Citation Nr: 21062631 Decision Date: 10/08/21 Archive Date: 10/08/21 DOCKET NO. 17-50 370A DATE: October 8, 2021 ORDER Service connection for a chronic right leg disorder is denied. FINDINGS OF FACT 1. The Veteran had active duty from July 1969 to June 1971. 2. The Veteran sustained a right leg injury in service; symptoms of a right leg disorder were not chronic in service, were not continuous since service, and were not shown to a compensable degree within one year of service. A current right knee disorder, diagnosed as degenerative joint disease (DJD) of the right knee, is not causally or etiologically related to service. CONCLUSION OF LAW A chronic right leg disorder was not incurred in service and is not presumed to have been incurred in service. 38 U.S.C. §§ 1110, 5103(a), 5103A, 5107 (2012); 38 C.F.R. §§ 3.159, 3.303, 3.307, 3.309 (2020). REASONS AND BASES FOR FINDINGS AND CONCLUSION As a procedural matter, in June 2019, the Board remanded the issue for further development. In August 2020, the Board sent a letter to the Veteran indicating that she needed to file a VA Form 10182 to appeal to the Board. As her appeal was being processed in the Legacy system, and she had not attempted to opt-in following the June 2020 supplemental statement of the case (SSOC), this letter was incorrect. The Veteran, in response to the letter, attempted to file a VA Form 10182 the next month; however, it was untimely given the date of the June 2020 SSOC and the original decision on appeal, and further, indicated she did not want to withdraw any issues from the SSOC. As such, the opt-in was improper, and the Board retains jurisdiction to review the appeal under the Legacy system. Turning to the relevant laws and regulations, service connection may be granted on a direct basis as a result of disease or injury incurred in service based on nexus using a three-element test: (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 in or aggravated by service. See 38 C.F.R. §§ 3.303(a), (d); Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009). Service connection may be granted on a presumptive basis for diseases listed in 38 C.F.R. § 3.309 under the following circumstances: (1) where a chronic disease or injury is shown in service and subsequent manifestations of the same disease or injury are shown at a later date unless clearly attributable to an intercurrent cause; or (2) where there is continuity of symptomatology since service; or (3) by showing that the disorder manifested itself to a degree of 10 percent or more within one year from the date of separation from service. See 38 C.F.R. § 3.307. Turning to the evidence, the first element of service connection a current disability is met, as a 2016 private X-ray reflected DJD of the medial compartment of the right knee. This was also shown in subsequent X-rays during the appeal period. As such, the first element of service connection is met. Next, the second element an in-service incurrence is also met, as the evidence shows that the Veteran bruised her right shin falling over a pipe as noted in a July 1969 service treatment record (STR). A July 1969 X-ray was negative, but a shin laceration was noted. In August 1969, a right leg infection and pain were noted, and blood clots from the site of injury were removed. The Veteran was placed on a July 1969 7-day partial profile for a bruised right shin. As an injury to the right leg was shown in service, the second element is met. However, the third element a medical nexus is not met. Specifically, a May 2014 VA examiner found that the right leg laceration was treated in service and did not expect any additional sequalae from the event. In addition, the 2014 examiner found no organic problem with the right leg. In the October 2017 substantive appeal, the Veteran argued that the May 2014 VA examiner failed to consider the severity of her in-service right leg injury, that she was not given enough time to heal and was given noncombat roles due to her leg, which was so swollen she could not lace a boot. Further, she said that her orthopedic surgeon told her that her limp was due to the Army not letting her leg heal properly. In January 2020, a VA examiner found that it was less likely than not that a current right knee disorder was caused by the injury to the right leg in service. The examiner reasoned that the clot was removed from the wound area, and not a deep vein thrombosis. Further, the examiner noted that the profile that the Veteran was placed on was temporary, she was cleared for deployment to Vietnam in May 1970, and there was no chronicity of the right leg condition after 1970, including in the 1971 separation physical. The January 2020 VA examiner noted that right leg injury during service but found there were no residuals other than a scar with no current symptomatology or abnormality. The January 2020 medical opinion was detailed and engaged with the medical evidence both during and following service. Additionally, there is no contradictory medical opinion that connects the Veteran's knee disability to service. Following the July 2019 remand, private medical records to include the notes of her orthopedic surgeon were obtained, and they do not include any findings that her limp or DJD was due to service. Additionally, May 1970 STRs show that she was evaluated for feet disabilities and was deemed fit to deploy to Vietnam and recommended a permanent profile in a supply military occupational specialty as she had difficulty running. Thus, she was not in a combat role due her feet disorders rather than her right leg injury. Additionally, the January 2020 VA examiner considered in detail the injury to the right leg that occurred during service. As such, the third element is not met and the medical evidence does not support service connection on a direct basis DJD is a chronic disease such that presumptive service connection under 38 C.F.R. §§ 3.307 and 3.309 will be considered. To that end, the Veteran was not diagnosed with a chronic disease during service nor did one manifest to a compensable degree in the year following separation from service. As noted above, DJD was not shown during service and was not diagnosed until 2016, more than 40 years after discharge. Next, continuity of symptomatology has not been shown. Here, STRs from the last two years of service are silent for right knee pain, to include the separation examination. Further, the post-service medical records do not show right knee symptoms until she filed her claim in 2014. October 2015 private medical records show she denied knee problems at that time. While private medical records show treatment for a right knee disorder and a history of right knee pain, they do not show a history of consistent symptoms beginning decades earlier when the Veteran separated from service. As such, the medical evidence does not support continuity of symptomatology, and service connection on a presumptive basis is not warranted by the evidence. The Board has considered the Veteran's lay statements that that her disorder was caused by service. She is competent to report symptoms because this requires only personal knowledge as it comes to her through her senses. However, she is not competent to offer an opinion as to the etiology of her current disorder due to the medical complexity of the matter involved. Such competent evidence has been provided by the service records, clinical evidence, and examinations obtained and associated with the claims file. Here, the Board attaches greater probative weight to the clinical findings than to her statements. In light of the above, the preponderance of the evidence is against the claim for service connection and there is no doubt to be otherwise resolved. As such, the appeal is denied. Finally, the Veteran has not raised any other issues, nor have any other issues been reasonably raised by the record, for the Board's consideration. See Doucette v. Shulkin, 28 Vet. App. 366, 369-370 (2017) (confirming that the Board is not required to address issues unless they are specifically raised by the claimant or reasonably raised by the evidence of record). L. HOWELL Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Brendan A. Evans, 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.