Citation Nr: 21012282 Decision Date: 03/04/21 Archive Date: 03/04/21 DOCKET NO. 14-22 174 DATE: March 4, 2021 ORDER Service connection for a right knee disability is denied. Service connection for a left knee disability is denied. FINDINGS OF FACT 1. The preponderance of the evidence is against finding that a right knee disability began during active service or is otherwise related to an in-service injury or disease. 2. The preponderance of the evidence is against finding that a left knee disability began during active service or is otherwise related to an in-service injury or disease. CONCLUSIONS OF LAW 1. The criteria for service connection for a right knee disability have not been met. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303. 2. The criteria for service connection for a left knee disability have not been met. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from February 1963 to August 1966. The Veteran asserts that his disabilities of the right and left knee are due to improper landings during airborne training. 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). Service treatment records do not reflect treatment for disabilities of the right or left knee. The Veteran did not report a history of trick or locked knee, bone, joint or other deformity, or arthritis or rheumatism. The separation examination does not reflect a diagnosis referable to the knees. 06/25/2015 STR-Medical at 38. A February 1996 private treatment record reflects a past medical history of right knee torn cartilage. 06/10/2011 Medical Treatment Record-Non-Government Facility at 10. An October 1998 private treatment record reflects a past medical history of status post cartilage repair in both knees. Id. at 28. In May 2012 the Veteran underwent a VA medical examination wherein the examiner diagnosed a left knee sprain in 1963 and proffered a negative etiological opinion. Specifically, the examiner stated that review of medical records does not shown any parachute accident. His DD 214 shows he has a parachutist badge. A December 2011 medical report shows he has a history of knee surgery, but it does not state the origin of the knee condition or when it happened. In his active duty medical records there is no mention of knee problems. 02/22/2012 VA Examination at 17, 40. In October 2018, these matters were remanded to afford the Veteran an examination as the examiner failed to reference the prior diagnoses in formulating a negative etiological opinion. In October 2019, the Veteran underwent an examination wherein the examiner found that the Veteran did not have any diagnoses of the knees. The Board is cognizant of McLain v. Nicholson, 21 Vet. App. 319 (2007), in which the Court held that the requirement that a claimant have a current disability before service connection may be awarded for that disability is also satisfied when a claimant has a disability at the time a claim for VA disability compensation is filed or during the pendency of that claim, even if no disability is present at the time of the claim’s adjudication. In light of the diagnoses reflected in the record, further opinion was sought, in which the examiner accounted for the diagnoses contained in the treatment records. See McLain v. Nicholson, 21 Vet. App. 319 (2007). In January 2021, the Veteran underwent a C&P examination, wherein the examiner diagnosed tendonitis/tendinosis of the knees. The examiner stated that the Veteran claimed a knee condition that reportedly occurred during service. However, after thorough review of the claims folder, including lay assertions, no evidence could be found to establish a nexus to service. Therefore, it is less likely than not that the claimed knee conditions are due to service. Based on the above, the Board concludes that the Veteran has current diagnoses pertaining to the right and left knees, and finds his assertions of his in-service experiences, to include airborne training, to be credible. However, the preponderance of the evidence weighs against finding that the Veteran’s disabilities of the knees are due to service. As detailed above, service treatment records are negative for any complaints or treatment related to the knees. A February 1996 record reflects a past medical history of right knee torn cartilage, and an October 1998 records reflects a past medical history of status post cartilage repair in both knees, but such records were generated approximately 30 years after separation from active service. Moreover, the January 2021 examiner proffered a negative etiological opinion with regard to the knees. Such opinion was based on consideration of the Veteran’s assertions and review of the claims folder. The Board finds such opinion to be probative and relevant to the matter at hand. The Veteran has not offered any medical opinion in support of a relationship between his knees and service. While the Board acknowledges the Veteran’s lay assertions, as detailed above, disabilities of the knees are reflected decades after separation from service. While the Veteran is competent to report his in-service experiences, he is not competent to provide diagnoses nor determine that symptoms or diagnoses were manifestations of airborne training. The issue is medically complex, as it requires knowledge of the interaction between multiple organ systems in the body and interpretation of complicated diagnostic medical testing. Jandreau v. Nicholson, 492 F.3d 1372, 1377, 1377 n.4 (Fed. Cir. 2007). Therefore, it is outside the competence of the Veteran in this case because the record does not show that he has the medical training or credentials to make such a determination. Id; see also Kahana v. Shinseki, 24. Vet. App. 428 (2011). Moreover, neither the clinical records nor the lay evidence in this case demonstrated knee symptomatology dating back to service. Based on the Veteran’s lay assertions, an opinion was sought, which was negative. Consequently, the Board gives more probative weight to the January 2021 opinion of the trained physician. (Continued on the next page)   In conclusion, the most probative, competent evidence is against a link between disabilities of the knees and service. Because the preponderance of the evidence is against the issue, reasonable doubt does not arise, and service connection is denied. See 38 U.S.C. § 5107(b). Eric S. Leboff Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board M.W. Kreindler, 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.