Citation Nr: 21063011 Decision Date: 10/12/21 Archive Date: 10/12/21 DOCKET NO. 14-38 285A DATE: October 12, 2021 ORDER Entitlement to service connection for an acquired psychiatric disorder is granted. FINDING OF FACT Resolving all reasonable doubt in the Veteran's favor, his psychiatric disorder is proximately caused by his service-connected left knee disability. CONCLUSION OF LAW The criteria for entitlement to service connection for an acquired psychiatric disorder have been met. 38 U.S.C. § 1110; 38 C.F.R. §§ 3.102, 3.303, 3.310. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran had active duty service in December 2001. The Board notes that the Veteran initially requested a Board hearing on this issue, but has since waived his hearing request. Service Connection Service connection is warranted where the evidence of record establishes that a particular injury or disease resulting in disability was incurred in the line of duty in the active military service or, if pre-existing such service, was aggravated thereby. 38 U.S.C. § 1110; 38 C.F.R. § 3.303(a). Service connection may be established for any disease diagnosed after discharge, when all of the evidence, including that pertinent to service, establishes that disease was incurred in service. 38 C.F.R. § 3.303(d). Generally, to prevail on a claim of service connection on the merits, there must be competent evidence of (1) current disability; (2) medical, or in certain circumstances, lay evidence of in-service incurrence or aggravation of a disease or injury; and (3) medical evidence or other competent evidence of a nexus between the claimed in-service disease or injury and the present disease or injury. See Hickson v. West, 12 Vet. App. 247 (1999); Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007). Service connection may also be established on a secondary basis for a disability that is proximately due to or the result of a service-connected disease or injury or aggravated by a service-connected disease or injury. 38 C.F.R. § 3.310. Secondary service connection generally requires (1) a current disability; (2) a service-connected disability; and (3) a nexus between the service-connected disability and the current disability. See Wallin v. West, 11 Vet. App. 509, 512 (1998). When there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, the benefit of the doubt will be granted to the claimant. 38 U.S.C. § 5107; 38 C.F.R. §§ 3.102, 4.3; Gilbert v. Derwinski, 1 Vet. App. 49, 53 (1990). To deny a claim on the merits, the preponderance of the evidence must be against the claim. Alemany v. Brown, 9 Vet. App. 518, 519 (1996). 1. Entitlement to service connection for bipolar disorder The Veteran contends that he has a mental disability caused by his service-connected left knee disability. The Board notes that the evidence indicates that the Veteran has a current diagnosis of bipolar disorder. The Veteran's medical records from February 2005 to November 2012 also show that the Veteran received mental health treatment for depressive disorder, and an August 2012 record notes a diagnosis of bipolar disorder. The Veteran's records from February 2012 to May 2014 also show mental health care and diagnoses of bipolar disorder and mood disorder. The Veteran has also submitted lay statements describing his observable symptoms. In addition, the Veteran's record confirms that he is currently service-connected for a left knee disorder. As such, the remaining question for the Board is whether the Veteran's currently diagnosed psychiatric disorders are related to his service-connected left knee disability. The Veteran was afforded a VA examination in April 2013. The examiner determined that the Veteran's bipolar disorder was less likely than not proximately due to or the result of laxity due to his left knee anterior cruciate degenerative joint disease of the left knee. The examiner reasoned that the service treatment records did not support the claim; bipolar disorder could not be caused by a left knee disability. The examiner further noted several medical definitions of bipolar disorder and included citations to his sources. In April 2015, a private clinical psychologist provided an opinion. The psychologist provided a lengthy and thorough review of the Veteran's symptoms and feelings, as well as his in-service knee injury and how that impacted him. At the end of the evaluation, the psychologist found that the Veteran's psychiatric disorder was most likely caused by or the result of his service-connected left lower extremity disorder. The psychologist reasoned that physical labor is all the Veteran knew and his only job experience for over 20 years. Upon losing his physical health, he developed depression. The Board determines that the evidence supporting a nexus between the Veteran's service-connected left knee disability and his psychiatric disorder is at least in equipoise to establish service connection on a secondary basis. Giving the benefit of the doubt to the Veteran, the Board must resolve reasonable doubt in favor of the Veteran. As each element of the service connection framework is met, secondary service connection for the Veteran's acquired psychiatric disorder is warranted and the claim is granted. JENNIFER HWA Veterans Law Judge Board of Veterans' Appeals Attorney for the Board E. Vosburgh, Associate 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.