Citation Nr: 21073223 Decision Date: 12/07/21 Archive Date: 12/07/21 DOCKET NO. 18-34 482 DATE: December 7, 2021 ORDER Entitlement to service connection for right knee arthritis, to include as secondary to service-connected shin splints, is granted. Entitlement to service connection for left knee arthritis, to include as secondary to service-connected shin splints, is granted. Entitlement to service connection for right lower extremity radiculopathy (claimed as hip condition), to include as secondary to service-connected shin splints, is granted. Entitlement to service connection for a back disability, to include as secondary to service-connected shin splints, is granted. FINDING OF FACT The Veteran's right knee arthritis, left arthritis, right lower extremity radiculopathy, and back disability are etiologically related to her service-connected shin splints. CONCLUSION OF LAW The criteria for service connection for right knee arthritis, left knee arthritis, right lower extremity radiculopathy, and a back disability as secondary to service-connected shin splints have been met. 38 U.S.C. § §§ 1110, 5107; 38 C.F.R. § §§ 3.102, 3.303, 3.310. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from April 1993 to June 1993. These matters come to the Board of Veterans' Appeals (Board) on appeal from a February 2016 rating decision issued by a Department of Veterans Affairs (VA) Regional Office (RO). The Board acknowledges the May 2017 rating decision, which noted these claims were received via a December 2016 application. However, the claims were previously addressed in a February 2016 rating decision. While the Veteran did not submit a Notice of Disagreement, new and material evidence was received within one year of the decision. See January 2017 Medical Treatment Record (containing a positive nexus statement towards the disabilities on appeal). No final decision addressed this evidence. Thus, the February 2016 rating decision did not become final, and these claims arrive at the Board from that decision. 38 C.F.R. § 3.156 (b). In November 2021, the Veteran presented testimony before the undersigned Veterans Law Judge. A transcript will be added to the record. Service Connection Establishing service connection generally requires competent evidence of three things: (1) a current disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship, i.e., a nexus, between the claimed in-service disease or injury and the current disability. Holton v. Shinseki, 557 F.3d 1362, 1366 (Fed. Cir. 2009). Service connection may alternatively be established on a secondary basis for a disability which is proximately due to, or the result of, a service-connected disability. 38 C.F.R. § 3.310 (a). Secondary service connection may also be established for a disorder which is aggravated by a service-connected disability. See 38 C.F.R. § 3.310 (b); Allen v. Brown, 8 Vet. App. 374 (1995). In adjudicating a claim for VA benefits, VA is responsible for determining whether the evidence supports the claim or is in relative equipoise, with the veteran prevailing in either event, or whether a preponderance of the evidence is against the claim, in which case the claim is denied. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102; Gilbert v. Derwinski, 1 Vet. App. 49, 53-56 (1990). 1 4. Entitlement to service connection for right knee arthritis, left knee arthritis, right lower extremity radiculopathy, and a back disability as secondary to service-connected shin splints is granted. Service connection is warranted for the Veteran's claimed disabilities as related to her service-connected shin splints. Notably, Veteran was medically discharged from service due to her shin splints. At her November 2021 Board hearing, the Veteran contended her claimed disabilities stem from her service-connected shin splints, which have pained her since service. The Veteran was provided VA examinations in February 2016 and March 2017 to investigate whether her claimed disabilities are related to her service-connected shin splints. Together, the examination reports demonstrate the Veteran has been diagnosed with bilateral knee arthritis, right lower extremity radiculopathy, and degenerative disc disease of the lumbar spine. Both the February 2016 and March 2017 VA examiners found these disabilities to be less likely than not related to the Veteran's service-connected shin splints. The February 2016 examiner noted the Veteran's in-service shin splints would have been expected to resolve without residuals, thus they were not due to her service-connected shin splints. The March 2017 examiner concluded there is no medical or scientific evidence to support finding shin splints cause the Veteran's disabilities. The Board finds both the February 2016 and March 2017 VA opinions inadequate. Notwithstanding the speculative nature of the February 2016 opinion nor the conclusory nature of the March 2017 opinion, neither provided separate findings and rationales for causation and aggravation, as required by the United States Court of Appeals for Veterans Claims (Court) in Atencio v. O'Rourke, 30 Vet. App. 74 (2018) for secondary service connection claims such as the ones here. However, the Veteran supplied medical evidence received in January 2017 which contains a letter from the Veteran's prior physical therapist that adequately supports finding a nexus between the Veteran's claimed disabilities and her shin splints. The physical therapist opined because the Veteran's shin splints were not restored to optimum health following her separation from service, her lower extremity pain increased, which led to inactivity, which increased the Veteran's risk of further musculoskeletal injury, which, in this particular Veteran's case, eventually consisted of bilateral knee arthritis, right lower extremity radiculopathy, and her back disability. The Board finds this opinion probative, as it was provided by a clinician familiar with the Veteran through prior treatment and with specialized knowledge of our bodies' mechanics. See Nieves-Rodriguez v. Peake, 22 Vet. App. 295 (2008). Accordingly, medical evidence weighs in favor of finding the Veteran's right knee arthritis, left knee arthritis, right lower extremity radiculopathy, and lumbar degenerative disc disease are related to her service-connected shin splints. Guerrieri v. Brown, 4 Vet. App. 467 (1993). The appeal is granted. L. CHU Veterans Law Judge Board of Veterans' Appeals Attorney for the Board P.A. Infante, 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.