Citation Nr: 21069190 Decision Date: 11/17/21 Archive Date: 11/17/21 DOCKET NO. 17-23 677 DATE: November 17, 2021 ORDER Service connection for osteoarthritis of the left ankle is granted. FINDINGS OF FACT 1. The Veteran has a current disability of osteoarthritis of the left ankle. 2. Symptoms of osteoarthritis of the left ankle were chronic in service and continuous since service. CONCLUSION OF LAW Resolving reasonable doubt in the Veteran's favor, the criteria for service connection for osteoarthritis of the left ankle have been met. 38 U.S.C. §§ 1110, 1112, 1131, 1154, 5103, 5013A, 5107; 38 C.F.R. §§ 3.102, 3.159, 3.303, 3.307, 3.309. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty in the Army during the Gulf War Era and Peacetime from May 1987 to January 1992. Service connection for a left ankle disorder was initially denied in an August 2003 Rating Decision. The issue was considered reopened in a December 2014 Rating Decision, but the Agency of Original Jurisdiction (AOJ) denied the claim. The Veteran filed a timely appeal. Accordingly, the December 2014 Rating Decision is the basis of the current Board decision. Service connection for osteoarthritis of the left ankle is granted. Service connection may be granted for a disability resulting from disease or injury incurred in or aggravated by active military, naval, or air service. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303(a). Service connection may be granted for any disease diagnosed after discharge, when all the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303(d). As a general matter, service connection for a disability requires evidence of: (1) the existence of a current disability; (2) the existence of the disease or injury in service, and; (3) a relationship or nexus between the current disability and any injury or disease during service. Osteoarthritis (a form of arthritis) is a "chronic" disease under 38 C.F.R. § 3.309(a); therefore, the presumptive service connection provisions under 38 C.F.R. § 3.303(b) for service connection based on "chronic" symptoms in service and "continuous" symptoms since service are applicable. Walker v. Shinseki, 708 F.3d 1331 (Fed. Cir. 2013). For the 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. With chronic disease as such in service, subsequent manifestations of the same chronic disease at any later date, however remote, are service connected, unless clearly attributable to intercurrent causes. If a condition noted during service is not shown to be chronic, then generally, a showing of continuity of symptoms after service is required for service connection. 38 C.F.R. § 3.303(b). In addition, the law provides that, where a veteran served 90 days or more of active service, and certain chronic diseases such as osteoarthritis become manifest to a degree of 10 percent or more within one year after the date of separation from such service, such disease shall be presumed to have been incurred in service, even though there is no evidence of such disease during the period of service. 38 U.S.C. §§ 1101, 1112, 1113, 1137; 38 C.F.R. §§ 3.307, 3.309(a). While the disease need not be diagnosed within the presumption period, it must be shown, by acceptable lay or medical evidence, that there were characteristic manifestations of the disease to the required degree during that time. The Veteran contends that he injured his left ankle during training in 1987. He reports that ankle pain and swelling persisted, and the ankle give out throughout service, and that these symptoms continued after service. See August 2021 Board Hearing Transcript. The evidence shows a current disability of osteoarthritis of the left ankle. A January 2017 VA examination confirmed a diagnosis of osteoarthritis of the left ankle. After weighing the evidence, lay and medical, the Board finds that the evidence is at least in equipoise on the questions of whether symptoms of osteoarthritis of the left ankle were chronic in service and continuous after separation. Service treatment records show chronic symptoms of ankle pain in service. The Veteran was treated for a left ankle injury in July 1987. Treatment records from December 1987 note a separate ankle sprain that occurred three months prior (September 1987). The December 1987 treatment record notes chronic pain from a grade I ankle sprain. The Veteran was treated again for a sore left ankle in June 1990. VA treatment records show that after service the Veteran has received treatment for left ankle pain. A record from December 2010 notes treatment for left ankle pain. A September 2015 VA treatment record notes treatment for chronic left ankle pain. The Veteran has credibly and competently reporting experiencing pain and some instability in the left ankle continuously since the 1987 in-service injury. See August 2021 Board Hearing Transcript. History reported by the Veteran for treatment purposes to a private physician in February 2015 is consistent with this narrative: the Veteran stated that he has never felt fully stable on the left ankle since 1987, and has had swelling and pain on a regular basis since 1987. See February 2017 Private Treatment Record. Resolving reasonable doubt in the Veteran's favor, the Board finds that the criteria for presumptive service connection for osteoarthritis of the left ankle have been met. 38 U.S.C. § 5107; 38 C.F.R. § 3.102. As presumptive service connection is being granted, there is no need to discuss entitlement to service connection on a direct or any other basis, as other theories of service connection have been rendered moot, leaving no question of law or fact to decide. See 38 U.S.C. § 7104. In this regard, while January 2017 VA examiner opined that it was less likely than not that the current left ankle osteoarthritis was connected to service, this direct service connection opinion has been rendered moot. J. PARKER Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Plambeck, Charles 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.