Citation Nr: 21022834 Decision Date: 04/19/21 Archive Date: 04/19/21 DOCKET NO. 15-45 607 DATE: April 19, 2021 ORDER Service connection for a left knee disorder is denied. REMANDED Service connection for right ear hearing loss is remanded. FINDING OF FACT A left knee disorder was not incurred until years after service and is not etiologically related to service. CONCLUSION OF LAW The criteria for service connection for a left knee disorder have not been met. 38 U.S.C. §§ 1101, 1110, 1112, 1131, 1137; 38 C.F.R. §§ 3.303, 3.307, 3.309. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran had active service from January 1977 to July 1982. A hearing before the undersigned Veterans Law Judge was held in March 2019. Service connection may be established for disability resulting from disease or injury incurred in or aggravated by active military, naval, or air service. 38U.S.C. §§1110, 1131; 38C.F.R. §3.303. Service connection may be granted for any disease initially diagnosed after discharge, when all the evidence, including that pertinent to service, establishes the disease was incurred in service. 38C.F.R. §3.303(d). Where a veteran served for at least 90 days during a period of war or after December 31, 1946, and manifests arthritis to a degree of 10 percent within one year from the date of termination of such service, such disease shall be presumed to have been incurred or aggravated in service, even though there is no evidence of such disease during the period of service. 38U.S.C. §§1101, 1112, 1137; 38C.F.R. §§3.307, 3.309. 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 opposed to merely isolated findings or a diagnosis including the word “chronic.” When the fact of chronicity in service (or during any applicable presumptive period) is not adequately supported, then a showing of continuity after discharge is required to support the claim. 38C.F.R. §3.303(b). The term “chronic disease” refers to those diseases listed under section 1101(3) of the statute and section 3.309(a) of VA regulations. 38U.S.C. §1101(3); 38C.F.R. §3.309(a); Walker v. Shinseki, 708 F.3d 1331 (Fed. Cir. 2013). A December 2002 VA treatment record reveals the Veteran’s history of left knee pain. He denied significant past medical history. He denied injury and reported pain and stiffness in the previous two weeks and occasional swelling. The examiner diagnosed arthralgia. X-ray imaging showed mild arthritis in the patellar region. A September 2011 VA treatment record reveals a history of left knee pain. Diagnoses included stable left knee pain and myalgia. March 2012 VA treatment record reveals the Veteran’s history of painful left knee for two weeks. He also reported swelling and stiffness. VA X-ray reports reveals finding of mild three-compartmental degenerative joint disease and suspected small joint effusion. An April 2012 VA treatment record reveals the Veteran’s history of left knee pain, worse for the previous three years. The diagnosis was chronic left knee pain. Subsequent records reveal treatment for chronic left knee pain. A September 2012 magnetic resonance imaging (MRI) report reveals findings of arthritis. A November 2019 VA examination record reveals diagnosis of bilateral knee arthritis. The examiner determined that it was less likely than not that the left knee disorder was incurred in or related to service. The examiner explained that the Veteran complained of left knee pain in 2004 and that a nexus was not established. A February 2021 VA medical opinion notes treatment for the left knee since 2002. The physician determined the left knee disability was less likely than not incurred in or caused by service. The physician explained that there was no documentation in the medical records to support in-service diagnosis, treatment, or evaluation associated with left knee condition during service. After consideration of the record, the Board finds service connection is not warranted for a left knee disorder. Service medical records do not reveal any finding of a left knee disorder, and the initial complaints and diagnosis pertaining to the left knee date in 2002. Additionally, the VA medical opinions reveal determinations that the left knee disorder was less likely than not incurred in or caused by service and there is no contrary medical evidence. The Veteran has reported left knee symptoms during and since service. The Board finds the Veteran’s history of continuous symptoms since service is not credible because it is contradicted by the medical record, notably the two week history of symptoms in 2002. The Board finds the 2002 history is particularly probative as to the duration of the knee symptoms as it is consistent with the previous VA treatment records, which date from 1997 and which do not reveal any history of left knee abnormality. In the absence of competent nexus evidence, service connection is not warranted. Accordingly, the claim must be denied. REASON FOR REMAND In December 2020, the Board remanded the matter in order to obtain a medical opinion as to whether the right ear hearing loss increased in severity in service with consideration of the August 1980 audiogram. Although an opinion was obtained, the opinion does not explicitly address the August 1980 audiogram. This must be done. The matters are REMANDED for the following action: Obtain an addendum opinion from the February 2021 audiologist or other appropriate medical professional to address whether the right ear hearing loss underwent an increase in service. The opinion must explicitly address the August 1980 audiometric findings. The Board notes that the August 1980 audiometric findings are located below the December 1979 audiometric findings. T. REYNOLDS Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board N. Snyder, 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.