Citation Nr: 21071159 Decision Date: 11/29/21 Archive Date: 11/29/21 DOCKET NO. 13-07 998 DATE: November 29, 2021 ORDER Service connection for a back disability is granted. Service connection for a left knee disability is granted. FINDINGS OF FACT 1. A March 2020 VA examination report obtained on remand confirmed diagnoses for low back disabilities (e.g., degenerative arthritis, spondylosis, and intervertebral disc syndrome with associated radiculopathy and neuropathy). 2. The Veteran has presented competent and credible lay evidence (including during sworn testimony before the undersigned) that provides detailed accounts of a back injury that occurred during service after he slipped and fell off a makeshift ramp to empty 55-gallon barrels into a tanker during his time in Southeast Asia. VA previously conceded that he did serve in Southeast Asia, and although formal inquiries could not confirm the specific incident, these inquiries, critically, do not refute or otherwise contradict the Veteran's consistent reports. 3. The Veteran has also presented competent and credible lay reports and testimony that he has dealt with back symptoms ever since that injury that initially went unreported and undetected because of their mild nature at onset and the fact that his back problems were "the last thing" on his mind following the in-service fall and loss of consciousness. The March 2020 VA examiner's opinion supports a relationship between his present low back disability and the in-service injury, citing to the consistency of his account throughout the record and across evaluations for different medical concerns, as well as to psychiatric evaluations that found him a credible historian. The examiner also noted that there is nothing in the medical records to support "another cause for further back conditions" and pointed to literature indicating his military occupational specialty (heavy equipment operator) is consistent with tasks, movements, activity, and hazards that "expose them to many hazards which may lead to health problems," including musculoskeletal disorders. 4. Considering the above and the fact that the Board's prior decisions collectively found the other relevant opinions of record inadequate to decide the claim, the Board finds the evidence reasonably shows that the current low back disability is causally related to military service. 5. A March 2020 VA examination report obtained on remand confirmed multiple left knee diagnoses, including degenerative arthritis confirmed by X-rays. 6. The Veteran has presented competent and credible lay reports and sworn testimony providing consistent and detailed accounts of a left knee injury that occurred during basic training when a heavy container fell on his left knee, and that he has dealt with observable left knee symptoms (like tenderness and pain) ever since. 7. The March 2020 VA examiner's opinion also supports a relationship between his present left knee disability and the in-service injury, citing to the consistency of the Veteran's accounts throughout the record and those reports' consistency with his left knee medical history, characteristics of an overuse injury, and "multi-factorial events that led to a chronic condition." Specifically, she felt that these events "led to the progression of degenerative arthritis" and noted evidence showing "continuing care and treatment for both the left and right knee." She also pointed again to the literature indicating heavy equipment operators are exposed to hazards and strains that may further contribute to development of various musculoskeletal disorders. 8. Considering the above and the fact that the Board's prior decisions collectively found the other relevant opinions of record inadequate to decide the claim, the evidence reasonably shows a left knee disability is related to military service. CONCLUSIONS OF LAW 1. The criteria for service connection for a back disability are met. 38 U.S.C. §§ 1110, 1112, 1113, 5107(b) (2018); 38 C.F.R. §§ 3.102, 3.303(b), 3.307, 3.309 (2020). 2. The criteria for service connection for a left knee disability are met. 38 U.S.C. §§ 1110, 1112, 1113, 5107(b) (2018); 38 C.F.R. §§ 3.102, 3.303(b), 3.307, 3.309 (2020). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The appellant is a Veteran who served on active duty from February 1965 to October 1968. These matters are before the Board of Veterans' Appeals (Board) on appeal from a September 2011 rating decision. In September 2015, the Veteran testified before a Veterans Law Judge (VLJ) who issued a February 2016 decision, but is no longer at the Board. The Board denied these claims in February 2018. The United States Court of Appeals for Veterans Claims granted a Joint Motion for Partial Remand (JMPR) in these matters in October 2018. In July 2019, the Veteran testified at a new hearing before the undersigned, and these claims were remanded in December 2019. Transcripts of both hearings in these matters are of record. Although this appeal previously included service connection for a right knee disability, that claim has been resolved by a July 2021 rating decision fully granting that benefit. The Board notes that the July 2021 supplemental statement of the case (SSOC) improperly added the issue of a total disability rating based on individual unemployability (TDIU) to the issues on appeal. There is no indication that a TDIU appeal was ever formally perfected and there is no legal mechanism by which the Board could assume jurisdiction of that appeal sua sponte, because the issues currently before the Board are matters of service connection, and implicit TDIU pertains to the disability rating for disabilities that are already service connected. For the reasons outlined above, the Board grants the appeals in full, obviating any need for further detailed discussion thereof at this time. VICTORIA MOSHIASHWILI Veterans Law Judge Board of Veterans' Appeals Attorney for the Board M. Yuan, 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.