Citation Nr: 21013131 Decision Date: 03/08/21 Archive Date: 03/08/21 DOCKET NO. 18-48 897 DATE: March 8, 2021 ORDER Service connection for a left knee disorder is granted. Service connection for a right knee disorder is granted. Service connection for a right shoulder disorder is granted. FINDINGS OF FACT 1. The competent and probative evidence is at least in equipoise as to whether a left knee disorder had its onset in or is otherwise related to the Veteran’s periods of active service. 2. The competent and probative evidence is at least in equipoise as to whether a right knee disorder had its onset in or is otherwise related to the Veteran’s periods of active service. 3. The competent and probative evidence is at least in equipoise as to whether a right shoulder disorder had its onset in or is otherwise related to the Veteran’s periods of active service. CONCLUSIONS OF LAW 1. The criteria for service connection for a left knee disorder have been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303. 2. The criteria for service connection for a right knee disorder have been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303. 3. The criteria for service connection for a right shoulder disorder have been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from January 1994 to January 1997 and October 2001 to September 2002. These matters come before the Board of Veterans’ Appeals (Board) on appeal from a January 2017 rating decision issued by a Department of Veterans Affairs (VA) Regional Office (RO). In January 2021, the Veteran testified at a Board hearing. A transcript of the hearing has been associated with the virtual file. Service Connection 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. § 1110; 38 C.F.R. § 3.303(a). 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). 1. Service connection for a left knee disorder. 2. Service connection for a right knee disorder. The Veteran contends that bilateral knee pain, swelling, and locking began during service as a result of his military occupational specialty (MOS) as a mechanized infantryman and have continued since discharge. Specifically, the Veteran stated that during active duty, his knees were painful, swollen, and frequently locked from the required five to 25-mile forced marches on uneven roads while carrying 40 to 65 pounds of gear; the Manchu road march wherein he would take two steps, drop on one knee, stand up from a kneeling position, and repeat the process for miles; patrol responsibilities; and Bradley fighting vehicle drills that entailed running full-speed down the vehicle’s incline onto the road. The Veteran stated during the marches, patrols, and Bradley drills, he would forcibly snap his knees back into place and took Motrin for bilateral knee pain. See January 2021, Hearing transcript; October 2018, VA Form 9. After review of the record, the Board finds the criteria for service connection for a left and right knee disorder have been met. The record contains competent diagnosis of bilateral knee joint osteoarthritis. See October 2016, Disability Benefits Questionnaire (DBQ). The Board, accordingly, finds competent evidence of a current disorder. In October 2016, Hector U. Lopez, M.D., the Veteran’s private treating physician since 2010, conducted a physical examination and indicated the Veteran reported ongoing painful and locking knees since 1995 from frequent kneeling and standing during military service. Dr. Lopez noted flare-ups of pain with walking, moving from kneeling to standing, inability to stand up with ease, and painful knees no matter the position. Dr. Lopez opined bilateral knee pain is the result of military service as the Veteran was evaluated by field medics during service and has continued to receive treatment for bilateral osteoarthritis. See January 2021, Hearing transcript; September 2017, Private treatment record; October 2016, DBQ. The Board accords moderate probative weight to Dr. Lopez’s positive nexus opinion as he has been actively treating the Veteran since 2010, conducted an in-person physical examination, and considered the Veteran’s lay statements of onset and continuity of knee pain since discharge from service. See Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 304 (2008). In light of the foregoing, the Board finds that the weight of the competent and probative evidence is at least in equipoise as to whether the Veteran’s current left and right knee disorders had their onset during or are otherwise related to active service. The Board finds the Veteran’s statements concerning onset and continuity of bilateral knee pain, swelling, and locking since discharge from service to be competent and credible, and therefore, accords high probative weight to same. Jandreau, 492 F.3d at 1377; see January 2021, Hearing transcript; October 2018, VA Form 9. Resolving all reasonable doubt in favor of the Veteran, the Board finds service connection for a left and right knee disorder is warranted. See 38 U.S.C. § 5107(b); Gilbert, 1 Vet. App. at 57-58. 3. Service connection for a right shoulder disorder. The Veteran contends that right shoulder pain and numbness began during service as a result of his MOS and has continued since discharge. Specifically, the Veteran stated that he is right-hand dominant and during forced marches ranging from five to 25 miles, he carried his weapons on his right side and a pack weighing 40 to 65 pounds. The Veteran contends that while marching, his right arm would go numb, he would have to switch his weapons to his left side, vigorously shake his right hand to restore feeling, and use his left hand to reposition his gear. The Veteran stated he managed right shoulder pain during service by taking Motrin. See January 2021, Hearing transcript; October 2018, VA Form 9. After review of the record, the Board finds the criteria for service connection for a right shoulder disorder have been met. The record contains competent diagnoses of a right rotator cuff full-thickness tear and mild acromioclavicular joint osteoarthritis. See September 2016, DBQ; September 2016, Private treatment record. The Board, accordingly, finds competent evidence of a current disorder. In September 2016, Ralph J. Curtis, M.D., the Veteran’s private treating physician since 2016, conducted an in-person examination, reviewed an MRI of the right shoulder, and noted the Veteran’s statements of right shoulder pain and numbness that began during military service. Dr. Curtis noted current symptoms of joint instability, tenderness, swelling, pain, and weakness. Dr. Curtis opined the Veteran’s current right shoulder disorder is a result of overuse during military service. The Board accords moderate probative weight to Dr. Curtis’ positive nexus opinion as he has been actively treating the Veteran since 2016, conducted an in-person physical examination, and considered the Veteran’s lay statements of onset and continuity of right shoulder pain since discharge from service. See September 2016, Private treatment records; September 2016, DBQ; see also Nieves-Rodriguez, 22 Vet. App. at 304. In January 2019, a VA examination for the shoulder was conducted. The VA examiner noted the Veteran’s report that he injured his right shoulder around 1996 while attempting to remove a ruck sack that was struck from a Bradley vehicle, the Veteran self-treated with Motrin for pain, and has continued to experience pain since discharge from service. After an in-person examination, the VA examiner opined it was less likely than not that the current right shoulder disorder was incurred in or caused by active service because there was no evidence of a right shoulder injury during service in the claims file. The Board accords low probative weight to the January 2019 VA examiner’s negative nexus opinion as it failed to consider the Veteran’s statements of continuity and did not address the September 2016 positive private nexus opinion. See January 2019, VA examination; see also Dalton v. Nicholson, 21 Vet. App. 23, 39-40 (2007) (a medical opinion is inadequate if it does not take into account the Veteran’s reports of symptoms and history). In light of the foregoing, the Board finds that the weight of the competent and probative evidence is at least in equipoise as to whether the Veteran’s current right shoulder disorder had its onset during or are otherwise related to active service. The Board finds the Veteran’s statements concerning onset and continuity of right shoulder numbness and pain since discharge from service to be competent and credible, and therefore, accords high probative weight to same. Jandreau, 492 F.3d at 1377; see January 2021, Hearing transcript; October 2018, VA Form 9. Resolving all reasonable doubt in favor of the Veteran, the Board finds service connection for a right shoulder disorder is warranted. See 38 U.S.C. § 5107(b); Gilbert, 1 Vet. App. at 57-58. 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.