Citation Nr: 20021779 Decision Date: 03/27/20 Archive Date: 03/27/20 DOCKET NO. 16-61 942 DATE: March 27, 2020 ORDER Entitlement to service connection for a right knee condition is granted. Entitlement to service connection for a left knee condition is granted. FINDINGS OF FACT 1. The Veteran’s right knee condition is etiologically related to his active service. 2. The Veteran’s left knee condition is etiologically related to his active service. CONCLUSIONS OF LAW 1. The criteria for entitlement to service connection for a right knee condition have been met. 38 U.S.C. §§ 1110, 1131, 5107 (2012); 38 C.F.R. § 3.102, 3.303 (2019). 2. The criteria for entitlement to service connection for a left knee condition have been met. 38 U.S.C. §§ 1110, 1131, 5107 (2012); 38 C.F.R. § 3.102, 3.303 (2019). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty in the U.S. Navy from May 1971 to July 1978. In March 2020, the Veteran testified at a local VA office hearing before the undersigned. 1. Entitlement to service connection for a right knee condition is granted. 2. Entitlement to service connection for a left knee condition is granted. The Veteran contends his bilateral knee conditions were caused by his active service. 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). Service connection may also be granted for any disease diagnosed after discharge, when all the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303(d). When there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, the Secretary shall give the benefit of the doubt to the claimant. 38 U.S.C. § 5107; 38 C.F.R. § 3.102; see also Gilbert v. Derwinski, 1 Vet. App. 49 (1990). First, the evidence shows a current disability. Specifically, a private physician provided that the Veteran has a diagnosis of post-traumatic arthritis of his right knee and osteoarthritis of his left knee. See February 2020 Medical Treatment Record – Non-Government Facility, p. 1. Therefore, the first element of service connection is satisfied. Shedden, 381 F.3d at 1166-67. Second, with regard to the in-service element, the Veteran has credibly testified that he experienced knee issues in service. The Veteran’s assertions are corroborated by service treatment records (STRs), which show numerous complaints of bilateral knee pain from 1976 to 1977, including a notation of chondromalacia of both knees in his July 1978 report of medical examination. See June 1977 STR – Medical, pp. 29-30, 32-34, 36, 41, 46. Therefore, the second element of service connection is satisfied. Shedden, 381 F.3d at 1166-67. The remaining question is whether there is a medical nexus between the Veteran’s currently diagnosed bilateral knee conditions and his service. As to this matter, the evidence conflicts. In December 2015, the Veteran underwent a VA examination, in which the examiner noted diagnoses of bilateral knee arthritis, degenerative from February 2013. The Veteran reported that he injured his right ankle in 1973 and that his knees bother him due to his right ankle condition. He also reported he could not walk, sit, lift, carry, or climb stairs for a prolonged period due to his knees. The December 2015 examiner opined that it was less likely than not the Veteran’s bilateral knee conditions were related to his service or his right ankle condition because medical literature did not support a cause and effect relationship between the two conditions. Additionally, there was no objective evidence of aggravation. A May 2017 nexus statement from a private physician, Dr. M.S.S. was associated with the Veteran’s claims folder in July 2019. He opined the Veteran’s bilateral knee arthritis was caused by or a result of the Veteran’s military service. He noted that the Veteran’s medical records from March 1977 and July 1977 supported a diagnosis of traumatic arthritis right knee and chondromalacia of the left knee, respectively. Dr. M.S.S. provided another private opinion in February 2020, which was associated with the Veteran’s claims folder in March 2020. He noted that the Veteran’s STRs contained a note of “popping and grating” in both knees along with bilateral chondromalacia and that the Veteran benefited from a cane while ambulating due to instability in both his knees. He opined that “between 51-99% of [the Veteran’s] pain/injuries is most likely cause by or a result of the Veteran’s military service.” After careful consideration, the Board finds that the evidence regarding nexus is at least in equipoise. When the evidence for and against a claim is in relative equipoise, the Board has an obligation to resolve all reasonable doubt in favor of the Veteran. See 38 U.S.C. § 5107; 38 C.F.R. § 3.102; see also Gilbert v. Derwinski, 1 Vet. App. 49 (1990). Resolving all reasonable doubt in the Veteran’s favor, the Board finds that the third element of service connection is established. See Shedden, 381 F.3d at 1166-67. As all three elements of service connection are met, service connection for right and left knee conditions is warranted. A. S. CARACCIOLO Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board T. L. Park, 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.