Citation Nr: 20004253 Decision Date: 01/21/20 Archive Date: 01/17/20 DOCKET NO. 18-23 567 DATE: January 21, 2020 ORDER Entitlement to service connection for a right knee condition is granted. FINDING OF FACT The Veteran's right knee osteoarthritis is etiologically related to his in-service exostosis surgery. CONCLUSION OF LAW The criteria for entitlement to service connection for right knee osteoarthritis have been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from April 1951 to December 1953. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a February 2016 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO). In November 2019, the Veteran testified at a hearing before the undersigned Veterans Law Judge. A transcript is of record. SERVICE CONNECTION Service connection may be granted for a disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. § 3.303. Service connection may also be established for any disease diagnosed after discharge, when all the evidence, including that pertinent to service, establishes the disease was incurred in service. 38 C.F.R. § 3.303 (d). Entitlement to service connection for a right knee condition The Veteran seeks service connection for a right knee condition, which he contends is a result of his in-service exostosis surgery. A January 2016 VA examination report shows a current diagnosis of status post removal exostosis and osteoarthritis. The question in this case is whether a causal relationship or nexus exists between his in-service event and his current right knee condition. Based on review of the competent and credible evidence, the Board finds a causal nexus has been established. Thus, service connection for right knee osteoarthritis is granted. The Veteran’s service treatment records show that beginning in March 1953, he noticed a lump on the medial aspect of his right knee and experienced multiple episodes of give-way. Physical examination revealed an exostosis, which was surgically removed in August 1953. Post-surgical notes show that he was healing well, however, he still had a loss of about 10 degrees flexion when evaluated in September 1953. The November 1953 separation examination report shows a history of right knee bone chip removal, but no current sequelae or complaints. The Veteran underwent a VA examination in January 2016 during which an examiner opined that it is less likely than not that the current right knee osteoarthritis is related to the exostosis surgery in service. The rationale was that the condition was more likely than not related to normal age progression and deconditioning, and current x-rays were consistent with normal age progression. On the Veteran’s May 2018 VA Form 9, he reported having symptoms of knee pain, locking, and limitation of motion since service. At the recent hearing before the undersigned, the Veteran reported having right knee symptoms after service that became progressively worse. He denied any post-service injuries to the right knee and indicated that he worked in real estate for close to 40 years. In November 2019, the Veteran’s private physician opined that his osteoarthritis is more likely than not related to his service injury and subsequent exostosis surgery. Dr. P. explained that the Veteran’s knee injury resulted in a bone chip, which was surgically removed. He further explained that his opinion is supported by the fact that the Veteran has not suffered pain in his left knee or in other axial joints. The Board grants service connection in this case because the service records show the Veteran’s right knee was sound upon entrance and he later injured his right knee necessitating surgery. Although a right knee disability was not diagnosed at separation, the Veteran competently and credibly reports experiencing right knee pain and other symptoms since service discharge, with no post-service acute trauma to his knee. Further, the competing medical nexus opinions are both considered competent and probative as they were offered by medical professionals familiar with the pertinent clinical history. Both clinicians supported their opinions with rationale. The Board finds neither opinion outweighs the other and thus, the competent evidence regarding causal nexus is in relative equipoise. As the reasonable doubt created by this relative equipoise must be resolved in favor of the Veteran, service connection for right knee osteoarthritis is granted. 38 U.S.C. § 5107 (b); 38 C.F.R. § 3.102; Gilbert v. Derwinski, 1 Vet. App. 49 (1990). D. JOHNSON Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board J. Telamour, Associate 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.