Citation Nr: 21071987 Decision Date: 12/02/21 Archive Date: 12/02/21 DOCKET NO. 18-06 725 DATE: December 2, 2021 ORDER Entitlement to service connection for right knee degenerative joint disease as secondary to service-connected right foot hallux valgus is granted. FINDING OF FACT The Veteran's right knee degenerative joint disease is proximately due to her service-connected right foot hallux valgus. CONCLUSION OF LAW The criteria for service connection for right knee degenerative joint disease as secondary to service-connected right foot hallux valgus are met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.310. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from October 1984 to March 1985. The claim was previously before the Board in April 2021. There has been substantial compliance with the remand in connection with claim decided here and the Board will proceed with adjudication. Stegall v. West, 11 Vet. App. 268 (1998). Subsequent to the remand, service connection was granted for the left knee. See July 2021 rating decision. Service connection right knee disability. The Veteran contends that her right knee disability is due to his service-connected right foot hallux valgus. Service connection may be granted for a disability resulting from disease or injury incurred or aggravated during active military service. 38 U.S.C. § 1131. Generally, service connection requires (1) the existence of a present disability, (2) in-service incurrence or aggravation of an injury or disease, 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 (Fed. Cir. 2004). Service connection may also be established on a secondary basis for a disability which is proximately due to or the result of service-connected disease or injury. 38 C.F.R. § 3.310 (a). Establishing service connection on a secondary basis requires evidence sufficient to show (1) that a current disability exists, and (2) that the current disability was either (a) proximately caused or (b) proximately aggravated by a service-connected disability. Allen v. Brown, 7 Vet. App. 439 (1995). The record includes reports of numerous VA knee examinations which the Board previously determined were inadequate. Therefore, the Board's analysis will focus on the most recent VA examinations. The June 2021 VA examination shows the Veteran has a current disability of right knee osteoarthritis, and the examiner opined that it is at least as likely as not proximately due to or the result of her service-connected right foot hallux valgus. The examiner provided a positive opinion as to both knees. The examiner specifically cited medical literature that supports the development of degenerative joint disease in the knee due to leg length discrepancy, which the examiner found to be a result of the Veteran's severe right foot pronation. Following this opinion, the agency of original jurisdiction (AOJ) sought to obtain an addendum that addressed whether a fall that resulted in a right knee injury was related to the service-connected hallux valgus. A different examiner answered that question in the negative. The Board affords that opinion little probative value because it did not address whether the Veteran had a right knee disability that was caused or aggravated by her service-connected hallux valgus. The examiner focused only on the cause of the specific injury and did not address the prior examiner's positive opinion that considered the effect on both knees. The Board finds the evidence to at least be in equipoise as to whether the Veteran's current right knee degenerative joint disease is proximately due to her service-connected right foot hallux valgus. Accordingly, after resolving all doubt in favor of the Veteran, the Board finds that service connection for right knee degenerative joint disease is warranted. 38 U.S.C. § 5107; 38 C.F.R. § 3.102. M.E. Larkin Veterans Law Judge Board of Veterans' Appeals Attorney for the Board P.S. McLeod 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.