Citation Nr: 21072672 Decision Date: 12/06/21 Archive Date: 12/06/21 DOCKET NO. 16-38 365 DATE: December 6, 2021 ORDER Entitlement to service connection for a right knee disability is denied. FINDING OF FACT The Veteran's right knee disability did not manifest during active service, arthritis did not manifest within one year of discharge from active service, and there is no indication that his right knee disability is otherwise related to his active service. CONCLUSION OF LAW The criteria for service connection for a right knee disability are not met. 38 U.S.C. §§ 1101, 1110, 1112, 5107 (2018); 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309 (2020). REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from August 1974 to September 1976. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a November 2015 rating decision issued by a Department of Veterans Affairs (VA) Regional Office (RO). This case was previously before the Board in June 2021, at which time the issue currently before the Board was remanded for additional development. The case has now been returned to the Board for appellate review. The issue of entitlement to service connection for a low back disability was also remanded by the Board in June 2021. However, in a September 2021 rating decision, the Veteran was granted entitlement to service connection for degenerative disc disease other than intervertebral disc syndrome (IVDS) and lumbar strain. There is no indication from the record that the Veteran has disagreed with the rating or effective date assigned in that decision. Therefore, that decision constitutes a full grant of the benefit sought on appeal and the Board has limited its consideration accordingly. Service Connection Right Knee Disability The Veteran maintains that his current right knee disability was incurred in or is related to active service. Specifically, he asserts that his right knee disability is related to wear and tear and the rigors of military service. A September 1974 service treatment record indicated that the Veteran complained of pain in his right patella due to being kicked. On physical examination, it was noted that there was slight edema with crepitus to the right patella, good range of motion, and pain with palpation. The assessment was soft tissue injury. He was given Robaxin, an analgesic balm, and ace wrap, and was put on light duty for three days. There were no follow-up complaints, treatment, or diagnoses pertaining to the right knee during service. Post service, a June 2007 VA treatment record indicated that the Veteran complained of knee pain. Later records note an assessment of degenerative joint disease/osteoarthritis of the right knee. An August 2015 private treatment record noted that the Veteran complained of right knee pain that started insidiously on or about 1975. During an October 2019 VA examination, the Veteran reported that he believed his knee disability was due to wear and tear over the years since 1975 and that he had experienced a lot of pain since service. X-rays of the right knee were normal. The examiner diagnosed the Veteran with a right knee strain and opined that the disability was less likely than not incurred in or caused by the claimed in-service injury, event, or illness. As explained in the Board's June 2021 remand, the rationale supporting the opinion was inadequate. Therefore, the Board remanded the claim to obtain an additional medical opinion. An additional medical opinion was obtained in September 2021. The VA examiner found that the Veteran's right knee disability did not clearly and unmistakably pre-exist active service. The examiner opined that it is less likely than not the Veteran's current right knee disability had its onset or was otherwise etiologically related to his active service. As rationale, the examiner noted that aside from a right knee soft tissue injury documented in service, the Veteran's medical records were silent for other knee treatments for over ten years following active service. The examiner reasoned that if the Veteran had knee ligament damage or meniscal damage that could have led to an accelerated development of arthritis, he would have needed treatment or evaluation at an earlier time following his separation from service. Regarding the articles submitted by the Veteran in September 2015 and his contention that his right knee disability was related to his duties as a boatswain, the examiner noted that those duties could put some undue strain on the knees; however, if any significant damage had occurred during service, it would be reasonable to expect some record of treatment within 1-2 years of service for the knee conditions due to those injuries. The Board finds that the September 2021 VA medical opinion is adequate because the examiner thoroughly reviewed the claims file and discussed the relevant evidence, considered the contentions of the Veteran, and provided a thorough supporting rationale for the conclusions reached. Barr v. Nicholson, 21 Vet. App. 303 (2007); Stefl v. Nicholson, 21 Vet. App. 120 (2007); Nieves-Rodriguez v. Peake, 22 Vet. App. 295 (2008). Further, there is no medical opinion of record to the contrary. As such, the VA medical opinion of record is the most probative evidence of record. While laypersons are competent to report observable symptoms of a right knee disability, the Veteran is not competent to provide an opinion linking a disability to active service, as that requires medical expertise and is outside the realm of common knowledge of a layperson. Kahana v. Shinseki, 24 Vet. App. 428 (2011); Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007). Therefore, the Veteran is not competent to provide an etiology opinion in this case. Accordingly, the Board finds that the preponderance of the evidence is against the claim and entitlement to service connection for a right knee disability is not warranted. 38 U.S.C. § 5107(b) (2018); Gilbert v. Derwinski, 1 Vet. App. 49 (1990). Sonja A. Mishalanie Acting Veterans Law Judge Board of Veterans' Appeals Attorney for the Board I. Umez-Eronini, Associate 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.