Citation Nr: 20028876 Decision Date: 04/24/20 Archive Date: 04/24/20 DOCKET NO. 17-54 215 DATE: April 24, 2020 ORDER Entitlement to service connection for a right knee disability is granted. FINDING OF FACT The Veteran’s right knee disability is proximately due to her service-connected left knee disability. CONCLUSION OF LAW The criteria for entitlement to secondary service connection for a right knee disability are met. 38 U.S.C. §§ 1131, 5107(b); 38 C.F.R. §§ 3.303(a), 3.310. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty in the United States Army from June 1977 to October 1989. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a January 2016 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO). In February 2020, the Veteran testified at a videoconference hearing before the undersigned Veterans Law Judge. The Board acknowledges that VA has associated additional medical records with the Veteran’s claims file since the RO’s last adjudication of her claim. However, at the February 2020 Board hearing, she waived RO consideration of this evidence. See February 2020 Board Hearing Transcript (Tr.) at 2. Moreover, as the Board is awarding service connection, there is no prejudice to the Veteran in considering this evidence in the first instance. Service connection may be established on a secondary basis for a disability proximately due to or aggravated by a service-connected disease or injury. See 38 C.F.R. § 3.310; see also Allen v. Brown, 7 Vet. App. 439 (1995) (en banc). To establish secondary service connection, a Veteran must show: (1) the existence of a present disability; (2) the existence of a service-connected disability; and (3) a causal relationship between the present disability and the service-connected disability. See Wallin v. West, 11 Vet. App. 509, 512 (1998). As secondary service connection under 38 C.F.R. § 3.310(a) is warranted on a proximate cause basis, the Board need not address the Veteran’s contentions on direct service connection. Here, the Veteran has current diagnoses of right knee joint severe osteoarthritis, right knee strain, and shin splints. See December 2015 and January 2019 VA Examination reports; see also April 2016 VA Treatment Record. She is also service-connected for a left knee disability. Therefore, the first two elements of secondary service connection are satisfied. Regarding the last element, a causal relationship between the current disability and the service-connected disability, the record includes the Veteran’s competent and credible reports that she has been using her right knee to compensate for her left knee disability. See August 2004 (noting the Veteran stands for about five minutes before she has to shift her weight to her right leg) and March 2017 (noting the Veteran favors her right knee) VA Treatment Records; see also January 2019 VA examination report; see also February 2020 Board Hearing Transcript (Tr.) at 3-5. Indeed, a January 2019 VA examiner notes that “flare ups of the right knee can be described as over [compensating with] the right leg (knee) due to the left knee.” Additionally, after considering the Veteran’s reports of overcompensation, P.K., who holds a doctorate degree in physical therapy and is well-versed with the Veteran’s relevant medical history, opined in the Veteran’s favor. Specifically, he stated that the Veteran “had been observed in [the] clinic with compensatory movements in the r[ight] l[ower] e[xtremity] to make up for deficits of strength and mobility in the l[eft] knee. Given her long history of pain and multiple surgical procedures on the left knee, it is very likely that pain and limited function that she is experiencing in the r[ight] knee is at least in part due to the compensation she had to perform in order to function day to day.” See March 2020 P.K. Report. Dr. P.K.’s favorable opinion is well-reasoned and supported by the other competent and credible evidence of record, including the Veteran’s statements and testimony. The Board acknowledges the opinions of the December 2015 and September 2017 VA examiners against the claim. However, the examiners’ rationales are inadequate, because they are conclusory (simply noting no support in medical literature for her contentions), fail to address service connection based on aggravation and fail to consider the above-cited competent and credible evidence of the Veteran using right knee to compensate for her left. Thus, as the only probative evidence is in favor of the claim, secondary service connection is established for the Veteran’s right knee disability. S. BUSH Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board M. Ramirez, 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.