Citation Nr: 20038092 Decision Date: 06/03/20 Archive Date: 06/03/20 DOCKET NO. 20-13 008 DATE: June 3, 2020 ORDER Entitlement to service connection for acquired psychiatric condition, to include anxiety and depression is granted. Entitlement to service connection for right knee patellofemoral pain syndrome and patellar tendinopathy (right knee disability) is granted. Entitlement to service connection for left knee patellofemoral pain syndrome and patellar tendinopathy (left knee disability) is granted. FINDINGS OF FACT 1. The Veteran’s diagnosed anxiety and depression are etiologically related to active duty. 2. The evidence is at least in equipoise as to whether the Veteran’s diagnosed right knee patellofemoral pain syndrome and patellar tendinopathy are etiologically related to active duty. 3. The evidence is at least in equipoise as to whether the Veteran’s diagnosed left knee patellofemoral pain syndrome and patellar tendinopathy are etiologically related to active duty. CONCLUSIONS OF LAW 1. The criteria for service connection for acquired psychiatric condition, to include anxiety and depression, have been met. 38 U.S.C. §§ 1110, 5107 (2018); 38 C.F.R. §§ 3.102, 3.303 (2019). 2. The criteria for service connection for right knee patellofemoral pain syndrome and patellar tendinopathy (right knee condition) have been met. 38 U.S.C. §§ 1110, 5107 (2018); 38 C.F.R. §§ 3.102, 3.303 (2019). 3. The criteria for service connection for left knee patellofemoral pain syndrome and patellar tendinopathy (left knee condition) have been met. 38 U.S.C. §§ 1110, 5107 (2018); 38 C.F.R. §§ 3.102, 3.303 (2019). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran had active service in the U.S. Marine Corps from October 2011 to July 2017. This appeal comes to the Board of Veterans’ Appeals (Board) from a September 2018 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO). 1. Entitlement to service connection for acquired psychiatric condition The Veteran asserts that he has anxiety and depression as a result of his period of active service from October 2011 to July 2017, including his deployments. Service treatment records (STRs) reflect that on both April 2011 enlistment examination and April 2017 separation examination, psychiatric evaluation was normal. The Veteran denied a history of nervous trouble and depression or excessive worry on both accompanying reports of medical history. Post-service, the Veteran presented to VA mental health for a consultation in April 2018. The Veteran reported that he was referred by his primary care provider because he had been experiencing anxiety at nighttime. The examining psychologist diagnosed unspecified anxiety disorder. In May 2018, a VA mental health hotline note indicated that the Veteran called to seek information about how he could receive treatment for depression, anxiety, hypervigilance, panic attacks, and disrupted sleep. He reported that issues with mood began while on active duty and he has become more aware of them now because they are affecting his ability to function. The Veteran was afforded a VA psychiatric examination in connection with his claim in January 2020. The examiner diagnosed adjustment disorder with mixed anxiety and depression, panic disorder, and cannabis use disorder, and opined that his anxiety and depression were at least as likely as not incurred in or caused by anxiety and depression during service. The examiner reasoned that the Veteran entered the military with no past psychiatric history, cognitive, mood, or sleep disruptions. During service he was deployed twice and exposed to some in-service stressors and subsequently developed these overlapping symptoms of cognitive/concentration, anxiety, mood, and sleep disturbances and symptoms and also developed maladaptive coping mechanism of self-medicating with cannabis. Based on the foregoing, the Board finds that service connection for an acquired psychiatric disability, to include anxiety and depression, is warranted. Although there is no notation of psychiatric complaints in service, the Veteran was diagnosed with anxiety disorder within a year of separation from active duty. A VA examiner also provided a positive etiological opinion. There is no opinion to the contrary. Consequently, service connection is granted. 38 U.S.C. § 5107 (2018); 38 C.F.R. § 3.102 (2019). 2. Entitlement to service connection for right and left knee disabilities The Veteran claims that his current right and left knee disabilities had their onset during active duty. Specifically, he reported that he experienced knee swelling during boot camp. After boot camp, he endured knee pain after repetitive crawling and positions his knees “in a very impractical and uncomfortable manner” so that he could accomplish his tasks in maintaining the naval ship. He also reported injuring his knees after falling on the naval ship. He reported that did not seek medical treatment during service because he feared being medically separated or not being able to perform his job and letting his fellow Marines down. STRs reflect that, on both April 2011 enlistment examination and April 2017 separation examination, musculoskeletal evaluation was normal. The Veteran denied a history of knee trouble on both accompanying reports of medical history. Post-service, the Veteran submitted a claim for a bilateral knee disability in June 2018. Following a January 2020 VA knee examination, the examiner diagnosed bilateral patellofemoral pain syndrome and patellar tendinopathy. The examiner noted that the Veteran reported experiencing pain in the anterior knees following landing in a crouch on the aircraft or after a lot of bending while working. The Veteran reported that his pain had stayed the same since service. Unfortunately, the examiner noted that no opinion was requested and did not render an etiological opinion. However, the Board finds that the record as it stands is at least in equipoise, such that the benefit-of-the-doubt doctrine applies to the Veteran’s knee disability claims. The Veteran has described knee injuries during service that are consistent with his duties aboard the naval ships between 2011 and 2017. He reported continuing pain since service, and the record contains documentation of his knee complaints within one year of separation from active duty. He has current diagnoses pertaining to the knees, and there is no medical opinion against his claims. (Continued on the next page)   Resolving any reasonable doubt in favor of the Veteran, service connection for the claimed right and left knee disabilities, diagnosed as right and left patellofemoral pain syndrome and patellar tendinopathy, is granted. 38 U.S.C. § 5107 (2018); 38 C.F.R. § 3.102 (2019). Kristin Haddock Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Roya Bahrami, 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.