Citation Nr: 21003532 Decision Date: 01/21/21 Archive Date: 01/21/21 DOCKET NO. 17-12 644 DATE: January 21, 2021 ORDER Service connection for right knee disability is granted. Service connection for left knee disability is granted. FINDING OF FACT Resolving doubt in favor of the Veteran, the Veteran’s right and left knee disabilities are related to his active duty service. CONCLUSIONS OF LAW 1. The criteria for service connection for right knee disability have been met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303. 2. The criteria for service connection for left knee disability have been met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303. REASONS AND BASES FOR FINDING AND CONCLUSIONS The Veteran served on active duty from March 1981 to October 1985 and September 1988 to October 1995. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a May 2015 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO) that, inter alia, denied service connection for right and left knee disabilities. The Veteran timely appealed that decision. In September 2020, the Veteran, his wife, and his daughter testified via videoconference before the Board. A transcript of the hearing is associated with the claims file. Entitlement to service connection for right and left knee disabilities The Veteran contends that his knee disabilities are related to service. Specifically, he testified that he sustained knee injuries while performing work aboard several ships without proper knee protection, and that his knee pain has continued since discharge from service. See September 2020 Board hearing testimony. Service connection will be granted if the evidence demonstrates that current disability resulted from a disease or injury incurred in active military service. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303(a). Establishing service connection generally requires competent evidence of (1) current disability; (2) in-service incurrence of a disease or injury; and (3) a causal relationship between the current disability and the in-service disease or injury. Saunders v. Wilkie, 886 F.3d 1356, 1361 (Fed. Cir. 2018). Consistent with this framework, service connection is warranted for a disability first diagnosed after discharge when all the evidence, including that pertinent to service, establishes that the disability was incurred in service. 38 C.F.R. § 3.303(d). In relevant part, 38 U.S.C. § 1154(a) requires that VA give “due consideration” to “all pertinent medical and lay evidence” in evaluating a claim for disability or death benefits. Davidson v. Shinseki, 581 F.3d 1313 (Fed. Cir. 2009). When there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, the Secretary shall give the benefit of the doubt to the claimant. 38 U.S.C. § 5107; see also Gilbert v. Derwinski, 1 Vet. App. 49, 53 (1990). Service treatment records (STRs) dated in January 1990 note that the Veteran had pinched nerves in both knees, as well as some pain. An STR dated in January 1991 reports that the Veteran went on sick call due to sharp pain in his left leg. An STR dated in February 1992 reflects that the Veteran went on sick call after he reported waking up with pain in his right knee. The STR also notes that the Veteran has a history of right knee pain after falling three feet from a ladder. Following service, November 2010 private treatment records indicate that the Veteran’s knee pain had been bothering him. Private treatment records dated in February 2012 reflect that the Veteran had knee joint pain. December 2014 VA treatment records confirm diagnoses for knee osteoarthritis. An April 2015 VA examination report confirmed the Veteran had bilateral knee pain, left knee swelling, and difficulty walking up and down the stairs. The Veteran reported that he cannot squat, kneel, or climb ladders. The examiner concluded that the condition was less likely than not (less than 50 percent probability) incurred in or caused by the claimed in-service injury. As rationale, the examiner stated that although the STRs document bilateral knee and lower leg pain, “the Veteran’s exit exam documented that he was in good health and had no knee issues/complaints upon leaving service.” The examiner posited that there was insufficient evidence to suggest that the Veteran’s current knee issues are related to service. The Board notes that the Veteran is competent to report continuous knee pain during and since service, and that he is credible in his assertions. Although the April 2015 VA examination did not find evidence that the Veteran’s knee issues are connected to service, the evidence is in equipoise as to whether there is a causal link between the Veteran’s current right and left knee disabilities and his service. See Buchanan v. Nicholson, 451 F.3d 1331, 1335 (Fed. Cir. 2006) (“[N]othing in the regulatory or statutory provisions [relating to evidence to be considered] require both medical and competent lay evidence; rather, they make clear that competent lay evidence can be sufficient in and of itself”). The benefit-of-the-doubt rule is therefore for application. See 38 U.S.C. § 5107; 38 C.F.R. § 3.102. Resolving reasonable doubt in the Veteran’s favor, the evidence supports the grant of service connection for right knee and left knee disabilities. See 38 U.S.C. § 5107. JAMES L. MARCH Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board M. Kovacs, 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.