Citation Nr: 20002865 Decision Date: 01/14/20 Archive Date: 01/13/20 DOCKET NO. 19-19 717 DATE: January 14, 2020 ORDER Service connection for bilateral knee osteoarthrosis is denied. FINDINGS OF FACT The preponderance of the evidence is against finding that the Veteran’s bilateral knee osteoarthrosis began during active service or is otherwise related to an in-service injury or disease CONCLUSIONS OF LAW The criteria for service connection for bilateral knee osteoarthritis have not been met. 38 U.S.C. §§ 1110, 1112, 1131, 5103, 5103A, 5107; 38 C.F.R. §§ 3.102, 3.159, 3.303, 3.307, 3.309. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran honorably served from January 1988 to July 1988. This matter is before the Board of Veterans Appeals (Board) on appeal from a January 2018 rating decision. Service Connection Legal Criteria Service connection may be granted for disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. § 3.303. The three-element test for service connection requires evidence of (1) a current disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the current disability and the in-service disease or injury. Shedden v. Principi, 381 F.3d 1163, 1166 -67 (Fed. Cir. 2004). For a chronic disease such as arthritis, service connection may be established under 38 C.F.R. § 3.303 (b) if a chronic disease or injury is shown in service, and subsequent manifestations of the same chronic disease or injury at any later date, however remote, are shown, unless clearly attributable to intercurrent causes. For a showing of a chronic disorder in service, the mere use of the word chronic will not suffice; rather, there is a required combination of manifestations sufficient to identify the disease entity, and sufficient observation to establish chronicity at the time. Continuity of symptomatology after service is required where a condition noted during service is not, in fact, chronic, or where a diagnosis of chronicity may be legitimately questioned. 38 C.F.R. § 3.303 (b). The presumptive service connection provisions based on “chronic” in-service symptoms and “continuity of symptomatology” after service under 38 C.F.R. § 3.303(b) have been interpreted as an alternative to service connection only for the specific chronic diseases listed in 38 C.F.R. § 3.309 (a). See Walker at 311(holding that the “chronic” in service and “continuous” post-service symptom presumptive provisions of 38 C.F.R. § 3.303 (b) only apply to “chronic” diseases at 3.309(a)). Service connection may also be established with certain chronic diseases such as arthritis based upon a legal presumption by showing that the disorder manifested itself to a degree of 10 percent disabling or more within one year from the date of separation from service. Such disease shall be presumed to have been incurred in service, even though there is no evidence of such disease during the period of service. 38 U.S.C. §§ 1101, 1112, 1113, 1137; 38 C.F.R. §§ 3.307, 3.309(a). While the disease need not be diagnosed within the presumptive period, it must be shown, by acceptable lay or medical evidence, that there were characteristic manifestations of the disease to the required degree during that time. Service connection for a bilateral knee condition Factual Background & Analysis The Veteran contends generally that he has a bilateral knee condition that is related to his service. Initially, the Board notes that the Veteran’s STRs do not contain any treatment for or reports of any knee conditions. January 2018 X-rays revealed a diagnosis of “minimal medial compartment osteoarthrosis bilaterally.” During a February 2019 VAMC pain screening, the Veteran noted knee pain with an onset of over 20 years in the past. The medical evidence does not warrant a finding that the Veteran’s bilateral knee osteoarthrosis is a chronic condition under 38 C.F.R. § 3.303 (b). The Veteran’s STRs do not reflect any manifestations of this disability during service and post-service treatment records show no chronicity of symptoms. Moreover, there is no medical evidence establishing that the Veteran’s bilateral knee osteoarthrosis manifested to a degree of 10 percent disabling or more within one year from the date of separation from service. In sum, the evidence does not warrant a grant of service connection for osteoarthrosis as a chronic disease pursuant to 38 C.F.R. §§ 3.303(b), 3.309(a). Further, regarding a theory of direct service connection, the Veteran has not alleged or submitted any evidence suggesting an in-service incurrence or aggravation of his bilateral knee osteoarthrosis. Absent such evidence or contention, service connection cannot be granted. Shedden v. Principi, 381 F.3d 1163, 1166 -67 (Fed. Cir. 2004). Additionally, the Board notes that the VA did not provide the Veteran with a VA examination for the purposes of determining the nature and cause of the Veteran’s bilateral knee osteoarthrosis. In light of the holding in McLendon v. Nicholson, 20 Vet. App. 79 (2006), the Board finds that an examination is not required. VA must provide a medical examination when there is (1) competent evidence of a current disability or persistent or recurrent symptoms of a disability, and (2) evidence establishing that an injury, or disease occurred in service or establishing certain diseases manifesting during an applicable presumptive period for which the claimant qualifies, and (3) an indication that the disability or persistent or recurrent symptoms of a disability may be associated with the Veteran’s service or with another service-connected disability, but (4) insufficient competent medical evidence on file for the VA to make a decision on the claim. The standards of McLendon are not met in this case because the evidence of records fails to suggest that knee pain, first reported many years after service, had its onset in service or is otherwise related to service. In the absence of any allegations or evidence of an in-service injury and any reports of symptoms until many years after service, the Board finds that the evidentiary threshold for when VA is required to provide an examination has not been met. As the preponderance of the evidence is against this claim, the benefit-of-the-doubt doctrine does not apply, and the claim of service connection for bilateral knee osteoarthrosis must be denied. See Gilbert v. Derwinski, 1 Vet. App. 49 (1990). VICTORIA MOSHIASHWILI Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Kyle McKone The Board’s decision in this case is binding only with respect to the instant matter decided. This decision is not precedential, and does not establish VA policies or interpretations of general applicability. 38 C.F.R. § 20.1303.