Citation Nr: 18155132 Decision Date: 12/04/18 Archive Date: 12/03/18 DOCKET NO. 15-19 336 DATE: December 4, 2018 ORDER Service connection for left knee degenerative joint disease is granted. FINDING OF FACT Resolving reasonable doubt in the Veteran’s favor, his degenerative joint disease of the left knee is related to his service. CONCLUSION OF LAW The criteria for service connection for degenerative joint disease of the left knee are met. 38 U.S.C. §§ 1101, 1110, 1112, 1113, 1131, 1137; 38 C.F.R. §§ 3.303, 3.307, 3.309. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty in the United States Navy from March 1986 to March 1990, with subsequent service in the Reserves. The Board sincerely thanks him for his service to his country. This matter is before the Board of Veterans’ Appeals (Board) on appeal from a December 2013 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO). In June 2018, the Veteran testified at a Video Conference hearing before the undersigned. A transcript of the hearing is associated with the record. Service connection for degenerative joint disease of the left knee Establishing service connection generally requires medical or, in certain circumstances, lay evidence of: (1) a current disability; (2) an in-service incurrence or aggravation of a disease or injury; and (3) a nexus between the claimed in-service disease or injury and the present disability. See Davidson v. Shinseki, 581 F.3d 1313 (Fed. Cir. 2009). The Veteran currently has a diagnosis of degenerative joint disease (DJD) of the left knee, as evidenced by his December 2013 VA Exam. The Veteran asserts that regular running on steel decks and stairs, as required by his service on naval vessels, caused his left knee disability. The Service Treatment Records (STRs ) show the Veteran was treated for left knee pain in January 1990. At that time, he reported recurring pain over the preceding three months. The record also notes a “prior entry of [left] knee pain,” and that the Veteran reported the first onset of pain while jogging on steel decks. The Veteran again sought treatment for his left knee within a year of service, in March 1991, when he complained of swelling and occasionally extreme pain. X-rays were noted as normal. The Board notes that no record of the 1991 treatment was associated with the claim file until after the June 2018 hearing. The Veteran also noted a history of knee soreness following physical activity in a November 2002 medical history questionnaire. In testimony at his hearing, the Veteran asserted that his employment history following service consisted primarily of “desk work” until his most recent job. Letters from the Veteran’s private treating physician in 2013 and 2018 opined the Veteran’s current knee symptoms originated in the Navy. The 2018 statement found the Veteran’s symptom history “suggests the current knee pain symptoms are more likely than not, due to his knee problems originating with his time in the Navy.” The Board can reasonably understand these statements as linking the current DJD to service. The 2013 letter refers to the Veteran’s 1990 treatment in service, while the 2018 letter additionally relies on the Veteran’s work history. The Board finds no reason to doubt the Veteran’s lay testimony, relied upon by the private physician, regarding the nature of his post-service employment. The Board acknowledges that a December 2013 VA examination report presents a medical opinion weighing against finding a nexus between the current knee DJD and the Veteran’s in-service knee pain. The rationale for this opinion cites post-service employment and aging as more likely causes of the knee DJD. The Board notes that entitlement to service connection does not require that service is the sole cause of a disability, and thus the rationale does not necessarily contradict the private opinion linking the Veteran’s left knee pain to service. The 2013 exam rationale also cites a lack of evidence of further treatment after 1990 in service. However, the examiner was unable to consider the Veteran’s 1991 treatment –less than a year after the initial treatment– because in 2013 that record had not yet been associated with the claim file. Because the opinion was unable to address this pertinent evidence that conflicts with at least one stated grounds for the conclusion, the Board finds the opinion is of diminished relative probative value in this case.   Accordingly, resolving reasonable doubt in favor of the Veteran, the Board concludes that it is more likely than not that a nexus exists between the Veteran’s in-service knee pain and the Veteran’s current left knee DJD. Therefore, service connection is granted. M. C. GRAHAM Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD D. McCormick, Associate Counsel