Citation Nr: 21077020 Decision Date: 12/28/21 Archive Date: 12/28/21 DOCKET NO. 17-56 731 DATE: December 28, 2021 ORDER Entitlement to service connection for left patellofemoral pain syndrome (claimed as left knee condition) is denied. Entitlement to service connection for a low back condition is denied. FINDINGS OF FACT 1. The preponderance of the evidence is against finding that left patellofemoral pain syndrome (claimed as left knee condition) began during active service. 2. The preponderance of the evidence of record is against finding that the Veteran has had a low back disability at any time during or approximate to the pendency of the claim. CONCLUSIONS OF LAW 1. The criteria for service connection for left patellofemoral pain syndrome (claimed as 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 low 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 with the Army from October 2002 to November 2005. 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 left patellofemoral pain syndrome (claimed as left knee condition) The Veteran claims that his left knee condition is the result of his active service. Service treatment records indicate a non-specific complaint of joint pain however they are silent for any actual complaints, treatment, or diagnosis of a left knee disability. In February 2017, the Veteran attended a VA Knee Conditions examination. The examiner diagnosed left patellofemoral pain syndrome as of "2017." Further, he opined that this condition was less likely than not due to the Veteran's active service. The rationale provided was: The Veteran has findings consistent with left PFS. There does not appear to be chronic left knee complaints while in service and what appears to be the last Report of Medical History dated 8/23/2005, "no" is checked for knee trouble. The claimed condition was less likely than not (less than 50 percent probability) incurred in or caused by the claimed in-service injury, event, or illness. The remaining evidence of record details complaints associated with 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 earliest record of left patellofemoral pain syndrome was in 2017, approximately 12 years after the Veteran's discharge. This delay, while not conclusive, weighs against the establishment of service connection. See Mense v. Derwinski, 1 Vet. App. 354, 356 (1991) (affirming Board's denial of service connection where veteran failed to account for lengthy time period between service and initial symptoms of disability). The Board finds the February 2017 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 February 2017 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 low back condition The Veteran contends that his claimed low back condition is the result of his active service. Service treatment records indicate a complaint of recurrent back pain, however they are silent for any actual complaints, treatment, or diagnosis of a low back disability. In February 2017, the Veteran attended a VA Back Conditions examination. The examiner indicated that the Veteran did not have a current diagnosis associated with his low back. The remaining evidence of record is also silent for an actual diagnosis of a low back condition. The Board concludes that the Veteran does not have a current diagnosis of a low back disability and has not had one at any time during the pendency of the claim or recent to the filing of the claim. Romanowsky v. Shinseki, 26 Vet. App. 289, 294 (2013); McClain v. Nicholson, 21 Vet. App. 319, 321 (2007). Further, the Board has considered Saunders v. Wilkie, 886 F.3d 1356 (Fed. Cir. 2018), in which the Federal Circuit held that "pain alone, without an accompanying diagnosis of a present disease, can qualify as a disability" if it "reaches the level of a functional impairment of earning capacity." Id. at 1367-69. However, no functional impairment was noted during the February 2017 impairment. While the Veteran believes he has a current low back disability, he is not competent to provide a diagnosis in this case. The issue is medically complex, as it requires the ability to interpret complicated diagnostic medical testing. Jandreau v. Nicholson, 492 F.3d 1372, 1377, 1377 n.4 (Fed. Cir. 2007). Consequently, the Board gives more probative weight to the competent medical evidence. 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.