’s lay statements regarding the onset and continuity of his left knee pain. As such, the November 2013 medical opinion is the most probative evidence of record. Accordingly, the Board finds that the evidence for and against the claim of entitlement to service connection for left knee disability is at least in equipoise. Therefore, reasonable doubt must be resolved in favor of the Veteran and entitlement to service connection for a left knee disability is warranted. 38 U.S.C. § 5107 (b) (2012); Gilbert v. Derwinski, 1 Vet. App. 49 (1990). Service Connection – Hypertension STRs show that the Veteran was diagnosed with, and treated for hypertension during his last period of active service. While the Veteran has reported that his doctors told him he had high blood pressure prior to that period of service, there is no indication from the record that the Veteran was diagnosed with hypertension or received treatment for such prior to March 2009. A review of the post-service treatment notes of record shows that the Veteran has continued to receive treatment for hypertension since his separation from service. Accordingly, the Board finds that the evidence for and against the claim of entitlement to service connection for hypertension is at least in equipoise. Therefore, reasonable doubt must be resolved in favor of the Veteran and entitlement to service connection for hypertension is warranted. 38 U.S.C. § 5107 (b) (2012); Gilbert v. Derwinski, 1 Vet. App. 49 (1990). Kristin Haddock Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD Christina Quant, Law Clerk