Citation Nr: 21000605 Decision Date: 01/05/21 Archive Date: 01/05/21 DOCKET NO. 16-38 472 DATE: January 5, 2021 ORDER Service connection for a right knee disability is granted. Service connection for a left knee disability is granted. REMANDED Service connection for a nose disability to include nose bleeds due to chemical exposure is remanded. FINDINGS OF FACT 1. The Veteran continuously manifested symptomology of the Veteran’s current right knee disability since separation from service. 2. The Veteran continuously manifested symptomology of the Veteran’s current right knee disability since separation from service. CONCLUSIONS OF LAW 1. The criteria for service connection for a right knee disability have met. 38 U.S.C. §§ 1101, 1110, 1112, 1113, 1131, 1137; 38 C.F.R. §§ 3.303, 3.304; 3.307; 3.309. 2. The criteria for service connection for a left knee disability have been met. 38 U.S.C. §§ 1101, 1110, 1112, 1113, 1131, 1137; 38 C.F.R. §§ 3.303, 3.304; 3.307; 3.309. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served honorably in the United States Air Force from January 1984 to February 1988, from November 1990 to September 1991, from September 2006 to February 2007 and honorably in the United States Army from September 1997 to January 1998. This matter comes to the Board of Veterans’ Appeals (Board) on appeal from a September 2014 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO). This matter is being adjudicated under the legacy appellate framework. The Veteran testified at a personal hearing before the Board in September 2019, and a transcript of the hearing is of record. These matters were previously before the Board, and, in February 2020, the Board remanded these matters for further development. Further development in substantial compliance with the Board’s previous remand instructions has been completed. 1. Service connection for a right knee disability is granted. 2. Service connection for a left knee disability is granted. At issue is whether the Veteran is entitled to service connection for a bilateral knee disability. The weight of the evidence indicates that the Veteran is entitled to service connection. In seeking VA disability compensation, a Veteran generally seeks to establish that a current disability results from disease or injury incurred in or aggravated by service. 38 U.S.C. §§ 1110, 1131. “Service connection” basically means that the facts, shown by evidence, establish that a particular injury or disease resulting in disability was incurred coincident with service in the Armed Forces, or if preexisting such service, was aggravated therein. 38 C.F.R. § 3.303. Furthermore, service connection can be established through application of statutory presumptions, including for chronic diseases like arthritis, when manifested to a compensable degree within a year of separation from service; or when there is continuity of symptomology since separation from service. 38 C.F.R. §§ 3.307, 3.309. The Veteran testified at a personal hearing before the Board in September 2019 that he injured his right knee when he fell through a catwalk while working a night shift sometime between 1984 to 1988. The Veteran further testified that he injured his left knee while overcompensating on his left knee while waiting for his right knee to recover. The Veteran also indicated that his general work profile during his period of service included grueling physical labor moving 1000 pound pallets. Finally, the Veteran alleged that he continuously manifested knee symptomology since the knee injury. See Transcript. The Veteran’s testimony is corroborated by a December 1985 treatment record which indicates that the Veteran sought treatment for a right knee injury after falling through a catwalk. More importantly, the Veteran sought treatment for bilateral knee pain in September 2007; less than one year after completion of the Veteran’s final period of service from September 2006 to February 2007. The Veteran underwent a VA examination in September 2015. The Veteran reported that he injured his knees in 1984, and that his knee symptomology had continued to manifest thereafter. The examiner opined that the Veteran did not have a current diagnosis of a right knee disability. An October 2016 private medical opinion indicated that the Veteran has a current diagnosis of bilateral degenerative disease of both knees. The private provider’s opinion is corroborated by a April 2020 VA examination which diagnosed the Veteran with a bilateral knee disability. The weight of the evidence indicates that the Veteran is entitled to service connection for a bilateral knee disability. The Board finds the Veteran’s reports of continuous knee symptomology since separation from service to be credible. The Veteran has testified under oath that he has continued to manifest bilateral knee pain since an injury occurring in 1985. The Veteran’s reports are corroborated both by a treatment record memorializing the injury more or less as the Veteran reported it decades after the fact as well as a treatment record for a bilateral knee disability within one year after separation from service. Finally, a private provider and a VA examiner both indicate that the Veteran has a current bilateral knee disability. Based on the totality of the evidence, the Board is convinced that the Veteran continuously manifested bilateral knee symptomology since separation from service. In making this determination, the Board is aware that the record contains VA medical opinions disputing when the Veteran’s current bilateral knee disability first began to manifest as well as whether or not a medical nexus exists between an in-service incurrence and a current diagnosis of a bilateral knee disability. Regardless of whether or not the Veteran met the criteria for other legal theories used to establish service connection, the evidence of record is still sufficient to establish that the Veteran continuously manifested bilateral knee symptomology since separation from service. Here, the weight of the probative evidence of record demonstrates that the Veteran continually manifested symptomology of a current bilateral knee disability since separation from service. Therefore, the evidence in this case is evenly balanced enough so as to allow application of the benefit-of-the-doubt rule as required by law and VA regulations. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102. As such, service connection for a bilateral knee disability is granted. REASONS FOR REMAND Service connection for a nose disability to include nose bleeds due to chemical exposure is remanded. At issue is whether the Veteran is entitled to service connection for a nose disability to include nose bleeds due to chemical exposure. In an October 2020 appellate brief, the Veteran’s representative alleged that the full list of chemicals that the Veteran would have been exposed to would not have noted in the Veteran’s military personnel records or service treatment records that VA has obtained in order to assist the Veteran in substantiating his claim, but that they would have been documented by the U.S. Air Force. Out of an abundance of caution and in order to ensure that no stone is left unturned, the Board shall remand this matter one last time for the purposes of contacting the U.S. Air Force in an attempt to compile a list of contaminants that the Veteran would have been exposed to on a day to day basis. The matters are REMANDED for the following action: 1. First, contact the U.S. Air Force and request that they compile a list of any and all chemicals or contaminants that the Veteran would have been exposed to on a day to day basis based on his deployment history as well as his military occupational specialty. 2. Simultaneously, contact the Veteran and the Veteran’s representative and request that the Veteran and the Veteran’s representative report any and all chemical or contaminants that they believe the Veteran was exposed to during the Veteran’s periods of service as well as any documentation that they have to corroborate the Veteran’s claims. 3. Finally, provide the Veteran with a VA medical opinion based on the U.S. Air Force’s response, the Veteran’s and the Veteran’s representative’s response, as well as any and all evidence of record in order to address the following: (a.) Is it at least as likely as not (50 percent or more) that a medical nexus exists between an in-service incurrence and a current diagnosis of a nose disability to include one characterized by nose bleeds? Why or why not? (b.) What is the medical significance, if any, of any chemical exposure that the Veteran may have sustained during his periods of service? Why? DAVID L. WIGHT Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board D. Seaton 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.