Citation Nr: 21077621 Decision Date: 12/30/21 Archive Date: 12/30/21 DOCKET NO. 18-13 141 DATE: December 30, 2021 ORDER Entitlement to service connection for tinnitus is granted. Entitlement to service connection for a left knee condition is granted. Entitlement to service connection for a right knee condition is granted. FINDINGS OF FACT 1. The Veteran's tinnitus is related to in-service noise exposure. 2. The Veteran's left knee condition is related to service. 3. Resolving reasonable doubt in the Veteran's favor, his right knee condition is at least as likely as not related to service. CONCLUSIONS OF LAW 1. The criteria for service connection for tinnitus are met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303. 2. The criteria for service connection for left knee condition are met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303. 3. The criteria for service connection for right knee condition are met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from September 1979 to April 1984. This matter comes before the Board of Veterans' Appeals (Board) on appeal from an August 2016 rating decision issued by Department of Veterans Affairs (VA) Regional Office (RO). In September 2021, the Veteran testified at a hearing before the undersigned Veterans Law Judge. A copy of the hearing transcript is associated with the claims file. 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). The question for the Board is whether the Veteran has a current disability that began during service or is at least as likely as not related to an in-service injury, event, or disease. VA is responsible for determining whether the evidence supports the claim, with the veteran prevailing, 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. When there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, the VA shall give the benefit of the doubt to the claimant. 38 U.S.C. § 5107(b). 1. Entitlement to service connection for tinnitus The Veteran asserts that he is entitled to service connection for tinnitus due to in-service noise exposure. When filing his claim in March 2016, the Veteran stated his military occupational specialty was in artillery, and that there was always loud noise. Military personnel records show the Veteran was a field artillery officer. The Board concludes that the Veteran has a current diagnosis of tinnitus that began during active service. 38 U.S.C. §§ 1110, 1131, 5107(b); Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009); 38 C.F.R. § 3.303(a). Service treatment records are silent for any complaints of, treatment for, or diagnosis of tinnitus. At a March 2018 VA examination, the Veteran reported the ringing in his ears began in 1981, and the VA examiner diagnosed him with tinnitus. The VA examiner opined that it is at least as likely as not that the Veteran's tinnitus was caused by or the result of military noise exposure. As rationale, the VA examiner noted that although the Veteran's hearing was within normal limits during service, his occupation as an artillery officer was considered significant for hazardous noise exposure. The VA examiner concluded that tinnitus onset during service. The Board finds the Veteran is entitled to service connection for tinnitus. The Veteran stated, and his military personnel records confirm, that he was exposed to noise while in service. At the VA examination, the VA examiner determined the Veteran's tinnitus was due to in-service noise exposure, and the Veteran reported that ringing in his ears began during service. He is competent to testify to facts he personally observed by way of his senses. See Layno v. Brown, 6 Vet. App. 465, 469 (1994); see also Charles v. Principi, 16 Vet. App. 370, 374-75 (2002) ("ringing in the ears is capable of lay observation"). Moreover, tinnitus is a disorder ascertainable by the senses, and its existence may be determined by one experiencing its symptoms. See Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007). Resolving all reasonable doubt in the Veteran's favor, the Board concludes that service connection for tinnitus is warranted. 38 U.S.C. § 5107; 38 C.F.R. § 3.102. 2. Entitlement to service connection for a left knee condition The Veteran asserts that he is entitled to service connection for a left knee condition. The Board concludes that the Veteran has a current left knee disability that is related to an in-service injury. 38 U.S.C. §§ 1110, 1131, 5107(b); Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009); 38 C.F.R. § 3.303(a). During service, the Veteran sprained his left in 1982. A March 1983 radiology report indicates the Veteran's loss of lateral joint space on the left knee was consistent with previous trauma with degenerative change. The April 1984 service separation examination report shows the Veteran stated he was concerned about his knees. However, the examining physician at service separation noted that neither knee was swollen, nor did they have limited motion or instability. VA treatment notes from September 2016 indicate the Veteran sought treatment for bilateral knee pain and swelling, and that he has experienced knee pain since 1985. Records from December 2017 show the Veteran has degenerative joint disease of both knees. In June 2018, the Veteran was provided with a custom brace for his left knee. The Veteran was afforded a VA examination in February 2019, and was noted to have a diagnosis of degenerative arthritis of the left knee since September 2016. The Veteran explained that he hurt both knees during service. The VA examiner opined that it is at least as likely as not that the Veteran's current left knee condition was incurred in or caused by service. In support of the opinion, the VA examiner explained that the Veteran reported hurting his knee in service, an in-service radiology report showed degenerative changes, and X-rays from September 2018 confirmed the Veteran has degenerative joint disease. Upon review of the record, the Board finds the Veteran is entitled to service connection for a left knee condition. The evidence shows the Veteran was treated for a left knee injury during service, and was determined to have degenerative changes of the left knee. Further, the February 2019 VA examiner opined that the Veteran's current left knee disability is related to his military service. Accordingly, after resolving all doubt in favor of the Veteran, the Board finds that service connection for a left knee condition is warranted. 38 U.S.C. § 5107; 38 C.F.R. § 3.102. 3. Entitlement to service connection for a right knee condition The Veteran also contends that he is entitled to service connection for a right knee condition. During the Board hearing, the Veteran's representative explained that the February 2019 VA knee examination did not assess the right knee, and a nexus opinion was not provided for the right knee. The Veteran testified that he injured his right knee during service while playing basketball, and stated he has experienced knee swelling and popping since service. The Board concludes that the Veteran has a current right knee disability that is related to service. 38 U.S.C. §§ 1110, 1131, 5107(b); Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009); 38 C.F.R. § 3.303(a). Service treatment records from November 1982 show the Veteran injured his right knee while playing basketball. He was diagnosed with a right knee sprain. He sought treatment again for the right knee in December 1982 due to persistent pain. As noted above, the Veteran reported that he was concerned about both knees at service separation in 1984. Post-service medical records indicate the Veteran complained of and sought treatment for bilateral knee pain. In September 2016, the Veteran was noted to have right knee pain due to severe degenerative joint disease. In November 2018 he began receiving steroid injections to manage his knee pain. Upon review of the record, the Board finds the Veteran is entitled to service connection for a right knee disability. Service treatment records indicate the Veteran sustained an in-service right knee injury. He has reported experiencing pain and swelling since service, and is competent to report symptoms he has personally observed through his senses. See Layno, 6 Vet. App. at 469 (1994). Further, post-service treatment records show he has a diagnosis of severe degenerative joint disease. As it is clear from a review of the evidence and argument of record that the Veteran developed a right knee disability in service and symptoms have persisted since that time, additional delay and remand for further examination and opinion is not required. Accordingly, after resolving all doubt in favor of the Veteran, the Board finds that service connection for a right knee condition is warranted. 38 U.S.C. § 5107; 38 C.F.R. § 3.102. Cynthia M. Bruce Veterans Law Judge Board of Veterans' Appeals Attorney for the Board N. Miller, 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.