Citation Nr: 18159730 Decision Date: 12/20/18 Archive Date: 12/19/18 DOCKET NO. 16-25 756 DATE: December 20, 2018 ORDER Entitlement to service connection for a bilateral leg disability is denied. FINDINGS OF FACT 1. Service connection was previously established for varicose veins of the right leg. 2. An osteochondroma of the right leg clearly and unmistakably existed prior to service, and there is clear and unmistakable evidence showing that such a disorder was not aggravated inservice. 3. No other bilateral leg disorder was presented during the appellant’s active duty service, and none has been shown to be related thereto. CONCLUSIONS OF LAW A bilateral leg disability was not incurred in or aggravated by service. 38 U.S.C. §§ 1110, 1111, 1153, 5103, 5103A, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.306. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran had active military service from September 1966 to September 1968. This matter comes before the Board of Veterans’ (Board) on appeal from a March 2015 decision by the Department of Veterans Affairs (VA) Regional Office (RO) in Nashville, Tennessee. Service Connection The Veteran claims he has a bilateral leg disability that is related to his active duty service. 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. § 1110; 38 C.F.R. § 3.303 (a). To establish entitlement to service-connected compensation benefits, a veteran must show: (1) the existence of a present disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the present disability and the disease or injury incurred or aggravated during service. Holton v. Shinseki, 557 F.3d 1362, 1366 (Fed. Cir. 2010). A veteran is presumed to have been in sound condition when entering service, except as to defects, infirmities, or disorders noted at the time of the examination or where clear and unmistakable evidence demonstrates that the injury or disease existed prior to service and was not aggravated by such service. 38 U.S.C. § 1111. The determination as to whether there is clear and unmistakable evidence that a defect, infirmity, or disorder existed prior to service should be based upon "thorough analysis of the evidentiary showing and careful correlation of all material facts, with due regard to accepted medical principles pertaining to the history, manifestations, clinical course, and character of the particular injury or disease or residuals thereof." 38 C.F.R. § 3.304(b). Under the presumption of aggravation, a preexisting injury or disease will be considered to have been aggravated by active military, naval, or air service, where there is an increase in disability during such service, unless there is a specific finding that the increase in disability is due to the natural progress of the disease. 38 U.S.C. § 1153; 38 C.F.R. § 3.306. The usual effects of medical and surgical treatment in service, having the effect of ameliorating disease or other conditions incurred before enlistment, including postoperative scars, absent or poorly functioning parts or organs, will not be considered service connected unless the disease or injury is otherwise aggravated by service. 38 C.F.R. § 3.306 (b)(1); see also Verdon v. Brown, 8 Vet. App. 529 (1996) (holding that the only treatment effects that are not considered service connected are those that improved the condition and lowered the level of disability. In other words, if the preexisting disability is more severe after in-service medical treatment, the increase in the level of disability is service connectable). The Board notes that service connection was previously granted for varicose veins of the right leg. The issue before the Board pertains to whether a separate and distinct bilateral leg disorder should be service connected. A review of the service treatment records reveals that at his July 1966 preinduction examination the claimant was clinically evaluated as having normal lower extremities. On September 9, 1966, the day after beginning his tour of active duty, the claimant reported that a projection below the right knee had been growing in size. The growth was evaluated by an orthopedist who noted the appellant’s report that the growth first presented five years prior, and over the prior year it had increased in size. Following a physical examination a diagnosis of a right proximal tibia osteochondroma was entered. At an August 1968 separation examination the appellant reported a history of leg cramping and bone and joint deformity. Other than evidence of the right leg showing evidence of varicose veins, no disorder involving either leg was noted. There was no evidence that the osteochondroma had increased in severity. In this case, given that the Veteran entered active duty following a medical examination that did not find any leg abnormality he is entitled to the presumption of soundness regarding his lower extremities. Significantly, however, given the fact that the osteochondroma was found on the day following service entrance, and given the fact that the appellant reported a five-year history of the disorder with the growth occurring not during the prior 24 hours but over the prior year, the Board finds that the presumption of soundness is clearly and unmistakably rebutted. 38 U.S.C. § 1111. Further, given that no additional complaints, findings or diagnoses pertaining to an osteochondroma were ever presented inservice, the finds that there is clear and unmistakable evidence that the preexisting osteochondroma was not aggravated inservice. Id. There is no competent evidence postservice pertaining to any complaints, findings or diagnosis of an osteochondroma. Hence, service connection for that disorder is denied. As to whether any other lower extremity disorder should be service connected a review of postservice VA medical records reveals that in July 2011 the appellant reported intermittent complaints with his right knee. He denied problems with his left knee. Physical examination yielded a diagnosis of degenerative joint disease of the knees. In September 2013 a history of surgery in the 1970s following a fractured right patella was recorded. The Veteran was provided a VA examination in May 2016. The appellant believed that his knee problems were related to service, but he could not recall any specific incident. It was noted that he underwent a total right knee replacement in 2012. Following that examination the examiner concluded that the appellant’s knee problems were not related to service. The examiner noted both the absence of any complaints, findings or diagnoses pertaining to a knee disorder inservice, as well as the lack of any complaints of knee pain until 25 years after separation from active duty. There is no competent evidence to the contrary. Moreover, the passage of many years between discharge from active service and the medical documentation of a claim disability is a factor that further weighs against a claim for service connection. See Maxson v. West, 12 Vet. App. 453 (1999), aff’d sub nom. Maxson v. Gober, 230 F.3d 1330 (Fed. Cir. 2000) In this case, there is no competent evidence showing that any current bilateral leg disorder is related to service. While the appellant currently has degenerative joint disease of the knees, there is no competent evidence linking the disorder to service. While the claimant may believe that the disorder is related to service, as a lay person untrained in the field of medicine the claimant is not competent to offer an opinion linking his current knee disorders to service. Such an opinion requires specialized medical knowledge which the appellant does not possess. Jandreau v. Nicholson, 492 F.3d 1372, 1377 n.4 (Fed. Cir. 2007). In summary, the preponderance of the probative evidence is against finding that a bilateral leg disorder is related to a period of active service. As such, the doctrine of reasonable doubt is not for application. 38 C.F.R. § 3.102. The claim is denied. DEREK R. BROWN Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD Hines, Anthony