Citation Nr: 21003933 Decision Date: 01/25/21 Archive Date: 01/25/21 DOCKET NO. 11-25 935 DATE: January 25, 2021 ORDER Service connection for a right knee arthritis status post knee replacement is denied. Service connection for a left knee arthritis status post knee replacement is denied. FINDINGS OF FACT 1. The preponderance of the evidence is against finding that the current right knee arthritis status post knee replacement began during active service or is otherwise related to an in-service injury or disease. 2. The preponderance of the evidence is against finding that the current left knee arthritis status post knee replacement began during active service, or is otherwise related to an in-service injury or disease. CONCLUSIONS OF LAW 1. The criteria for service connection for a right knee arthritis status post knee replacement are not met. 38 U.S.C. §§ 1110, 1112, 1113, 1131, 1137, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309. 2. The criteria for service connection for a left knee arthritis status post knee replacement are not met. 38 U.S.C. §§ 1110, 1112, 1113, 1131, 1137, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran had active service in the Marine Corps from June 1980 to June 1984. This matter comes before the Board of Veterans’ Appeals (Board) from a September 2010 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO). The Veteran testified before the undersigned Veterans Law Judge at a videoconference hearing in June 2017. In September 2017 and February 2019, the Board remanded the case for further development. The Veteran seeks service connection for left and right knee disabilities, which he relates to wear and tear associated with the rigors of service, to include carrying heavy tools, forced marches, and physical training runs. The Veteran further asserts that left knee disability worsened due to overcompensating for his right knee. See Board hearing transcript (June 2017). Service connection may be granted for a disability resulting from a disease or injury incurred in or aggravated by active service. See 38 U.S.C. §§ 1110, 1131 (2012); 38 C.F.R. § 3.303 (2017). “To establish a right to compensation for a present disability, a Veteran must show: “(1) the existence of a present disability; (2) 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.” Holton v. Shinseki, 557 F.3d 1362, 1366 (Fed. Cir. 2010) (quoting Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004)). Additionally, for veterans who have served 90 days or more of active service during a war period or after December 31, 1946, certain chronic disabilities, such as arthritis, are presumed to have been incurred in service if manifest to a compensable degree within one year of discharge from service. 38 U.S.C. §§ 1101, 1112; 38 C.F.R. §§ 3.307, 3.309. Initially, the Board acknowledges that the current disability element is satisfied as the Veteran has current disabilities of the left and right knees: arthritis status post knee replacement. The in-service element is also satisfied as the above-referenced rigors of service could have resulted in a potential in-service injury. Additionally, a July 1982 servicer treatment record suggests that the Veteran could have injured his right knee after he kicked a board and was diagnosed with right achilles tendon strain. Turning to whether the current disabilities are related to service, the Board highlights that the following undisputed facts: the Veteran separated from service in 1984, the Veteran testified that he did not experience knee problems until 2007, and knee arthritis was not diagnosed until 2014. As the Veteran’s arthritis was not identified in service and there is no continuity of noted, knee problems in and since service, this case turns on whether the competent evidence of record relates the Veteran’s current knee disabilities to his military service. See 38 C.F.R. § 3.303(a, b, d). Initially, the Board finds that the Veteran is competent to report knee symptoms, such as pain, which are within the realm of his personal experience. 38 C.F.R. § 3.159; see Layno v. Brown, 6 Vet. App. 465, 469-71 (1994). However, the Veteran has not demonstrated the requisite medical experience to support his opinion that his knee problems, which he began to experience in 2007, were related to wear and tear in service more than 20 years earlier. An opinion to this effect is highly complex. In 2017, the Veteran testified that a treatment provider was prepared to render such an opinion. In September 2017 and February 2019, the Board remanded the Veteran’s appeal to afford him the opportunity to submit such an opinion. However, to date, he has not submitted the opinion. The competent medical opinions regarding the etiology of the Veteran’s left and right knee disabilities consist of VA opinions rendered in August 2010 and March 2020. The August 2010 examiner opined that it is less likely than not that the Veteran’s current right knee disability was related to his in-service achilles strain. The March 2020 examiner opined that it is less likely than not that the Veteran’s current left and right knee disabilities are related to service, to include the reported rigors of service or his documented right achilles strain. The examiner reasoned that there is a gap, spanning several decades, between separation from service and when the Veteran’s knee problems began, during which time the Veteran was working in a labor-intensive position. In sum, the Board finds that the competent lay and medical evidence of record does not establish that it is at least as likely as not that the Veteran’s current knee disabilities, which he first experienced in 2007, are related to his military service, which ended more than 20 years earlier. As such, the preponderance of the evidence is against the claims for entitlement to service connection for left and right knee disabilities; there is no doubt to be resolved; and service connection is not warranted. STEVEN D. REISS Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Joshua R. Castillo, 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.