Citation Nr: 18158597 Decision Date: 12/17/18 Archive Date: 12/17/18 DOCKET NO. 17-09 971 DATE: December 17, 2018 REMANDED Service connection for a right knee disability is remanded. Service connection for a left knee disability, as secondary to his right knee disability, is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Marine Corps from April 1961 until March 1985 including combat service in the Republic of Vietnam. He was awarded the combat action ribbon and combat air crew badge. He retired at the rank of sergeant major. In July 2015, the Winston Salem Regional Office (RO) denied entitlement to service connection for a right knee disability and secondary service connection for a left knee disability. The Veteran testified at a hearing before the undersigned Veterans Las Judge in August 2018. Service connection for the right and left knee disabilities Service treatment records show that the Veteran sought treatment in January 1978 for right knee pain and numbness after running, but the symptoms resolved with rest. The examining cilician limited additional observations to other concurrent symptoms. In September 1983, the Veteran again sought treatment for right knee pain after running and reported that it had occurred intermittently for many years. The pain usually resolved after several hours with rest. A clinician diagnosed lateral collateral ligament strain and prescribed anti-inflammatory medication and physical therapy exercises. There is also a notation of a left knee strain while water skiing in a month of July but the year is illegible. An X-ray on that occasion was normal. In a January 1985 discharge physical examination questionnaire, the Veteran denied any arthritis or “trick” or locked knees, and the examiner noted no lower extremity abnormalities. Records of private medical care starting in August 2007 show that the Veteran was diagnosed and treated for generalized arthritis of both knees. In November 2013, March 2016, and June 2016, he continued to seek private treatment for knee pain. The Veteran was afforded a VA examination regarding his right and left knee disabilities in August 2016. The examiner concluded that there was inadequate evidence to establish chronicity of either right or left knee conditions during service. He further concluded that it was less likely than not that the Veteran’s right or left knee was incurred in, caused by or a continuation of knee conditions reported, evaluated, diagnosed or treated during active military service. The examiner cited the episodes of treatment and imaging studies in service and that the discharge physical examination in 1985 was silent for any chronic manifestations or deficits. In his August 2018 hearing, he testified that the symptoms of his knee arthritis began in service and since his 1985 discharge he has been treating the pain and symptoms himself with wraps, braces and pain reliever. The Veteran is competent and credible to report a continuation of symptomatology and treatment, they are credible evidence in consideration of service connection for these disabilities. See Falzone v. Brown, 8 Vet. App. 398 (1995) (holding that the Veteran’s statements of treatment and pain should be considered in establishing continuity of symptomology). He does not provide medical evidence that supports and corroborates his statement regarding the beginning of his symptoms. However, the Veteran’s testimony at the hearing regarding continuing pain and self-treatment. the Veteran provided for his knee disabilities was not available to or considered by the examiner in 2016. Accordingly, the examiners rationale insufficiently considers the chronicity of the Veteran’s knee pain as a potential cause of his knee disability. The matters are REMANDED for the following action: 1. Afford the Veteran an appropriate VA examination with respect to his right knee. The medical professional must provide an opinion addressing the following: Whether it is at least as likely as not (i.e. 50 percent probability or greater) that the Veteran’s right knee disability onset in service from any injury to include his treatment for knee pain in January 1978 and September 1983 or by his general Marine duties. While review of the entire claims folder is required, the medical professional’s attention is invited to the Veteran’s service treatment records, the Veterans private physician treatment and his lay statements regarding his over the counter treatment of his knee pain. (Continued on the next page)   2. Afford the Veteran an appropriate VA examination with respect to his left knee. The medical professional must provide an opinion addressing the following: Whether it is at least as likely as not (i.e. 50 percent probability or greater) that the Veteran’s left knee disability onset from any water skiing activities in service or is proximately caused by Marine duties or caused or aggravated by his right knee or any of his service-connected diseases or injuries. J.W. FRANCIS Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD S.Sellers, Associate Counsel