Citation Nr: 21071156 Decision Date: 11/29/21 Archive Date: 11/29/21 DOCKET NO. 15-00 527 DATE: November 29, 2021 ORDER Service connection for left knee osteoarthritis is granted. FINDING OF FACT The Veteran's left knee osteoarthritis began in service. CONCLUSION OF LAW Resolving all doubt in favor of the Veteran, the criteria for service connection for left knee osteoarthritis, are met. 38 U.S.C. §§ 1101, 1110, 1112, 1113, 1137, 5107; 38 C.F.R. §§ 3.303, 3.304, 3.307, 3.309. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran had active duty service from July 1973 to July 1975. The appeal for service connection for the left knee disability was remanded in August 2018, May 2020, and June 2021 for further development. The Board also notes that in a February 2019 rating decision, the Veteran was declared incompetent to handle fiduciary matters, and a custodian was assigned. Entitlement to service connection for a left knee disorder. Service connection may be granted for a disability resulting from disease or injury incurred in or aggravated by service. 38 U.S.C. § 1110; 38 C.F.R. § 3.303 (a). Service connection may also be granted for any disease diagnosed after discharge, when all of the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303 (d). Direct service connection may not be granted without evidence of (1) a current disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a nexus between the claimed in-service disease or injury and the present disease or injury. 38 U.S.C. § 1112; 38 C.F.R. § 3.304. See Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004). Additionally, for Veterans who served 90 days or more of active service during a war period or after December 31, 1946, certain chronic disabilities, including arthritis, are presumed to have been incurred in service if manifest to a compensable degree within one year of discharge from service. 38 U.S.C. §§ 1101, 1112; 38 C.F.R. §§ 3.307, 3.309. Alternatively, when a disease at 38 C.F.R. § 3.309 (a) is not shown to be chronic during service or the one-year presumptive period, service connection may also be established by showing continuity of symptomatology after service. See 38 C.F.R. § 3.303 (b). The use of continuity of symptoms to establish service connection is limited only to those diseases listed at 38 C.F.R. § 3.309 (a). Walker v. Shinseki, 708 F.3d 1331 (Fed. Cir. 2013). The determination as to whether the requirements for service connection are met is based on an analysis of all the evidence of record and the evaluation of its credibility and probative value. 38 U.S.C. § 7104 (a) (2012); Baldwin v. West, 13 Vet. App. 1 (1999); see 38 C.F.R. § 3.303 (a). When there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, the Secretary shall give the benefit of the doubt to the claimant. 38 U.S.C. § 5107; 38 C.F.R. § 3.102; see also Gilbert v. Derwinski, 1 Vet. App. 49, 53 (1990). In this case, there is no dispute that the Veteran has a current diagnosis of left knee osteoarthritis. See e.g., August 2021 VA examination report. The Veteran asserts that his left knee disorder began in service when he was low crawling during training, in service. Service connection is already in effect for a right knee disability due, in part, to the same event. Service treatment records do not include treatment for either knee in service. The Veteran has indicated that he has experienced left knee symptoms since service. He has consistently reported the same since he filed his claim for service connection in January 2012. Additionally, a May 1991 VA examination report regarding a different claim, noted that the Veteran had a left patella dislocation "many years ago." During the pendency of the claim, the Veteran was provided with VA examinations in March 2021 and August 2021. Neither of the VA opinions were favorable; however, the Board finds neither can be relied upon to determine whether service connection is warranted. As explained in the June 2021 remand, the March 2021 VA examiner did not provide adequate rationale for the opinion with respect to the left knee. In August 2021, the VA examiner determined that the left knee disorder was not due to service and explained that the opinion was based on a lack of service treatment records showing injuries while low crawling. In reaching this conclusion, the examiner did not address the Veteran's reports of continuity of symptoms since service, or the March 2021 VA examiner's determination that the current right knee disability was related, in part, to the low crawling event in which the Veteran rammed his knee into stumps while crawling, even though service treatment records did not show treatment for right knee injuries. Further, VA treatment records indicated that the Veteran had meniscus tear in the left knee as well. See February 2021 VA treatment record citing 2016 MRI report; see also December 2011 VA MRI report. As the August 2021 VA examiner did not address the Veteran's statements, or the other VA records which lend credibility to the Veteran's statements, the Board affords the August 2021 VA opinion limited probative weight. There is no evidence of an intervening cause since service that would have led to the present arthritis in the left knee. Moreover, given the longstanding claim and that VA has twice attempted but failed to obtain an adequate VA opinion, the Board finds that a remand for an addendum opinion would be futile and only unduly delay resolution of the claim. Based on the above, the Board finds that the evidence is at least in equipoise as to whether the Veteran's left knee osteoarthritis had in-service onset. Resolving all doubt in the Veteran's favor, the benefit sought on appeal is granted. J. NICHOLS Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Donna D. Ebaugh, 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.