Citation Nr: 18160920 Decision Date: 12/28/18 Archive Date: 12/28/18 DOCKET NO. 16-53 241A DATE: December 28, 2018 ORDER Entitlement to service connection for a left knee disability is denied. Entitlement to service connection for a right knee disability is denied. Entitlement to service connection for a hernia disability is denied. FINDINGS OF FACT 1. The preponderance of evidence is against a finding that the Veteran’s left knee disability was manifested in service, within one year of service separation, or is otherwise related to service. 2. The preponderance of evidence is against a finding that the Veteran’s right knee disability was manifested in service, within one year of service separation, or is otherwise related to service. 3. The preponderance of evidence is against a finding that the Veteran’s hernia disability was manifested in service, within one year of service separation, or is otherwise related to service. CONCLUSIONS OF LAW 1. The criteria for entitlement to service connection for a left knee disability have not been met. 38 U.S.C. §§ 1110, 1131, 5103, 5103A, 5107 (2012); 38 C.F.R. §§ 3.159, 3.303 (2018). 2. The criteria for entitlement to service connection for a right knee disability have not been met. 38 U.S.C. §§ 1110, 1131, 5103, 5103A, 5107 (2012); 38 C.F.R. §§ 3.159, 3.303 (2018). 3. The criteria for entitlement to service connection for a hernia disability have not been met. 38 U.S.C. §§ 1110, 1131, 5103, 5103A, 5107 (2012); 38 C.F.R. §§ 3.159, 3.303 (2018). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from September 1976 to August 1979. Service Connection Service connection may be established for disability resulting from personal injury suffered or disease contracted in line of duty in the active military, naval, or air service. 38 U.S.C.A. § 1110. Establishing service connection generally requires competent evidence of three things: (1) a current disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship, i.e., a nexus, between the claimed in-service disease or injury and the current disability. Holton v. Shinseki, 557 F.3d 1362, 1366 (Fed. Cir. 2009). Service connection may also be granted for any injury or disease diagnosed after discharge, when all the evidence, including that pertinent to service, establishes that the disease or injury was incurred in service. 38 C.F.R. § 3.303(d). Entitlement to service connection for left and right knee disabilities, as well as a hernia disability The Veteran seeks entitlement to service connection for left and right knee disabilities and for a hernia disability. With respect to the knees, he contends that he injured both knees in service when he fell out of the top bunk of his sleeping quarters while stationed in Germany in 1977. Concerning his hernias, the Veteran contends he started having abdominal pain during his period of service. The Veteran was diagnosed with bilateral patellofemoral syndrome at a July 2014 VA examination. X-ray results at the time were negative for both knees, but a subsequent November 10, 2015 imaging report indicated mild degenerative changes for both knees. VA treatment records also confirm treatment of hernia symptoms, as well as a hernia repair surgery in January 2016. The Veteran’s service treatment records do not document any complaints of, or treatment for injuries to the right or left knee, or any abdominal or hernia problems. Although this absence of documented care does not in and of itself reduce the credibility of a Veteran’s lay accounts of in-service injury, the record in this case also contains conflicting statements from the Veteran as to the onset of disability, and progression of symptoms. Indeed, although the Veteran has reported having severe knee pain since his 1977 injury, as well as abdominal pain since service, he specifically denied swollen or painful joints, cramps in legs, rupture/hernia, indigestion, stomach or intestinal trouble, broken bones, arthritis, and a trick or locked knee on his July 1979 Report of Medical History. His examination upon separation was also “normal” with respect to abdomen and viscera (including hernia) and the lower extremities. The Veteran reported being in “good health” at the time of separation in 1979. The Veteran subsequently served in the National Guard until 1993. The Veteran filled out three additional Reports of Medical History in August 1983, October 1987 and March 1992. On each of these reports, the Veteran again denied experiencing swollen or painful joints, cramps in his legs, frequent indigestion, stomach, liver or intestinal trouble, a rupture or hernia, broken bones, arthritis, rheumatism or bursitis, a bone, joint or other deformity, or a “trick” or locked knee. The Board is aware that on his March 1992 Report of Medical History, the Veteran actually selected “yes” to every symptom in the second column from top to bottom, and “don’t know” to every symptom in the third column from top to bottom, but this appears to have been simply an error in placement of the check marks, as the Veteran reported at the time he was still in “good health,” and the physician reviewing his history indicated that the Veteran was “fit for work,” with no pathological past history. The Board must read medical reports as a whole and in the context of the evidence of record. See Acevedo v. Shinseki, 25 Vet. App. 286, 294 (2012). Each corresponding Report of Medical Examination included a “normal” clinical evaluation of the abdomen and viscera (including hernia) and the lower extremities. Crucially, when the Veteran sought post-service treatment for knee pain and hernia problems with VA in September 2013, he complained of bilateral knee pain for a period of only five years and denied an acute knee injury. He also reported the presence of hernia (umbilical and inguinal) for a period of only three years. See a September 6, 2013 VA Nursing Triage Note. Although the Veteran is competent to attest to his observable symptoms, and to the experiences he had in service, the Board finds the Veteran’s accounts of having injured both knees in service, with resultant chronic pain that has existed since that time, and his account of having abdominal pain or hernia since service to be not credible in light of (1) contemporaneous denials of such symptoms at the time of separation in 1979, as well as on three subsequent occasions spanning his National Guard career in 1983, 1987 and 1992; (2) “normal” clinical assessments of the abdomen and lower extremities in 1979, 1983, 1987 and 1992; and (3) the Veteran’s report to VA treatment providers in 2013 that he had knee pain for only 5 years, without acute injury, and hernias for only 3 years. The Board places greater weight of probative value on the history the Veteran presented to medical professionals for treatment purposes (i.e., during active service and years thereafter) than it does on his recent statements to VA in connection with his claim for monetary benefits. See Curry v. Brown, 7 Vet. App. 59, 68 (1994) (contemporaneous evidence has greater probative value than history as reported by the veteran); see also Cartright v. Derwinski, 2 Vet. App. 24, 25 (1991) (VA cannot ignore a veteran’s testimony simply because the veteran is an interested party; personal interest may, however, affect the credibility of the evidence). Indeed, the Veteran’s history of prior inconsistent statements weigh against his credibility. See Caluza v. Brown, 7 Vet. App. 498 (1995) (in determining whether lay evidence is satisfactory, the Board may also properly consider internal inconsistency of the statements, facial plausibility, and consistency with other evidence submitted on behalf of a veteran). The Board recognizes that during his National Guard service, the Veteran did receive treatment for abrasions and bruising of the thighs in July 1990 after falling from a truck. Trauma to the upper and middle third of the left and right leg respectively was noted, but there was no mention of any knee involvement. The Veteran does not assert his current knee disabilities resulted from this incident in the National Guard, and a July 2014 VA examiner specifically opined against such a relationship. Additional medical opinions specifically addressing whether the Veteran’s current knee or hernia disabilities are related to his period of active duty service are not necessary in this case, as the Board has found no credible evidence of in-service injury or disease. See Bardwell v. Shinseki, 24 Vet. App. 36 (2010) (finding that VA is not required to provide a medical examination when there is not credible evidence of an event, injury, or disease in service). (Continued on Next Page) For these reasons, the Board finds that a preponderance of the evidence is against the Veteran’s service-connection claims, and the benefit-of-the-doubt doctrine is not for application. 38 U.S.C.A. § 5107(b). Accordingly, the benefits sought on appeal are denied. V. Chiappetta Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD David M. Sebstead, Associate Counsel