Citation Nr: 21075536 Decision Date: 12/20/21 Archive Date: 12/20/21 DOCKET NO. 17-14 396 DATE: December 20, 2021 ORDER Entitlement to service connection for a left knee condition is denied. Entitlement to service connection for a lower back condition is denied. FINDINGS OF FACT 1. The preponderance of the evidence is against finding that a left knee condition began during active service. 2. The preponderance of the evidence is against finding that a low back condition began during active service. CONCLUSIONS OF LAW 1. The criteria for service connection for a left knee condition have not been met. 38 U.S.C. § 1110; 38 C.F.R. §§ 3.102, 3.303, 3.304, 3.309. 2. The criteria for service connection for a lower back condition have not been met. 38 U.S.C. § 1110; 38 C.F.R. §§ 3.102, 3.303, 3.304, 3.309. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty in the Army from August 1979 to June 1982. In October 2021, the Board remanded the issues on appeal for further development, and the case has since been returned to the Board. The Board finds that the agency of original jurisdiction (AOJ) has substantially complied with the remand directives. See Stegall v. West, 11 Vet. App. 268, 271 (1998). Service Connection Service connection may be granted for disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. § 3.303. The three-element test for service connection requires evidence of: (1) a current disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the current disability and the in-service disease or injury. Shedden v. Principi, 381 F.3d 1163, 1166 -67 (Fed. Cir. 2004). Entitlement to service connection for a left knee condition The Veteran contends that he injured his left knee while completing training in Mount Fuji, Japan. He contends that he was carrying full gear, stepped on a rock, lost his balance, and fell down injuring his back and knee. The Veteran said he was treated in service for his injuries. The Veteran's military personnel records indicate that he was deployed to "West PAC" in March 1981 and served 6 months overseas. An April 2015 Memorandum for the Record from the Department of the Navy indicated that the Veteran's health and dental records were missing. The Veteran submitted a June 2020 buddy statement from W.C. who served with the Veteran in Japan. W.C. contends that he was with the Veteran when he fell from Mount Fuji in Japan. He states that after falling, the Veteran was in considerable pain and was medically evacuated to sick bay. The Veteran attended a VA examination for in May 2021. The examiner opined that the Veteran's left knee condition was less likely than not related to falling while climbing Mount Fuji. The rationale provided by the examiner was that there is no documentation of treatment for his claimed condition in service. Nevertheless, in a June 2021 Board remand, this opinion was found inadequate, and a new opinion was ordered. In July 2021, an examiner opined that the Veteran's left knee condition was less likely than not due to his claimed in-service injury. The rationale provided was: ...The claimant has osteoarthritis or degenerative arthritis of the lumbar spine. This is age related wear and tear consistent with the claimant's age and occupational history. There is no indication of traumatic arthritis or old fracture or injury on the x-rays consistent with trauma or fall reported. While the claimant may have had a fall in service, there is no evidence of a chronic residual from that fall causing the current back condition which is more likely than not related to wear and tear arthritis and question of aggravation from MVA in 2015 reported. Based on medical records reviewed, the claimed condition of the lumbar spine is less likely than not incurred in or caused by the claimed in service injury or event. In an October 2021 VA examination, the examiner opined that the Veteran's arthritis was less likely than not caused by the claimed in-service injury. The rationale provided was: The remand letter and testimony as well as lay statements were reviewed in addition to an extensive review of the efile. The vet's activities in service to include the fall on Mt Fuji wearing full gear are acknowledged. However, there is no finding of chronic knee complaints in the records that follow the fall, neither in the STRs or in the records for decades following this fall. There's no evidence of trauma related arthritis in the record. The chronicity of the current condition cannot be traced back to the service in any objective manner. The vet's history of the injury during his time in Japan is acknowledged and lack of documentation due to deployment is also acknowledged however a disability which began in service or was caused by some event in service must be considered "chronic" before a nexus for service connection can be established. No permanent residual or chronic disability is shown by the evidence from the period immediately following separation from the service. The condition is likely to be due to his age, decades of weight bearing after separation such as his work as a police officer. Therefore, a nexus for service connection for the knee condition cannot be made The remaining evidence of record contains continued complaints and treatment for a left knee condition but no discussion on its etiology. Based on the foregoing evidence of record, the Board finds that service connection is not warranted. The Board finds the October 2021 VA opinion of record the most probative evidence of record as to the etiology of the Veteran's left knee condition because it is based on an accurate medical history and provides an explanation that contains clear conclusions and supporting data. Further, the Board notes that the evidence of record is silent for