Citation Nr: 21067180 Decision Date: 11/03/21 Archive Date: 11/03/21 DOCKET NO. 15-06 301 DATE: November 3, 2021 ORDER Service connection for bilateral knee pain to include swollen knees is granted. Service connection for a right ankle disability is granted. FINDINGS OF FACT 1. The Veteran asserts that she experiences bilateral knee pain. While the post-service evidence of record has not provided a specific diagnosis for the Veteran's complaints of bilateral knee pain, she has credibly reported that her bilateral knee pain causes functional impairment. 2. The Veteran asserts that she experiences right ankle pain. While the post-service evidence of record has not provided a specific diagnosis for the Veteran's complaints of right ankle pain, she has credibly reported that her right ankle pain causes functional impairment. CONCLUSIONS OF LAW 1. The criteria for service connection for a bilateral knee condition (manifested by pain and functional impairment) have been met. 38 U.S.C. §§ 1101, 1131, 5107; 38 C.F.R. § 3.303, 3.307, 3.309. 2. The criteria for service connection for a right ankle condition (manifested by pain and functional impairment) have been met. 38 U.S.C. §§ 1101, 1131, 5107; 38 C.F.R. § 3.303, 3.307, 3.309. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran was a member of the Army Reserve with active duty from March 1987 to June 1987. This appeal was previously remanded in October 2018 for additional development, which has since been completed. See Stegall v. West, 11 Vet. App. 268, 271 (1998). In September 2021, the Veteran failed to appear for a video conference hearing before a Veterans Law Judge. She has not provided good cause for her absence, or requested the hearing be rescheduled. As the Veteran was properly notified of the time, date and location of his scheduled hearing and failed to appear, her hearing request is deemed withdrawn. Service Connection Service connection requires competent evidence showing: (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. Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004). The Veteran asserts that his current right ankle and bilateral knee disability, each including pain and swelling and her is due to basic training during her active duty service. Specifically, the Veteran stated on her Notice of Disagreement and VA Form 9 that she injured her knees and right ankle during basic training and that over the years her pain has worsened. She further stated that she had pain while walking because her knees and legs were inflamed and swollen and that the pain also prevented her from stand for long periods of time. The Veteran's service treatment records show a that in April 1987 the Veteran had a right ankle sprain and was instructed not to march, run, jump, or perform physical training for three days. She was instructed to use crutches at all times. During the same month, a sick slip noted swollen knees. The Veteran was afforded a VA examination for her knees and ankle in March 2013. She stated that the date of onset of the symptoms were in 1987 during physical training while running on gravel. The Veteran stated her bilateral knees began to swell over time during training and worsened over time. The Veteran stated that she was unable to walk for long periods of time due to her conditions. She stated her right ankle condition worsened over time with sharp pain. Her bilateral knee conditions also prevented her from going up and down the stairs or getting up. After an in-person examination and a review of the Veteran's claims file, the VA examiner found that the Veteran did not have a diagnosis for any bilateral knee conditions or a right ankle condition. The VA examiner opined it was less likely than not that the Veteran's bilateral knee conditions and right knee condition was incurred in or caused by the claimed in-service injury, event, or illness. The VA examiner stated that there was no service treatment record referencing a knee or a right ankle condition, outside of a single sick slip describing "swollen knees" and a single notation referencing a temporary ankle sprain. The VA examiner stated this reflected that the conditions were temporary and demonstrated a 26 year time gap from this evaluation in 2013 which did not "establish a longitudinal trend of subjective complaints and objective findings; therefore, a causal relationship cannot be established." After consideration of the entire record and the relevant law, the Board finds that the Veteran's bilateral knee condition to include swollen knees and swollen right ankle with pain is related to service and service connection is established The Board acknowledges that the Veteran was afforded a VA examination in March 2013 where the VA examiner did not find a specific diagnosis for any bilateral knee or right ankle conditions. However, the Board notes that pain alone, even without an underlying pathology or diagnosis, can constitute a disability, where such pain results in functional impairment. Saunders v. Wilkie, 886 F.3d 1356 (Fed. Cir. 2018). Here, the Board finds that service connection for bilateral knee and right ankle pain is warranted. The Veteran credibly testified that she experienced injury to her knees and right ankle in service which is supported by the service treatment record. She has credibly stated that her since her injuries in active duty, her symptoms have continued since and have worsened. The Board acknowledges that the March 2013 VA examiner determined that the Veteran did not have a current diagnosed disability of the bilateral knees or right ankle. However, the Board finds that the Veteran has shown that her bilateral knee and right ankle pain constitutes a disability because she credibly testified that her pain results in functional impairment. For example, she testified that she was unable to stand for long periods of time and that she was unable to move up and down stairs. She also stated she was unable get up. It is noted that at a Social Security Administration examination, the Veteran consistently reported that her knee and right ankle pain had begun during basic training. Here, the Veteran is competent to describe a continuity of bilateral knee and right ankle symptoms, to include both pain swelling and she has consistently and credibly reported a continuity of such symptoms. The Board is satisfied that the evidence has established that the onset of the Veteran's bilateral knee and right ankle symptoms started during her active duty service, manifested by pain and swelling during and since separation; and that her bilateral knee and right ankle pain has resulted in functional impairment, which constitutes a disability. (Continued on the next page) Accordingly, based on the above findings and affording the Veteran the benefit of the doubt, the claims of service connection for bilateral knee pain and right ankle pain are granted. MATTHEW W. BLACKWELDER Veterans Law Judge Board of Veterans' Appeals Attorney for the Board H. Yoo, 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.