Citation Nr: 21004249 Decision Date: 01/26/21 Archive Date: 01/26/21 DOCKET NO. 15-00 079 DATE: January 26, 2021 ORDER Service connection for a right knee condition is denied. FINDING OF FACT The Veteran’s right knee condition was not shown as chronic in service and did not manifest to a compensable degree within the applicable presumptive period; continuity of symptomatology is not established; and the disability is not otherwise etiologically related to an in-service injury or disease. CONCLUSION OF LAW The criteria for service connection for right knee condition 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 FINDING AND CONCLUSION The Veteran served in the U.S. Navy from March 1982 to December 1984. The issue is on appeal from a November 2012 rating decision and was previously remanded by the Board of Veterans’ Appeals (Board) in May 2018 and May 2020 for additional development. In a September 2020 rating decision, service connection for left knee disability was granted. Therefore, as this claim for service connection was granted, it is no longer on appeal. See AB v. Brown, 6 Vet. App. 35 (1993). Service Connection Service connection may be granted for a disability resulting from a disease or injury incurred in or aggravated by active service. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303(a). 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.” Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004). For a showing of chronic disease in service, there is required a combination of manifestations sufficient to identify the disease entity, and sufficient observation to establish chronicity at the time, as distinguished from merely isolated findings or a diagnosis including the word “chronic.” Continuity of symptomatology is required where the condition noted during service is not, in fact, shown to be chronic or where the diagnosis of chronicity may be legitimately questioned. If the fact of chronicity in service is not adequately supported, then a showing of continuity after discharge is required to support the claim. 38 C.F.R. § 3.303(b). Certain chronic diseases, including arthritis, may be presumed to have been incurred during service if they become disabling to a compensable degree within one year of discharge from service, even though there is no evidence of such disease during service. 38 U.S.C. §§ 1101, 1112, 1113; 38 C.F.R. §§ 3.307, 3.309. When there is an approximate balance of positive and negative evidence regarding the merits of an issue material to the determination of the matter, the benefit of the doubt in resolving each such issue shall be given to the claimant. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102. Service connection for right knee condition The Veteran seeks service connection for right knee condition. The record reflects that the Veteran has a current right knee disability of degenerative arthritis. Therefore, Shedden element (1) has been established. The question before the Board is whether the Veteran’s right knee condition was incurred in or aggravated by service, satisfying Shedden elements (2) and (3). The Board finds that the weight of evidence of record demonstrates that the right knee condition was not incurred in or aggravated by service. Turning to the evidence, the Veteran’s service treatment records, including his December 1984 separation evaluation, are silent for complaints, injuries, or diagnosis involving the right knee. VA and private medical records show complaints and treatment for right knee pain. In August 2011, the Veteran reported to a private physician that his left knee pain was worse than his right knee pain. The Veteran was afforded a VA examination in August 2018. The examiner noted the Veteran had been diagnosed with right knee degenerative arthritis since the 2000’s. The examiner was unable to test active range of motion because the Veteran was paralyzed from the abdomen down and was unable to move his knees and legs due to a stroke. Passive range of motion testing was severely limited and measured from 0 to 15 degrees. Prior to the stroke, the Veteran was ambulating with the assistance of a cane for stability and support due to his bilateral knee degenerative arthritis. The examiner opined that the Veteran’s right knee condition was less likely than not related to active duty service because the Veteran’s service treatment records were silent as to issues with his right knee and did not show a right knee injury. Further, the Veteran’s right knee pain and degenerative arthritis is first documented well after his period of active duty. While the Veteran believes his right knee condition is related to an in-service injury, event, or disease, he is not competent to provide a nexus opinion in this case. This issue is medically complex, as is the ability to interpret complicated diagnostic medical testing and knowledge of the cause and effect relationship of an in-service injury and diagnosis provided many years after separation from service. Jandreau v. Nicholson, 492 F.3d 1372, 1377, 1377 n.4 (Fed. Cir. 2007). Consequently, the Board gives more probative weight to the competent medical evidence. Based on the evidence, the Board finds the record does not show that the Veteran had arthritis during service or within a year of separation from service. The first notation of right knee pain is in August 2011 when the Veteran reported right knee pain to his private physician. Therefore, service connection may not be presumed pursuant to 38 C.F.R. § 3.307 and § 3.309(a). Finally, given the above, the Board finds that service connection for right knee condition must be denied. In reaching this conclusion, the Board has considered the applicability of the benefit-of-the-doubt doctrine. However, as the preponderance of the evidence is against the Veteran’s claim, that doctrine is not applicable. See 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102; see also Gilbert v. Derwinski, 1 Vet. App. 49 (1990); Ortiz v. Principi, 274 F. 3d 1361 (Fed. Cir. 2001). L. M. BARNARD Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board J. Lee 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.