Citation Nr: 21061431 Decision Date: 10/04/21 Archive Date: 10/04/21 DOCKET NO. 19-02 794A DATE: October 4, 2021 ORDER Entitlement to service connection for left knee tendonitis/tendinosis is granted. Entitlement to service connection for a right knee tendonitis/tendinosis is granted. Entitlement to service connection for lumbosacral strain is granted. Entitlement to service connection for cervical strain is granted. FINDINGS OF FACT 1. The Veteran's left knee tendonitis/tendinosis had its onset in service. 2. The Veteran's right knee tendonitis/tendinosis had its onset in service. 3. The Veteran's lumbosacral strain had its onset in service. 4. The Veteran's cervical strain had its onset in service. CONCLUSIONS OF LAW 1. The criteria for service connection for left knee tendonitis/tendinosis have been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303. 2. The criteria for service connection for right knee tendonitis/tendinosis have been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303. 3. The criteria for service connection for lumbosacral strain have been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303. 4. The criteria for service connection for cervical strain have been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty in the United States Army from June 2005 to November 2005 and May 2008 to April 2010, including service in Afghanistan, as well as additional Army National Guard service. These matters come before the Board of Veterans' Appeals (Board) on appeal from a February 2018 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO). The Veteran testified before the undersigned Veterans Law Judge in a June 2021 virtual hearing. Service Connection 1. Entitlement to service connection for a left knee disability. 2. Entitlement to service connection for a right knee disability. 3. Entitlement to service connection for a lower back disability. 4. Entitlement to service connection for a neck disability. 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; 38 C.F.R. § 3.303. A veteran seeking compensation under these provisions must establish three elements: "(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." Saunders v. Wilkie, 886 F.3d 1356, 1361 (Fed. Cir. 2018) (quoting Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004)). In this case, the Veteran contends that her disabilities are due to a motor vehicle accident during service. See June 2021 hearing. The Veteran's service treatment records show that on August 20, 2008, the driver's side tire failed (i.e., exploded), causing her to lose control of the vehicle, the car overturned onto the passenger side and slid approximately 177 feet. See August 20, 2008 accident report. She received immediate treatment and was diagnosed with neck strain, back strain, and bilateral knee contusion. See August 20, 2008 injury status report. Subsequent outpatient service treatment records include an August 2008 x-ray report that found straightening of the cervical spine, which was indicated can be associated with cervical strain. An October 2008 report noted her complaint of cervical spine pain since the August 2008 accident, as well as her complaint of lower back pain. An April 2009 report listed the Veteran's problems included patellar tendonitis, cervicalgia, knee sprain, and backache. A September 2009 report noted her complaint of lower back pain secondary to the August 2008 injury and her complaint of neck pain on both sides. And October 2009 reports document the Veteran's rehabilitation for her back strain. Post-service treatment records show in October 2010, within a year of discharge from active duty, the Veteran received VA treatment for complaints of bilateral knee pain, low back pain, and neck pain since service. The record also reflects diagnoses of bilateral knee tendonitis/tendinosis, lumbosacral strain and cervical strain. See December 2017 VA knee and lower leg conditions, back conditions, and neck conditions examinations. Thus, the Veteran has satisfied the first element of service connection for her disabilities. The Veteran has testified experiencing recurrent right and left knee, lower back, and neck pain that had its onset during active service, and particularly the August 20, 2008 motor vehicle accident. See, e.g., June 2021 virtual hearing. The Veteran is competent to report right and left knee, lower back, and neck pain, and the Board does not question the credibility of the Veteran's reports of recurrent right and left knee, lower back, and neck pain. Indeed, her statements are corroborated by the in-service and post-service treatment records, as documented above. The Veteran has also submitted a June 2021 lay statement from B.B., who states knowing the Veteran since August 2004 (prior to the Veteran's active duty service), and that since the August 2008 motor vehicle accident, the Veteran has had recurrent bilateral knee, lower back and neck symptomatology. The Veteran has also submitted a June 2021 statement prepared by Dr. A.M., a VA staff physician. The VA physician noted that the Veteran received treatment for her conditions in the military and continues to have the issues; the examiner opined that it was more likely than not the Veteran's right and left knee, lower back, and neck pain were service connected. Hence, in light of the competent and credible lay evidence, as well as supporting lay statements and medical opinion, the Board finds that the Veteran's diagnosed right and left knee, lower back, and neck disabilities became manifested while she was on active duty. As such, the Board concludes that the evidence shows that the disabilities became manifest while the Veteran was on active duty and thus were incurred in service. 38 U.S.C. § 1110; 38 C.F.R. § 3.303(a). Thus, all three elements necessary to establish service connection have been met. In reaching this determination, the Board acknowledges the negative nexus opinions provided in the December 2017 VA examinations. The Board notes that the examiners indicated there was no evidence of a neck injury at the time of the accident in August 2008, and that following the accident the next record documenting treatment for a back condition or knee condition was eight years later (i.e., 2016). However, as provided above, the record contains clear evidence the Veteran received treatment for a neck strain at the time of the August 20, 2008 accident. In addition, treatment records during her active duty service show treatment for her lower back disability, and she complained of bilateral knee, lower back, and neck pain since service within one year after her active duty service. Hence, it appears the December 2017 negative nexus opinions were based on an inaccurate factual premise, and they are entitled to no probative value. See Reonal v. Brown, 5 Vet. App. 458 (1993). In summary, the Board has considered the applicability of the benefit of the doubt doctrine. As the preponderance of the evidence supports the Veteran's claim, the Veteran's claims for service connection for a right and left knee, lower back, and neck disabilities are granted. 38 U.S.C. § 5107; 38 C.F.R. § 3.102; Gilbert v. Derwinski, 1 Vet. App. 49 (1990). STEVEN D. REISS Veterans Law Judge Board of Veterans' Appeals Attorney for the Board J. Marley, 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.