Citation Nr: 21021746 Decision Date: 04/13/21 Archive Date: 04/13/21 DOCKET NO. 16-22 359 DATE: April 13, 2021 ORDER Entitlement to service connection for a left knee disorder is denied. FINDING OF FACT A left knee disorder was not manifest during service and arthritis was not manifest within one year of separation from active service. A left knee disorder is unrelated to service. CONCLUSION OF LAW A left knee disorder was not incurred in or aggravated by active service, and arthritis may not be presumed to have been incurred in active service. 38 U.S.C. §§ 1101, 1112, 1113, 1131, 1137; 38 C.F.R. §§ 3.303, 3.307, 3.309. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from December 1980 to December 1983. 1. Entitlement to service connection for a left knee disorder Veterans are entitled to compensation if they develop a disability “resulting from personal injury suffered or disease contracted in line of duty, or for aggravation of a preexisting injury suffered or disease contracted in line of duty.” 38 U.S.C. §§ 1110 (wartime service), 1131 (peacetime service). 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.” See Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004). Service connection may be granted for any disease diagnosed after discharge, when all the evidence, including that pertinent to service establishes that the disability was incurred in service. 38 C.F.R. § 3.303(d). The determination as to whether these requirements are met is based on an analysis of all the evidence of record and the evaluation of its credibility and probative value. See Baldwin v. West, 13 Vet. App. 1, 8 (1999). Relevant to the Veteran’s appeal, arthritis is identified as a “chronic disease” under 38 U.S.C. § 1101 and 38 C.F.R. § 3.309(a). “For the showing of chronic disease in service there is required a combination of manifestations sufficient to identify the disease entity, and sufficient observation to establish chronicity at the time, as distinguished from merely isolated findings or a diagnosis including the word “Chronic.” When the disease identity is established (leprosy, tuberculosis, multiple sclerosis, etc.), there is no requirement of evidentiary showing of continuity. Continuity of symptomatology is required only where the condition noted during service (or in the presumptive period) is not, in fact, shown to be chronic or where the diagnosis of chronicity may be legitimately questioned. When the fact of chronicity in service is not adequately supported, then a showing of continuity after discharge is required to support the claim.” 38 C.F.R. § 3.303(b). The Veteran claims that his left knee disorder was acquired during service. He also states that he has had knee pain for an extended amount of time. He notes pain in both knees, as well as diagnoses for torn meniscus and arthritis in both knees. Here, the Board notes that the Veteran only claimed a left knee condition on his October 2014 VA 21-526 Form. Service treatment records indicate that the Veteran had a right knee injury in August 1982. A medical record indicates that the Veteran was likely playing a sport when he was injured. An x-ray revealed that the Veteran had “mild loss” of medial joint space in the right knee and was diagnosed with right knee degenerative joint disease. On a Report of Medical Examination dated October 28, 1983, the Veteran was assessed with normal lower extremities. Post-service, medical records start mentioning the Veteran’s left knee disorder in around October 2014. The Veteran notes pain rated at 7/10 in his left knee. The doctor seeing the patient concluded that the Veteran acquired arthritic changes in the left knee joint. In approximately 2017, the Veteran’s left knee was replaced. The Veteran was afforded a VA examination in October 2019. When asked whether it was at least as likely as not that the Veteran’s left knee disorder was directly related to an event in service, the VA examiner concluded that it was less likely than not. The VA examiner wrote that There was a “indication of some kind of injury in 1982” but that his exam and x-rays were normal. The examiner noted that there was no indication of an issue at discharge. The examiner noted that the Veteran’s 2014 x-ray shows very mild anterior degeneration that appears to be age related. The examiner concluded that there “is no indication from the one service clinical record on the left knee to indicate mechanical forces that would lead to degeneration. Also his condition was bilateral.” In adjudicating a claim, the Board is charged with the duty to assess the credibility and weight given to evidence. See Madden v. Gober, 125 F.3d 1477, 1481 (Fed. Cir. 1997). Competency of evidence differs from weight and credibility. The former is a legal concept determining whether testimony may be heard and considered by the trier of fact, while the latter is a factual determination going to the probative value of the evidence to be made after the evidence has been admitted. Rucker v. Brown, 10 Vet. App. 67, 74 (1997). The probative value of a medical opinion primarily comes from its reasoning; threshold considerations are whether a person opining is suitably qualified and sufficiently informed. Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 304 (2008). In this case, the Board accepts the October 2019 VA medical opinion that the Veteran’s left knee disorder is less likely than not related to service as probative medical evidence on this point. The Board notes that the examiner rendered this opinion after thoroughly reviewing the claims file and relevant medical records. The examiner noted the Veteran’s pertinent history and provided a reasoned analysis of the case. See Hernandez-Toyens v. West, 11 Vet. App. 379, 383 (1998); Gabrielson v. Brown, 7 Vet. App. 36, 40 (1994). The Board has considered the lay statements of the Veteran regarding his left knee disorder. The Veteran is competent to provide evidence of what he experiences, including his symptomatology and medical history. See Layno v. Brown, 6 Vet. App. 465, 469 (1994). The Veteran is competent to report what he experienced. Jandreau v. Nicholson, 492 F.3d 1372, 1377 (Fed. Cir. 2007). However, the Board does not find his statements to be as probative as the VA examiner’s opinion, which was based on extensive review of the record, thorough examination, consideration of the lay statements, and the VA examiner’s medical expertise. Notably, the Veteran has not indicated that a medical professional provided him with a diagnosis of a left knee disorder during active service, or within a year of separation. There is no reliable evidence linking the Veteran’s left knee disorder to service. The contemporaneous records establish that there were no documented manifestations of a right knee disorder in service, the lower extremities were physically normal upon separation, there were no manifestations of arthritis within one year of separation, and arthritis was first manifest many years after separation. The Board finds the contemporaneous records to be far more probative than the Veteran’s reporting. Here, chronic disease (arthritis) of the left knee was not “noted” during service or within one year of separation within the meaning of section 3.303(b). While the Board notes the Veteran’s service treatment records noting history of an in-service event involving the right knee, it finds that the service treatment records do not show a combination of manifestations sufficient to identify the disease entity, and sufficient observation to establish chronicity at the time (on the left). Rather, the lower extremities were normal at separation. Furthermore, the evidence does not establish that arthritis of the knees was manifest to a compensable degree within one year of separation. 38 C.F.R. §§ 3.307; 3.309. In sum, there is insufficient competent and probative evidence linking the Veteran’s left knee disorder to service. The contemporaneous records establish that relevant systems were normal at separation and service treatment records do not document any relevant notations regarding the left knee disorder. The more probative evidence establishes that the Veteran did not have a left knee disorder during service, that such disorder is not related to any event in service, and arthritis was first manifest many years after separation. The evidence establishes that the remote onset of a left knee disorder is unrelated to service. H. N. SCHWARTZ Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Jonah Nelson, 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.