Citation Nr: 21022031 Decision Date: 04/14/21 Archive Date: 04/14/21 DOCKET NO. 20-17 351 DATE: April 14, 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. Resolving reasonable doubt in favor of the Veteran, the evidence of record demonstrates that his right knee disability is etiologically related to service. 2. Resolving reasonable doubt in favor of the Veteran, the evidence of record demonstrates that his left knee disability is etiologically related to service. CONCLUSIONS OF LAW 1. The criteria for entitlement to service connection a right knee disability have been met. 38 U.S.C. §§ 1110, 5107 (2012); 38 C.F.R. §§ 3.102, 3.303. 2. The criteria for entitlement to service connection a left knee disability have been met. 38 U.S.C. §§ 1110, 5107 (2012); 38 C.F.R. §§ 3.102, 3.303. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served active duty service from January 1996 to January 2000 and from March 2000 to January 2005. The issues come before the Board of Veterans’ Appeals (Board) on appeal from a June 2018 rating decision by the Department of Veteran Affairs (VA) Regional Office (RO). In April 2021, the Veteran testified at a videoconference Board hearing before the undersigned Veterans Law Judge (VLJ). 1. Entitlement to service connection for a right knee disability is granted. 2. Entitlement to service connection for a left knee disability is granted. Service connection may be granted for a disability resulting from disease or injury incurred in or aggravated by active military service. 38 U.S.C. § 1131 (2012); 38 C.F.R. § 3.303. If there is no showing of a resulting chronic condition during service, then a showing of continuity of symptomatology after service is required to support a finding of chronicity for certain diseases. 38 C.F.R. §§ 3.303 (a), (b), 3.309(a); Walker v. Shinseki, 708 F.3d 1331 (Fed. Cir. 2013). Service connection may also be granted for any disease diagnosed after discharge, when all the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303 (d). To establish service connection for the claimed disorder, there must be (1) evidence of a current disability; (2) medical, or in certain circumstances, lay evidence of in-service incurrence or aggravation of a disease or injury; and (3) medical, or in certain circumstances, lay evidence of a nexus between the claimed in-service disease or injury and the current disability. 38 C.F.R. § 3.303; Shedden v. Principi, 381 F.3d 1163 (Fed. Cir. 2004). The requirement of a current disability is “satisfied when a claimant has a disability at the time a claim for VA disability compensation is filed or during the pendency of that claim.” McClain v. Nicholson, 21 Vet. App. 319, 321 (2007). The Board must determine the value of all evidence submitted, including lay and medical evidence. Buchanan v. Nicholson, 451 F.3d 1331 (Fed. Cir. 2006). The evaluation of evidence generally involves a three-step inquiry. First, the Board must determine whether the evidence comes from a competent source. The Board must then determine if the evidence is credible or worthy of belief. Barr v. Nicholson, 21 Vet. App. 303 (2007). The third step of this inquiry requires the Board to weigh the probative value of the evidence considering the entirety of the record. The standard of proof to be applied in decisions on claims for veterans’ benefits is outlined in 38 U.S.C. § 5107 (2012). A claimant is entitled to the benefit of the doubt when there is an approximate balance of positive and negative evidence. 38 C.F.R. § 3.102. When a claimant seeks benefits and the evidence is in relative equipoise, the claimant prevails. Gilbert v. Derwinski, 1 Vet. App. 49 (1990). The preponderance of the evidence must be against the claim for benefits to be denied. Alemany v. Brown, 9 Vet. App. 518 (1996). The Veteran has been diagnosed with bilateral patellofemoral syndrome, which he contends was incurred in service. Specifically, in his Form 9, Appeal to the Board, he stated that his bilateral knee disability was caused by years of physical activity mandated by the Army, to include physical training; field training exercises; rucksack marches of up to 12 miles; running with boots on, as well as, running with personnel on a stretcher, and M16/60; and jumping on and off HUMVEES helicopters, and 5-ton trucks. His condition worsened in service as the years went by. The Veteran’s service treatment records (STRs) are silent for complaints, treatment, or diagnosis of any knee disorders in service. His private post-service treatment records, however, show treatment and a diagnosis of bilateral patellofemoral pain syndrome. His private physician, Dr. P. C., M. D., diagnosed bilateral patellofemoral pain syndrome and provided a positive nexus to service. Dr. P. C. stated in a March 2021 correspondence that he has treated the Veteran since 2014 and is familiar with his medical history, including the circumstances and events of his military service. As such, it is his professional opinion that the Veteran’s bilateral knee disorder was likely a direct result of the repetitive high-impact physical activity during his years of military service. He added, in support, that medical literature supports that bilateral patellofemoral syndrome can occur due to repetitive stress injury and/or activity. The Board finds Dr. P. C. competent and credible, and his conclusion most probative in the finding that the Veteran’s diagnosed bilateral knee disability was a result of his service. Nieves-Rodriguez v. Peake, 22 Vet. App. 295 (2008) (noting that the probative value of a medical opinion comes from its being factually accurate, fully articulated, and having a sound reasoning for the conclusion.). Further, there is not any competent medical evidence of record that contradicts his findings. Accordingly, the Board finds the element of a nexus between the Veteran’s patellofemoral pain syndrome and service has been satisfied. Thus, service connection is, therefore, warranted. 38 U.S.C. §§ 1131, 5107; 38 C.F.R. §§ 3.102, 3.303. D. Martz Ames Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board N. Stevens, 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.