Citation Nr: 21023812 Decision Date: 04/21/21 Archive Date: 04/21/21 DOCKET NO. 14-34 133 DATE: April 21, 2021 ORDER Service connection for a chronic back disorder is granted. Service connection for a chronic right knee disorder is granted. Service connection for a chronic right wrist disorder is granted. FINDINGS OF FACT 1. The Veteran had active duty from January 1976 to April 1983, from March 2009 to February 2010, with additional period of active duty for training (ACDUTRA) in June 2012, and inactive duty for training (INACDUTRA) in the National Guard. 2. A back disorder, right knee disorder, and right wrist disorder manifested to a compensable degree in the year following separation from service. CONCLUSIONS OF LAW 1. A chronic back disorder was incurred in service. 38 U.S.C. §§ 1110, 1112, 1131, 5103(a), 5103A, 5107 (2012); 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309, 4.59 (2020). 2. A chronic right knee disorder was incurred in service. 38 U.S.C. §§ 1110, 1112, 1131, 5103(a), 5103A, 5107 (2012); 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309, 4.59 (2020). 3. A chronic right wrist disorder was incurred in service 38 U.S.C. §§ 1110, 1112, 1131, 5103(a), 5103A, 5107 (2012); 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309, 4.59 (2020). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS An April 2019 Board decision was vacated by the Court of Appeals for Veterans Claims (Court) in a February 2020 Joint Motion for Remand (JMR). In August 2020, the Board remanded the issues plus a claim for a right hip disorder to the Regional Office (RO) for further development. Thereafter, the RO granted service connection for the right hip disorder based on an injury in June 2012 while the Veteran was with the National Guard. The remaining issues were returned to the Board. The Board had previously determined the June 2012 as a period of INACDUTRA; however, the Court instead deemed it ACDUTRA. As this is the law of the case, it is found to be a period of ACDUTRA. A period of INACDUTRA or ACDUTRA is treated as active service if a disability was service connected as a result of an injury or disease therein. Hill v. McDonald, 28 Vet. App. 243 (2016). As such, the volleyball injury in June 2012 which the Veteran claimed caused his remaining claims on appeal, occurred during a period of active service. Turning to the relevant laws and regulations, service connection may be granted on a direct basis as a result of disease or injury incurred in service based on nexus using a three-element test: (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 in or aggravated by service. See 38 C.F.R. §§ 3.303(a), (d); Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009). Service connection may be granted on a presumptive basis for diseases listed in 38 C.F.R. § 3.309 under the following circumstances: (1) where a chronic disease or injury is shown in service and subsequent manifestations of the same disease or injury are shown at a later date unless clearly attributable to an intercurrent cause; or (2) where there is continuity of symptomatology since service; or (3) by showing that the disorder manifested itself to a degree of 10 percent or more within one year from the date of separation from service. See 38 C.F.R. § 3.307. As the evidence for all the disabilities is similar, they will be discussed together. Turning to the evidence, the Veteran has current chronic diseases for each disorder. X-rays taken pursuant to an April 2013 VA examination showed degenerative arthritis of the right knee, multilevel degenerative osteoarthritis of scaphotrapezial joint in the right hand, and osteoarthritis of the thoracic spine. Each of these is a chronic disease, and as such the first element of service connection is met. As to an in-service incurrence, the Veteran was service connected for a right hip disability in a January 2021 rating decision for an injury incurred while playing volleyball during a two-week period of ACDUTRA in June 2012. The April 2013 VA examination which diagnosed each disorder on appeal was within a year following this period of active service. As such, the threshold question is whether the disorder(s) manifested to a compensable degree in the year following separation. As to the low back, the April 2013 VA examiner noted that the Veteran had a reduced range of motion and pain on range of motion on the back. September 2012 VA medical records also show pain with movement. A compensable rating may be warranted for arthritis with painful motion under 38 C.F.R. § 4.59. As such, the Veteran’s back disability manifested to a compensable degree in the year following separation from active duty. As to the right knee, the Veteran reported limited symptoms of pain during the April 2013 VA examination. He later clarified in a February 2020 brief submitted to the Court that he continued to experience knee joint symptoms following the June 2012 injury, and that this was misconstrued by the examiner at that time. The Veteran told an October 2020 VA examiner that after the June 2012 injury he had developed pain that was rated as a 3 out of 10 but worsened to a 6 or 7 out of 10 with climbing stairs or prolonged walking. Pain and painful motion are lay observable symptoms, although additionally, the Veteran has medical training from his various military occupational specialty in service and additional medical training, increasing the probative value of his statements. As such, his statements are competent, credible, and given significant probative weight and painful motion coupled with X-ray evidence of arthritis indicates that his disability manifested to a compensable degree in the year following separation from active service. As to the wrist, the April 2013 VA examiner stated that the combination of wrist and finger disorders make it difficult for the Veteran to grasp and hold objects with his right hand. The Veteran also reported residual pain and loss of motion, which he treated with ibuprofen for pain relief. As such, the evidence demonstrates X-ray evidence of arthritis and confirmed painful motion sufficient for a compensable rating. Therefore, the wrist disorder manifested to a compensable degree in the year following separation from active service. For each of the disabilities on appeal, VA examiners in April 2013 and October 2020 have found no connection between the disorders and service. In addition, a June 2014 VA examiner found no connection between service and the right wrist. However, the Board does not need to reach the weight assignable to nexus opinions because service connection is granted on a presumptive basis under 38 C.F.R. § 3.303(b) for the “chronic” disease of arthritis based on development to a compensable level in the year following active service, rather than on a theory of direct or secondary service connection. In sum, there is X-ray evidence of arthritis for each disability, with symptoms of painful motion, in the year following a period of active duty; therefore, each disorder is presumed to have been incurred in service and the appeals are granted. Because the Board is granting service connection on a presumptive basis for a chronic disease, all other service connection theories are rendered moot. Finally, the Veteran has not raised any other issues, nor have any other issues been reasonably raised by the record, for the Board’s consideration. See Doucette v. Shulkin, 28 Vet. App. 366, 369-370 (2017) (confirming that the Board is not required to address issues unless they are specifically raised by the claimant or reasonably raised by the evidence of record). L. HOWELL Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Brendan A. Evans, 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.