Citation Nr: 21012313 Decision Date: 03/04/21 Archive Date: 03/04/21 DOCKET NO. 07-00 336A DATE: March 4, 2021 ORDER Service connection for kidney disease, as secondary to service-connected bilateral knee and back disabilities, is granted. FINDING OF FACT The weight of the competent and probative evidence is at least in equipoise as to whether current kidney disease is proximately due to or the result of the Veteran’s service-connected bilateral knee and back disabilities. CONCLUSION OF LAW The criteria for service connection for kidney disease have been met. 38 U.S.C. §§ 1131, 5107(b); 38 C.F.R. §§ 3.102, 3.303, 3.310. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from May 1982 to June 1985. This matter is before the Board of Veterans’ Appeals (Board) on appeal from an October 2017 rating decision issued by a Department of Veterans Affairs (VA) Regional Office (RO). In January 2019, the Board denied the above-captioned claim. The Veteran appealed the January 2019 denial to the United States Court of Appeals for Veterans Claims (Court). In a November 2019 Order, the Court granted a Joint Motion for Partial Remand (JMPR), vacating the January 2019 decision to the extent it denied compensation under 38 U.S.C. § 1151 for kidney disease. In May 2020, the Board granted the Veteran’s motion to advance his case on the docket and remanded the issue of entitlement to compensation under 38 U.S.C. § 1151 for kidney disease for further development. The Board notes that the evidence of record indicates that current kidney disease is the result of or proximately due to the medications used to treat the Veteran’s service-connected bilateral knee and back disabilities. See May 2018, Private treatment record. The Board, accordingly, has recharacterized the issue on appeal as a claim of service connection for kidney disease as secondary to service-connected bilateral knee and back disabilities. Service connection will be granted if the evidence demonstrates that a current disability resulted from an injury or disease incurred in or aggravated by active military service. 38 U.S.C. § 1131; 38 C.F.R. § 3.303(a). A disability which is proximately due to or the result of a service-connected disease or injury shall be service connected. 38 C.F.R. § 3.310. As a general matter, establishing service connection requires competent evidence of (1) a current disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a nexus between the in-service disease or injury and the present disability. Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004); 38 C.F.R. § 3.303. The Veteran is competent to report symptoms and experiences observable by his senses. See Jandreau v. Nicholson, 492 F.3d 1372, 1377 (Fed. Cir. 2007); 38 C.F.R. § 3.159(a). In relevant part, 38 U.S.C. § 1154(a) requires that VA give “due consideration” to “all pertinent medical and lay evidence” in evaluating a claim for disability benefits. Davidson v. Shinseki, 581 F.3d 1313, 1316 (Fed. Cir. 2009). When there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, VA shall give the benefit of the doubt to the claimant. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102; Gilbert v. Derwinski, 1 Vet. App. 49, 57-58 (1990). The Veteran contends that end-stage kidney disease is secondary to pain medication he took for his service-connected disabilities, to include bilateral knee and back pain. See June 2018, Hearing transcript. After review of the record, the Board finds that the criteria for service connection for kidney disease have been met. Initially, the Board notes the Veteran’s left and right knee disabilities and degenerative joint disease with spondylolisthesis status post spinal fusion have been service connected since 1989, 2007, and 2006, respectively. The record contains a competent diagnoses of end-stage renal disease and bilateral nephrectomy. Private treatment records dated May 2018 and February 2020. The Board, accordingly, finds competent evidence of a current disorder. VA treatment records indicate that in June 2006 the Veteran discontinued taking ibuprofen for knee pain after being advised by a VA physician’s assistant that it was negatively impacting his kidney function. In November 2007, the Veteran’s VA primary care physician placed him back on ibuprofen; a December 2009 VA examination report and February 2010 treatment note reflected the Veteran was taking ibuprofen for pain in his service-connected knees. In February 2012, chronic renal disease was diagnosed, and the Veteran was advised to avoid all nonsteroidal anti-inflammatory drugs, such as ibuprofen and Aleve. Between 2017 and 2018, the Veteran underwent left and right nephrectomy due to renal masses. See February 2020, Private treatment record; VA treatment records dated June 2006, November 2007, February 2010, and February 2012; December 2009, VA examination. In May 2018, the Veteran’s private doctor conducted a physical examination and noted that the Veteran’s extensive history of back and knee surgeries, current limited mobility due to bilateral knee disabilities, and 18-year history of taking 800 mg of ibuprofen to treat back and bilateral knee pain. Based on the above, the doctor opined that current end-stage renal disease was secondary to hypertension and chronic use of nonsteroidal anti-inflammatory drug. See May 2018, Private treatment records dated. The Board finds the May 2018 opinion to be competent, credible, and highly probative, as it is supported by an in-person physical examination, accurately reported the Veteran’s medical history, and provided clear clinical findings supported by data. See Nieves-Rodriguez v. Peake, 22 Vet. App. 295 (2008). In light of the above, the Board finds the weight of the competent and probative evidence is at least in equipoise as to whether current kidney disease is the result of or proximately due to the Veteran’s service-connected bilateral knee and back disabilities. 38 C.F.R. §§ 3.303, 3.310. Thus, service connection for kidney disease is warranted. JAMES L. MARCH Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board S. Straughn, 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.