Citation Nr: 21000972 Decision Date: 01/06/21 Archive Date: 01/06/21 DOCKET NO. 16-21 437 DATE: January 6, 2021 ORDER Entitlement to service connection for a bilateral knee disability, to include total knee arthroplasty, is granted. FINDING OF FACT The Veteran’s bilateral knee disability, to include total knee arthroplasty, is etiologically related to injuries sustained during service. CONCLUSION OF LAW The criteria to establish service connection for a bilateral knee disability, to include total knee arthroplasty, have been met. 38 U.S.C. §§ 1110, 1131, 5103, 5103A, 5107; 38 C.F.R. §§ 3.102, 3.159, 3.303. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from June 1982 to September 1992 and October 1993 to May 1998. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a December 2014 rating decision by a Department of Veterans Affairs (VA) Regional Office (RO), which denied the Veteran service connection for bilateral total knee arthroplasty. In a March 2019 decision, the Board denied the claim. The Veteran appealed that denial to the Court of Appeals for Veterans Claims (Court). In March 2020, the Court granted a Joint Motion for Partial Remand (JMPR) filed by representatives for both parties and remanded it to the Board for further proceedings consistent with the JMPR. In July 2020, the Board remanded the Veteran’s claim to the Agency of Original Jurisdiction (AOJ) for further action consistent with the Board’s remand directives. Specifically, the Board remanded to afford the Veteran a new VA examination to include addressing the Veteran’s lay contentions as agreed in the JMPR. The claim is back before the Board for further appellate proceedings. A Veteran is entitled to VA disability compensation if there is a disability resulting from personal injury suffered or disease contracted in the line of duty in active service, or for aggravation of a preexisting injury suffered or disease contracted in the line of duty in active service. 38 U.S.C. §§ 1110, 1131. Generally, to establish a right to compensation for a present disability, a veteran must show: (1) a present disability; (2) an in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the present disability and the disease or injury incurred or aggravated during service, the so-called “nexus” requirement. Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004). Service connection may be granted for any disease diagnosed after discharge, when all of the evidence, including that pertinent to service, establishes that a disease was incurred in service. 38 C.F.R. § 3.303(d). In May 2014, the Veteran had a bilateral total knee arthroplasty after years of pain from osteoarthritis that impaired his activities of daily living. See August 2020 and May 2014 private medical records. Residuals of this surgery include pain and limited range of motion, bilaterally. See October 2020 VA examination report. Thus, the Board finds that the Veteran has a current disability for compensation purposes and the first Shedden element is met. The Veteran contends that his bilateral total knee arthroplasty is related to several injuries he sustained during service. See December 2013 VA Form 21-526b. Service treatment records (STRs) show that the Veteran was treated for pain, trauma, and irritation to his knees. See STRs. Thus, the second Shedden element is met. The Veteran’s private physician, Dr. R.P., performed the Veteran’s bilateral total knee arthroplasty. See August 2020 private medical records. Prior to the Veteran’s surgery, Dr. R.P. recorded a long history of the bilateral knee’s progression, to include osteoarthritis, and noted a discussion with the Veteran related to the probable causes of his symptoms. Id. In an April 2014 letter, Dr. R.P. opined that the Veteran’s need for a bilateral total knee arthroplasty is “almost certainly” related to his injuries and involvement in active duty service. See May 2014 private medical records. Dr. R.P. is a medical professional who reviewed the Veteran’s medical history and lay statements, performed the bilateral total knee arthroplasty, and supplemented his opinion with adequate rationale. Id. Thus, the Board finds Dr. R.P.’s opinion probative. Therefore, the third Shedden element is met. (Continued on the next page)   Accordingly, the Board finds that the Veteran’s bilateral total knee arthroplasty is etiologically related to service. Therefore, the criteria for service connection for the Veteran’s bilateral total knee arthroplasty have been met. See 38 C.F.R. §§ 3.102, 3.159, 3.303; Gilbert v. Derwinski, 1 Vet. App. 9, 55-57 (1990). DONNIE R. HACHEY Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board A. Strickland 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.