Citation Nr: 21003577 Decision Date: 01/22/21 Archive Date: 01/22/21 DOCKET NO. 11-25 439 DATE: January 22, 2021 ORDER Service connection for a right knee strain is granted. Service connection for a left knee strain is granted. FINDINGS OF FACT 1. The Veteran’s right knee strain is related to his active service. 2. The Veteran’s left knee strain is related to his active service. CONCLUSIONS OF LAW 1. The criteria for service connection for right knee strain have been met. 38 U.S.C. §§ 1101, 1110, 1154, 5107; 38 C.F.R. § 3.303, 3.304. 2. The criteria for service connection for left knee strain have been met. 38 U.S.C. §§ 1101, 1110, 1154, 5107; 38 C.F.R. § 3.303, 3.304. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from July 1999 to August 2003 with the United States Marine Corps. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a February 2010 rating decision from the Regional Office (RO). This case was previously before the Board in November 2019, where the issues on appeal were remanded to obtain a VA examination to assist in determining service connection for injuries in both knees based on direct and secondary service connection.. Service Connection 1. Service connection for a right knee strain 2. Service connection for a left knee strain The Veteran contends that he bilateral knee condition related to his military service. To prevail on a direct service connection claim, there must be competent evidence of (1) a current disability, (2) 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. Holton v. Shinseki, 557 F.3d 1362, 1366 (Fed. Cir. 2009); 38 U.S.C. § 1110; 38 C.F.R. § 3.303(a). The question for the Board is whether the Veteran has a bilateral knee condition that is etiologically related to, or aggravated by, an in-service disease or injury. The Board finds that competent, credible, and probative evidence establishes that the Veteran’s bilateral knee strain is etiologically related to the Veteran's active service. The claims folder reflects that during active service the Veteran complained of and was treated for a back injury associated with falling from a ladder. (See December 2000 Chronological Record of Medical Care). Throughout the appeals process, the Veteran’s lay statements have been consistent, in that he experienced bilateral knee pain during his active service due to the in-service fall and that he has continued throughout his life. (See Hearing transcript page 3). The Board notes that the Veteran is considered competent to report the observable manifestations of his claimed disability. See Charles v. Principi, 16 Vet. App. 370, 374 (2002). The Board notes that the Veteran received a medical opinion in December 2019. The examiner opined that the Veteran’s bilateral knee condition is less likely than not related to the Veteran’s military service or service-connected back disability. The examiner’s opinion was based mainly on the lack of in-service medical treatment for the claimed condition. In so doing, the examiner failed to discuss relevant medical treatment records and the Veteran’s credible lay statements. An opinion based on the absence of treatment records without consideration of a Veteran’s competent reports is inadequate. Dalton v. Nicholson, 21 Vet. App. 23, 39-40 (2007). Further, in the November 2019 remand, the Board instructed the examiner to assume that the Veteran has had chronic knee pain since service. The December 2019 medical opinion does not consider the Veteran’s lay statements or assume that the Veteran’s bilateral knee pain has been chronic. As such, the Board finds the December 2019 medical opinion to be inadequate. A December 2019 VA examination report noted the Veteran with a knee strain, bilaterally. (Continued on the next page) Thus, in light of the Veteran’s confirmed in-service incurrence, the objective clinical medical evidence, and the Veteran’s credible and competent statements in support of the claim, the Board finds that the evidence is at least in equipoise regarding service connection for right knee strain and left knee strain and will resolve reasonable doubt in favor of the appellant. See 38 U.S.C. § 5107; Gilbert v. Derwinski, 1 Vet. App. 49 (1990). Accordingly, service connection for right knee strain and left knee strain is granted. 38 U.S.C. § 5107(b); Gilbert v. Derwinski, 1 Vet. App. 49, 55 (1990). DELYVONNE M. WHITEHEAD Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Brandon A. Williams, 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.