Citation Nr: 21010593 Decision Date: 02/25/21 Archive Date: 02/25/21 DOCKET NO. 18-46 331 DATE: February 25, 2021 ORDER Service connection for a left knee disorder including degenerative osteoarthritis is granted. Service connection for a right knee disorder including degenerative osteoarthritis is granted. FINDINGS OF FACT 1. The left knee disorder began in service, has been continuously present since then, and is now diagnosed as left knee degenerative osteoarthritis. 2. The right knee disorder began in service, has been continuously present since then, and is now diagnosed as right knee degenerative osteoarthritis. CONCLUSIONS OF LAW 1. The criteria for service connection for left knee degenerative osteoarthritis are met. 38 U.S.C. § 1131, 5107; 38 C.F.R. § 3.102, 3.303. 2. The criteria for service connection for right knee degenerative osteoarthritis are met. 38 U.S.C. § 1131, 5107; 38 C.F.R. § 3.102, 3.303. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served in the United States Navy on active service from September 1983 to September 1987. This claim arises from a May 2018 rating decision in which Saint Petersburg, Florida. The Veteran testified before the undersigned Veterans Law Judge in February 2021 by videoconference. The appeal is being granted, and the transcript of the hearing will be associated with the file at a later date. The Veteran testified that he injured his knees during active service, that he was discharged by medical board due, in part, to his bilateral knee pain, and that this pain has been present from that time to the present. The Board agrees. Service connection will be granted if it is shown that a Veteran has a disability resulting from an injury or disease contracted in the line of duty, or for aggravation of a per-existing injury or disease contracted in the line of duty in the active military, naval or air service. 38 U.S.C. § 1131, 5107; 38 C.F.R. § 3.102, 3.303. “To establish a right to compensation for a present disability, a veteran must show: ‘(1) the existence of a present disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the present disability and the disease or injury incurred or aggravated during service’—the so-called “nexus” requirement.” Holton v. Shinseki, 557 F.3d 1362, 1366 (Fed. Cir. 2010) (quoting Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004)). In certain cases, competent lay evidence may demonstrate the presence of any of these elements. Davidson v. Shinseki, 581 F.3d 1313, 1316 (Fed. Cir. 2009). The nexus element may also be fulfilled by (1) a nexus opinion or (2) competent and credible evidence showing that the veteran has experienced frequent and persistent symptoms of the disease since service. 38 U.S.C. § 1154 (a); 38 C.F.R. §§ 3.303 (a),(d); see also Davidson v. Shinseki, 581 F.3d 1313 (Fed. Cir. 2009). Service connection may be granted for any disease diagnosed after discharge, when all of the evidence, including that pertinent to service, establishes that a disease was incurred in service. 38 C.F.R. § 3.303 (d). In making all determinations, the Board must fully consider the lay assertions of record. A layperson is competent to report on the onset and continuity of his or her current symptomatology. See Layno v. Brown, 6 Vet. App. 465, 470 (1994) (a Veteran is competent to report on that of which he or she has personal knowledge). “[L]ay evidence can be competent and sufficient to establish a diagnosis of a condition when (1) a layperson is competent to identify the medical condition, (2) the layperson is reporting a contemporaneous medical diagnosis, or (3) lay testimony describing symptoms at the time supports a later diagnosis by a medical professional.” Davidson v. Shinseki, 581 F.3d 1313, 1316 (Fed. Cir. 2009); Jandreau v. Nicholson, 492 F.3d 1372, 1376-77 (Fed. Cir. 2007). When considering whether lay evidence is competent, the Board must determine on a case by case basis, whether the Veteran’s disability is the type of disability for which lay evidence may be competent. Kahana v. Shinseki, 24 Vet. App. 428 (2011); see also Jandreau v. Nicholson, 492 F.3d 1372, 1377 (Fed. Cir. 2007); see also Buchanan v. Nicholson, 451 F.3d 1331, 1337 (Fed. Cir. 2006) (“[T]he Board cannot determine that lay evidence lacks credibility merely because it is unaccompanied by contemporaneous medical evidence”). There is no dispute that the Veteran is currently diagnosed with a bilateral knee disability. The May 2018 VA examination shows the Veteran is diagnosed with bilateral knee degenerative osteoarthritis. There is, further, no dispute as to in-service incurrence of bilateral knee injury. The Veteran’s service treatment records show numerous entries of bilateral knee pain, particularly as associated with neck and back pain resulting from prolonged stooping and an inability to stand completely upright on board ship. Moreover, he was diagnosed with retropatellar pain syndrome of both knees, found to have minimal abnormalities in his right knees, diagnosed with abrasions and avulsion of the left lower leg during active service. The Veteran underwent medical board evaluation, the outcome of which was that he was given shore duty with medical treatment to determine if his neck, back and knees would improve. He never returned to full duty. The Board also observes that the Veteran incurred various other injuries during active service, to include two bicycle accidents, foot trauma, and hip trauma. In addition, and crucially, the Veteran testified competently and credibly that his bilateral knee pain started during active service and has continued to the present. While he noted, consistent with the medical board findings, that his knee and back problems had improved when moved to light duty ashore, he also stated that he never recovered entirely. The remaining issue before the Board is whether there is a nexus connecting the Veteran’s current diagnosis to his in-service incurrence. The Veteran was afforded a VA examination for knee and lower leg in 2018, as noted above. The examiner diagnosed bilateral knee degenerative osteoarthritis. The examiner opined that the Veteran’s bilateral knee disability was less likely than not caused by or a result of his active duty service. As rationale, the examiner stated that the Veteran’s service treatment records were silent for diagnosis of or treatment for any chronic disability of the knees and, at the time of the Veteran’s medical board, examination of the knee was not remarkable. Therefore, the VA examiner found the Veteran’s bilateral degenerative osteoarthritis of left and right knee to be more consistent with normal and expected aging. However, this ignores the Veteran’s competent and credible reports of pain ever since service, an indicator of chronicity, and does not address the presence of those symptoms at the medical board, in favor of documentary medical evidence. Because the VA examiner did not address the complete factual record, the negative nexus opinion has no probative value. In contrast, the Veteran testified that his bilateral knee pain began during active service, a statement supported by the service treatment records. Moreover, it is observed that service personnel records show the Veteran’s military occupational specialty was as a hull technician, and that he served on the damage control crew. Both these jobs require extensive physical duty in dangerous locations and circumstances aboard ship. The circumstances of his military occupational specialty serve to corroborate his assertions of bilateral knee and pain during active service. In sum, the Board finds the Veteran’s February 2021 testimony credible and overwhelmingly supported by the service treatment records and circumstances of his active service.   Therefore, the Board finds that the probative lay and medical evidence of record shows that each element required for service connection has been met as the Veteran has a current diagnosis of degenerative arthritis of left and right knees that began in-service and has continued since. 38 C.F.R. §§ 3.303 (a),(d); see also Davidson v. Shinseki, 581 F.3d 1313 (Fed. Cir. 2009). Accordingly, service connection for left a left knee disorder to include degenerative osteoarthritis is warranted; and service connection for a right knee disorder to include degenerative osteoarthritis is warranted. WILLIAM H. DONNELLY Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Bakke, Lila J. 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.