Citation Nr: 21014756 Decision Date: 03/15/21 Archive Date: 03/15/21 DOCKET NO. 18-45 851 DATE: March 15, 2021 ORDER Entitlement to service connection for a right knee disability is granted. Entitlement to service connection for a left knee disability is granted. FINDINGS OF FACT 1. It is at least as likely as not that the Veteran’s right knee disability is related to his active duty service. 2. It is at least as likely as not that the Veteran’s left knee disability is related to his active duty service. CONCLUSIONS OF LAW 1. The criteria service connection for a right knee disability have been met. 38 U.S.C. § 1110, 5107(b); 38 C.F.R. §§ 3.102, 3.303. 2. The criteria for service connection for a left knee disability have been met. 38 U.S.C. § 1110, 5107(b); 38 C.F.R. §§ 3.102, 3.303. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty in the United States Army from April 1966 to November 1968. Service Connection Service connection may be granted for a disability resulting from a disease or injury incurred in or aggravated by active service. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303 (a). To establish entitlement to service-connected compensation benefits, 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)). The United States Court of Appeals for the Federal Circuit (Federal Circuit) has held that “[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.” 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”). Service connection must be considered on the basis of the places, types, and circumstances of his service as shown by his service records, the official history of each organization in which he served, his medical records, and all pertinent medical and lay evidence. See 38 C.F.R. § 3.303(a); see also Jandreau v. Nicholson, supra; and Buchanan v. Nicholson, supra. When there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, the VA shall give the benefit of the doubt to the claimant. 38 U.S.C. § 5107(b).). Entitlement to service connection for a bilateral knee disability The Veteran contends that his bilateral knee disability is related to his active service. The Board finds that the evidence supports the Veteran’s contention and service connection is warranted for a bilateral knee disability. At the onset, the Board finds that there is no dispute that the Veteran has a current disability, namely, bilateral knee osteoarthritis as noted in an October 2019 VA treatment record. Turning to an in-service incurrence, the Board finds that the Veteran’s and his spouse’s January 2021 testimony regarding an in-service incurrence are credible. Both the Veteran and his spouse of 50 years testified that the Veteran suffered from knee problems throughout their marriage and these problems began during the Veteran’s active service. The Veteran further elaborated that his military occupational specialty (MOS) put him on and around heavy machinery which required dismounting via jumping to the ground. The Veteran testimony is corroborated by his military personnel records (i.e. DD-214) which lists his MOS as heavy equipment operator. Thus, the Board finds that there is sufficient evidence to find that the type of Veteran’s active military service led to an incurrence of bilateral knee trauma. Turning to a nexus between the above disabilities and the Veteran’s in-service trauma, the Board finds that the July 2018 private medical opinion from the Veteran’s treating physician coupled with the testimony from the Veteran’s spouse provide probative evidence of a nexus. The Board notes that in July 2018 the Veteran’s treating physician wrote that the Veteran’s bilateral knee disability was “secondary to mirco-repetitive trauma.” This medical analysis coupled with the Veteran’s spouse’s credible testimony documenting the Veteran’s continuous pain in his knee from his service provides both context and insight on how these micro-repetitive traumas occurred in the Veteran’s active service. Additionally, no other potential etiology has been suggested. Considering the foregoing, the Board finds this Veteran’s current bilateral knee disability is related to the repeated trauma to his knees during active service which was required due to his MOS as heavy equipment operator. As such, the Board finds that all elements of service connection for right and left knee disabilities are met and the claims are granted. GAYLE E. STROMMEN Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board J. Acosta, 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.