Citation Nr: 21015522 Decision Date: 03/17/21 Archive Date: 03/17/21 DOCKET NO. 17-23 997 DATE: March 17, 2021 ORDER Entitlement to service connection for a right knee disorder is granted. Entitlement to service connection for a left knee disorder is granted. REMANDED Entitlement to service connection for bilateral hearing loss is remanded. FINDINGS OF FACT 1. Resolving reasonable doubt in the Veteran’s favor, his right knee arthritis, status post total knee replacement surgery, is at least as likely as not related to in-service jumping and falling from large trucks. 2. Resolving reasonable doubt in the Veteran’s favor, his left knee arthritis, status post total knee replacement surgery, is at least as likely as not related to in-service jumping and falling from large trucks. CONCLUSIONS OF LAW 1. The criteria for service connection for right knee arthritis, status post total knee replacement surgery, are met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303. 2. The criteria for service connection for left knee arthritis, status post total knee replacement surgery, are met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran had active service in the United States Army from October 1970 to April 1972 with additional periods of active duty for training in the Army Reserves. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a May 2014 rating decision by a Department of Veterans Affairs (VA) Regional Office (RO; this case is in the Board’s legacy appeals system. The Veteran testified at a July 2017 Board hearing before the undersigned; a transcript is associated with the claims file. Service Connection 1. Entitlement to service connection for a bilateral knee condition The Veteran asserts that his arthritis of the bilateral knees (bilateral knee arthritis), now status post bilateral total knee replacement surgeries, was caused by his repeated jumping and falling from large trucks during service. The Board concludes that the Veteran has bilateral knee arthritis that is related to repeated jumping and falling from large trucks during service. 38 U.S.C. §§ 1110, 1131, 5107(b); Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009); 38 C.F.R. § 3.303(a). The Veteran’s post-service treatment records show that the Veteran was diagnosed with degenerative arthritis in both knees, ultimately treated with total knee replacement surgery of the left knee in 2011 and of the right knee in 2013. Thus, the question becomes whether the current disability is related to service. The evidence against the claim includes the lack of complaint, diagnosis, or treatment for any knee condition in the Veteran’s service treatment records or for at least one year after his separation from service. The evidence in favor of the claim includes the October 2019 opinion of a VA examiner, clarified by a July 2020 addendum opinion. The examiner opined that the Veteran’s description of his in-service experience of repeatedly jumping down from semi-trucks while loading and unloading were credible and consistent with his medical history and that this repeated jumping was at least as likely as not the cause of his developing bilateral knee arthritis. There is no medical opinion of record contradicting the VA examiner’s opinion. Upon review of the record, the Board finds the evidence to at least be in equipoise as to whether the Veteran’s current bilateral knee arthritis is related to service. Accordingly, after resolving all doubt in favor of the Veteran, the Board finds that service connection for bilateral knee arthritis is warranted. 38 U.S.C. § 5107; 38 C.F.R. § 3.102. REASONS FOR REMAND 1. Entitlement to service connection for bilateral hearing loss is remanded. During a July 2017 hearing, the Veteran stated that during service he had sought treatment at an emergency room for hearing loss, tinnitus, and bleeding from his ears after a tank fired nearby while the Veteran had no ear protection. The Veteran also stated that he sought treatement from VA for his hearing loss soon after leaving service in the 1970s. He stated that he sought treatment at VA every few years but his concerns were dismissed. An August 1999 VA treatment record is consistent with the Veteran’s statement, noting his report of hearing loss and request for a hearing test, which was denied because the Veteran did not have any service connected disabilities at the time. Finally the Veteran mentioned exposure to a .60 caliber gun without ear protection during his service in the Army Reserves. No private emergency room records and no VA records from earlier than May 1999 are of record. A remand is required to allow VA to obtain authorization and request these records. The Board acknowledges the recently obtained VA examination and opinion of October 2019, stating that the Veteran’s hearing loss is less likely than not related to active service. However, this opinion may have been based on an incomplete record. Furthermore, the examiner noted that the Veteran was not treated until 2014, but failed to discuss the Veteran’s documented complaint of hearing loss in May 1999. The examiner also relied on a September 1977 Army Reserve enlistment exam for support of the opinion that the Veteran’s hearing was within normal limits after separation from service but failed to address the Veteran’s statement that he was exposed to .60 caliber gunfire without hearing protection during his reserve service. A remand is necessary to obtain a new opinion with a rationale based on a complete and accuate medical record. The matters are REMANDED for the following action: 1. Ask the Veteran to complete a VA Form 21-4142 for (a.) the hospital where he testified he sought treatment for his hearing loss, tinnitus, and bleeding ears during service. (b.) Any provider who performed his tympanoplasty (consistently noted in his medical history without associated dates or providers) or provided any related diagnosis or treatment. Make two requests for the authorized records from any identified facility or provider, unless it is clear after the first request that a second request would be futile. Document all requests for information as well as all responses in the claims file. 2. Obtain the Veteran’s complete service treatment records, to include documents pertaining to his service in the Army Reserve from 1972 to 1979. Document all requests for information as well as all responses in the claims file. 3. Obtain the Veteran’s VA treatment records for the period from April 1972 to May 1999. 4. Once the above development is completed, forward the electronic claims file to an appropriate medical professional to offer an addendum opinion regarding the etiology of the Veteran’s bilateral hearing loss. An examination of the Veteran is not required unless deemed necessary by the medical professional selected to offer the opinion. The electronic claims file including a copy of this remand must be made available to, and be reviewed by, the examiner. Following a review of the claims file, the examiner is requested to provide an opinion as to whether it is at least as likely as not that the Veteran’s current bilateral hearing loss is related to his military service, to include his in-service noise exposure and noise exposure during any period of active duty for training. The examiner should also offer an opinion as to whether it is at least as likely as not that the Veteran had bilateral hearing loss within one year of his April 1972 service discharge, i.e., by April 1973, and if so, describe the manifestations. In offering such opinions, the examiner should consider the Veteran’s lay statements regarding noise exposure during his active service and active duty for training, the onset of his bilateral hearing loss, and continuity of symptomatology. The opinions should be supported by a clear rationale and not be based solely on the fact that the Veteran’s hearing tested within normal limits at service separation, and the examiner should consider the Veteran’s testimony that his post-service noise exposure was negligible. 5. After the above development, and any additionally indicated development, has been completed, readjudicate the issue on appeal. If any benefit sought is not granted to the Veteran’s satisfaction, send the Veteran a Supplemental Statement of the Case and provide an opportunity to respond. If necessary, return the case to the Board for further appellate review. L. M. BARNARD Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board M. Zimmerman 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.