Citation Nr: 21006154 Decision Date: 02/03/21 Archive Date: 02/03/21 DOCKET NO. 15-18 553 DATE: February 3, 2021 ORDER Entitlement to service connection for a left knee disorder, to include as secondary to a right knee disorder, is granted. FINDING OF FACT The most probative evidence is at least in relative equipoise as to whether the Veteran’s left knee disorder is proximately due to, a result of, or aggravated by a service-connected right knee disorder. CONCLUSION OF LAW The criteria for entitlement to service connection for a left knee disorder, to include as secondary to a right knee disorder, have been met. 38 U.S.C. §§ 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.310. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty for training in the United States Army from January 1982 to April 1982. This matter comes before the Board of Veterans’ Appeals (Board) on appeal of a rating decision issued by the Department of Veterans Affairs (VA). The Board previously remanded these matters in September 2018 and July 2020. As the appeal is being granted to the maximum extent allowed by law, no further discussion of the duty to assist is necessary. Legal Criteria – Service Connection Service connection may be granted for a disability resulting from disease or injury incurred coincident with or aggravated by service. 38 U.S.C. §§ 1110, 1131. A disability which is proximately due to or the result of a service-connected disease or injury shall be service-connected. Any increase in severity of a nonservice-connected disease or injury that is proximately due to or the result of a service-connected disease or injury will also be service-connected. 38 C.F.R. § 3.310. Entitlement to service connection for a left knee disorder, to include as secondary to a right knee disorder The Board finds that the most probative evidence is at least in relative equipoise as to whether the Veteran’s left knee disorder is proximately due to, a result of, or aggravated by his service-connected right knee disorder. Therefore, a grant of service connection is warranted. The Veteran has a current disorder of left knee degenerative arthritis. See C & P Exam, October 2019. He contends that his left knee degenerative arthritis is proximately due to, a result of, or aggravated by his service-connected right knee degenerative arthritis. See 38 C.F.R. § 3.310. The record reflects a medical opinion from Dr. T.S. submitted in December 2020. Dr. T.S. performed a physical examination, reviewed the claims file, and opined that it is more likely than not that the Veteran’s left knee disorder is service-connected secondary to the right knee disorder. As rationale, he explained that the Veteran was noted to have an antalgic gait, and that opposing knee disorders commonly arise from changes in gait. He stated that the primary mechanism is that alterations in gait cause pathologic transmissions in force through the opposing knee, leading to degeneration of the joint. He expressed disagreement with the VA medical opinion and contended that it did not consider the role of an antalgic gait in the left knee disorder. He cited to medical articles to support his opinion. The law is clear. Pursuant to the “benefit-of-the-doubt” rule, where there is “an approximate balance of positive and negative evidence regarding the merits of an issue material to the determination of the matter,” the Veteran shall prevail upon the issue. 38 U.S.C. § 5107(b). Although there is some evidence against the claim, the Board finds that Dr. T.S.’s opinion places the evidence at least into relative equipoise as to whether the Veteran’s left knee disorder is proximately due to, a result of, or aggravated by his service-connected right knee disorder. The Board therefore concludes that, with the benefit of the doubt resolved in the Veteran’s favor, a grant of service connection is warranted. See Gilbert v. Derwinski, 1 Vet. App. 49, 55 (1990) (“[T]he ‘benefit of the doubt’ standard is similar to the rule deeply embedded in sandlot baseball folklore that ‘the tie goes to the runner’.... [I]f... the play is close, i.e., ‘there is an approximate balance of positive and negative evidence,’ the veteran prevails by operation of [statute].”). ANTHONY C. SCIRÉ, JR Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board D. Reed, 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.