Citation Nr: 20032344 Decision Date: 05/07/20 Archive Date: 05/07/20 DOCKET NO. 14-09 469 DATE: May 7, 2020 ORDER Service connection for left knee painful motion, diagnosed as patellofemoral pain syndrome and lateral collateral ligament tear, is granted. Service connection for left foot condition, diagnosed as chronic left foot strain, is granted FINDINGS OF FACT 1. The Veteran’s left knee condition had its onset in service and is related to service. 2. The Veteran’s left foot condition had its onset in service and is related to service. CONCLUSIONS OF LAW 1. The criteria for service connection for left knee condition have been met. 38 U.S.C. §§ 1131, 5107; 38 C.F.R. §§ 3.102, 3.303. 2. The criteria for service connection for left foot condition have been met. 38 U.S.C. §§ 1131, 5107; 38 C.F.R. §§ 3.102, 3.303. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty in the United States Army from February 1984 to August 1985. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a September 2012 rating decision issued by the Department of Veterans Affairs (VA) Regional Office (RO). The Veteran testified at a hearing held before the undersigned Veterans Law Judge in February 2015. In June 2015, June 2016 and July 2017, the Board remanded this case for further development. Service Connection In general, service connection may be granted for a disability or injury incurred in or aggravated by active military service. See 38 U.S.C. § 1110; 38 C.F.R. § 3.303. To prevail on a direct service connection claim, there must be competent evidence of (1) a current disability, (2) an in-service incurrence or aggravation of a disease or injury, and (3) a nexus between the in-service disease or injury and the current disability. See Holton v. Shinseki, 557 F.3d 1362, 1366 (Fed. Cir. 2009); 38 U.S.C. § 1110; 38 C.F.R. § 3.303. Service connection may also be established by credible lay evidence and medical evidence provided by the Veteran or otherwise. 38 U.S.C. §§ 1110, 1131 (2012); 38 C.F.R. § 3.303 (2018). When there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, VA shall resolve reasonable doubt in favor of the claimant. See 38 U.S.C. § 5107; 38 C.F.R. § 3.102; Gilbert v. Derwinski, 1 Vet. App. 49 (1990). To deny a claim on its merits, the evidence must preponderate against the claim. See Alemany v. Brown, 9 Vet. App. 518 (1996). Determinations as to service connection will be based on review of the entire evidence of record, to include all pertinent medical and lay evidence, with due consideration to VA’s policy to administer the law under a broad and liberal interpretation consistent with the facts in each individual case. See 38 U.S.C. § 1154 (a); 38 C.F.R. § 3.303 (a). The Federal Circuit has held that "pain in the absence of a presently-diagnosed condition can cause functional impairment," which may qualify as a "disability" for VA compensation purposes. See Saunders v. Wilkie, 886 F.3d 1356, 1368 (Fed. Cir. 2018). The Federal Circuit in Saunders, however, cautioned against the notion that "a veteran could demonstrate service connection simply by asserting subjective pain" because, to establish that a disability is present, the veteran "will need to show that... pain reaches the level of a functional impairment of earning capacity." Id. at 1367-68. "Functional impairment," the Federal Circuit noted, is defined as the inability of the body or a constituent part of it "‘to function under the ordinary conditions of daily life including employment.’" Id. at 1363 (quoting 38 C.F.R. § 4.10). The Board is charged with the duty to assess the credibility and weight given to evidence. See Madden v. Gober, 125 F.3d 1477, 1481 (Fed. Cir. 1997), cert. denied, 523 U.S. 1046 (1998); Wensch v. Principi, 15 Vet. App. 362, 367 (2001). In Jefferson v. Principi, 271 F.3d 1072 (Fed. Cir. 2001), the United States Court of Appeals for the Federal Circuit (Federal Circuit), citing its decision in Madden, recognized that that Board had inherent fact-finding ability. Id. at 1076; see also 38 U.S.C. § 7104(a) (West 2002). Further, the United States Court of Appeals for Veterans Claims (Court) has declared that in adjudicating a claim, the Board has the responsibility to weigh and assess the evidence. See Bryan v. West, 13 Vet. App. 482, 488-89 (2000); Wilson v. Derwinski, 2 Vet. App. 614, 618 (1992). Left knee and foot condition The Veteran seeks service connection for his left knee and left foot conditions. In support, he reports that he injured his left foot and knee when a water tank fall on him in service and has continued to have pain since that time. See BVA hearing transcripts (February 2015). The Veteran received medical care in service for his injury and thereafter. See STR (December 1984) and see also VA medical treatment record (April 2019). The Veteran was diagnosed with patellofemoral pain syndrome and lateral collateral ligament tear in his left knee. See VA medical examination (August 2016 and September 2019). Additionally, he was diagnosed with chronic left foot strain. See VA medical examination (June 2015). Thus, the Veteran has a current condition in his left knee and foot, thus establishing the first element for service connection. Additionally, he continued his medical treatment for his conditions at VA and Non-VA facilities. See VA medical treatment records (April 2017) and Non-VA medical treatment records, Doctor J. E. statement (March 2014). The Board acknowledges that on September 2019 a VA examiner opined that it was less likely than not that the Veteran’s current left knee and foot conditions are related to service. See VA medical examination (September 2019). However, the Veteran provided sworn testimony explaining his in-service injury that caused his condition and treatments thereafter including medication and physical therapy. See BVA hearing transcripts (February 2015), and see also Non-VA medical record (February and September 2015 and August 2016). The Board finds that the medical and lay evidence linking the Veteran’s left knee and foot condition to service is probative, competent and credible. Additionally, the Veteran has various outpatient treatment records of his left knee and foot disability and treatment. Moreover, his military personnel record confirms he suffered an injury to his foot when a water tank fall on him. See STR (December 1984). Further, the Board also finds that the Veteran’s competent and credible sworn testimony shows that his left knee and foot problems began during service and have been recurrent since that time. See BVA hearing transcripts (February 2015). The Veteran is competent to report his left knee and foot symptoms that began in service and the Board finds the Veteran’s statements credible. See 38 C.F.R. § 3.159 (a)(2); Washington v. Nicholson, 19 Vet. App. 362, 368 (2005); Layno. The Board finds that the lay evidence is consistent with other evidence of record, both medical and lay, and further finds that it is competent and credible. The Board finds that the medical and lay evidence, including the Veteran’s, physician and buddy statements, shows that the Veteran’s left knee and foot conditions had its onset in service and have been recurrent since that time. Resolving all reasonable doubt in the Veteran’s favor, the Board finds that the Veteran’s left knee and foot disability had its onset during his period of military service. As such, service connection is granted. See 38 C.F.R. § 3.303 (a). STEVEN D. REISS Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board M. Alvarado- 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.