Citation Nr: 20002948 Decision Date: 01/14/20 Archive Date: 01/13/20 DOCKET NO. 14-33 470 DATE: January 14, 2020 ORDER Entitlement to service connection for a right knee disorder is granted. FINDING OF FACT Osteoarthritis of the right knee is attributable to service. CONCLUSION OF LAW The criteria for service connection for osteoarthritis of the right knee have been met. 38 U.S.C. §§ 1101, 1110, 1112, 1113, 1131, 1137, 5103, 5103A, 5107; 38 C.F.R. §§ 3.102, 3.159, 3.303, 3.307, 3.309 (2018). REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty in the U.S. Army from February 1976 to June 1998. This matter comes before the Board of Veterans’ Appeals (Board) on appeal of an October 2009 rating decision of the Regional Office (RO) of the Department of Veterans Affairs (VA) in Houston, Texas. Service Connection Service connection may be granted for disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. § §§ 1110, 1131; 38 C.F.R. § 3.303(a) (2018). To establish a right to compensation for a present disability, 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—the so-called “nexus” requirement. Holton v. Shinseki, 557 F.3d 1362, 1366 (Fed. Cir. 2009) (quoting Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004)). Service connection may be granted for any disease initially diagnosed after service when all of the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303(d). For the showing of chronic disease in service, there is required a combination of manifestations sufficient to identify the disease entity, and sufficient observation to establish chronicity at the time. For chronic diseases, if chronicity in service is not established, a showing of continuity of symptoms after discharge is required to support the claim. 38 C.F.R. § § 3.303(b), 3.309; Walker v. Shinseki, 708 F.3d 1331 (Fed. Cir. 2013). Entitlement to service connection for a right knee disorder. The Veteran contends that his currently diagnosed osteoarthritis of the right knee is due to his active service. In particular, the Veteran asserts that his osteoarthritis of the right knee is due to repetitive actions and use related to his military occupational specialty, namely, his time as a tank crewman; the Veteran asserts that the repetitive climbing and jumping on and off tanks, lifting and hauling heavy materials, and maintenance damaged his body such that he injured his back and knee. The Board observes that the Veteran is service-connected for lumbosacral strain. The Board finds that the evidence of record demonstrates service connection for osteoarthritis of the right knee is warranted. The Board acknowledges that the VA examiners have found that it was less likely than not that the Veteran’s osteoarthritis of the right knee is related to his service. However, the Board notes that the March 2018 VA examiner did not address the Veteran’s continued complaints and treatment for his right knee pain; to this point, the March 2018 VA examiner ignored the Veteran’s complaints of pain related to his knees at his retirement examination, as well as a November 1999 x-ray by VA which showed that the Veteran had degenerative changes of the right knee. The VA examiner merely indicated that the Veteran’s osteoarthritis of the right knee was not due to or the result of the Veteran’s service based on an August 2009 VA x-ray and the absence of a diagnosed right knee disability during service. Moreover, the August 2019 VA addendum opinion relied on the absence of a right knee diagnosis or symptoms consistent with osteoarthritis in the Veteran’s service treatment records. However, the medical opinion does not reflect that the VA examiner reviewed the November 1999 x-ray report, and the VA examiner did not address the Veteran’s report of knee pain at separation and consistent reports of chronic knee pain since service; the Veteran’s post-service treatment records reflect complaints of knee pain within one year of separation from service. The Board observes that the Veteran was first afforded a diagnostic x-ray reflecting degenerative changes consistent with arthritis just outside the one-year window for presumptive service connection and finds that it is not disqualifying in light of the evidence of record. Additionally, neither of these medical opinions are sufficient for determining whether the Veteran’s osteoarthritis of the right knee is related to repetitive use injuries from his duties as a tank crewman. As such, the Board finds the Veteran’s report of treatment in the years since service credible. The Veteran is competent to report continuity of symptoms. See Buchanan v. Nicholson, 451 F.3d 1331, 1336 (Fed. Cir. 2008) (lay evidence may suffice to prove service connection on its own merits). In addition, the Veteran’s treatment records confirm a history of treatment for chronic bilateral knee pain, with degenerative changes consistent with osteoarthritis upon x-ray, and a diagnosis of chondromalacia patella, without a history of an intercurrent disease or injury. Moreover, to this point, the Veteran submitted a statement from a fellow service member confirming the nature of the Veteran’s duties during service as well as the Veteran’s consistent complaints of knee pain in service, related to those duties. Thus, it is reasonable to find that the Veteran’s duties while in service required repetitive motions of the type to cause osteoarthritis of the right knee. For the foregoing reasons, the Board finds that the most probative evidence establishes that the Veteran’s osteoarthritis of the right knee is related to his service. Accordingly, entitlement to service connection for osteoarthritis of the right knee is warranted GAYLE STROMMEN Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board H. Brokowsky, Counsel 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.