a medical opinion stating otherwise. The Board considered the Veteran's lay assertions as to the etiology of his left knee condition. Although the Veteran is competent to attest to his experiences, he is not competent in these circumstances to opine as to the etiology of his left knee condition. The Veteran has not been shown to have specialized medical knowledge that would be necessary to provide a competent opinion regarding service connection. The Board finds the October 2021 VA opinion of record to be more probative in this regard. The examiner considered the Veteran's history, and ultimately concluded that from a medical perspective, it is less likely that his left knee condition is related to service. In conclusion, the weight of the evidence is against the claim for service connection for a left knee condition. Entitlement to service connection for a lower back condition The Veteran contends that he injured his low back while completing training in Mount Fuji, Japan. He contends that he was carrying full gear, stepped on a rock, lost his balance, and fell down injuring his back and knee. The Veteran said he was treated in service for his injuries. The Veteran's military personnel records indicate that he was deployed to "West PAC" in March 1981 and served 6 months overseas. An April 2015 Memorandum for the Record from the Department of the Navy indicated that the Veteran's health and dental records were missing. The Veteran submitted a June 2020 buddy statement from W.C. who served with the Veteran in Japan. W.C. contends that he was with the Veteran when he fell from Mount Fuji in Japan. He states that after falling, the Veteran was in considerable pain and was medically evacuated to sick bay. The Veteran attended a VA examination in May 2021. The examiner opined that the Veteran's low back condition was less likely than not related to falling while climbing Mount Fuji. The rationale provided by the examiner was that there is no documentation of back pain or treatment for his claimed condition in service. Nevertheless, in a June 2021 Board remand, this opinion was found inadequate, and a new opinion was ordered. In July 2021, a VA examiner stated that there was "no indication of traumatic arthritis or old fracture or injury on the x-rays consistent with trauma or fall reported." However, in an October 2021 Board remand, the Board noted that an x-ray interpretation from December 2013 stated there was "decrease in height of T11, T12, L1, L2, consistent with old process", and the July 2021 examiner didn't not explain whether this "old process" could be the Veteran's reported in-service injury. Accordingly, an addendum opinion was requested. In October 2021, an addendum opinion was provided. The examiner opined that the Veteran's low back condition was less likely than not caused by his claimed in-service injury. The rationale provided was: The remand letter and testimony as well as lay statements were reviewed in addition to an extensive review of the efile. The vet's activities in service to include the fall on Mt Fuji wearing full gear are acknowledged. However, there is no finding of chronic back complaints in the records that follow the fall, neither in the STRs or in the records for decades following this fall. There's no evidence of trauma related arthritis in the record. The chronicity of the current condition cannot be traced back to the service in any objective manner. Mention of "old process" on the x-ray simply means slowly advancing degeneration rather than an acute injury. The vet's history of the injury during his time in Japan is acknowledged and lack of documentation due to deployment is also acknowledged however a disability which began in service or was caused by some event in service must be considered "chronic" before a nexus for service connection can be established. No permanent residual or chronic disability is shown by the evidence from the period immediately following separation from the service. The condition is likely to be due to his age, decades of weight bearing after separation such as his work as a police officer. Therefore, a nexus for service connection for the back condition cannot be made. The remaining evidence of record contains continued complaints and treatment for a low back condition but on discussion on its etiology. Based on the foregoing evidence of record, the Board finds that service connection is not warranted. The Board finds the October 2021 VA opinion of record the most probative evidence of record as to the etiology of the Veteran's low back condition because it is based on an accurate medical history and provides an explanation that contains clear conclusions and supporting data. Further, the Board notes that the evidence of record is silent for a medical opinion stating otherwise. The Board considered the Veteran's lay assertions as to the etiology of his low back condition. Although the Veteran is competent to attest to his experiences, he is not competent in these circumstances to opine as to the etiology of his low back condition. The Veteran has not been shown to have specialized medical knowledge that would be necessary to provide a competent opinion regarding service connection. The Board finds the October 2021 VA opinion of record to be more probative in this regard. The examiner considered the Veteran's history, and ultimately concluded that from a medical perspective, it is less likely that his low back condition is related to service. In conclusion, the weight of the evidence is against the claim for service connection for a low back condition. L. M. BARNARD Veterans Law Judge Board of Veterans' Appeals Attorney for the Board R. A. Elliott II, 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.