Citation Nr: 21025968 Decision Date: 04/29/21 Archive Date: 04/29/21 DOCKET NO. 18-40 647 DATE: April 29, 2021 REMANDED Entitlement to service connection for a right knee disability is remanded. Entitlement to service connection for a left knee disability is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Army from February 1987 to September 1990. This matter comes to the Board of Veterans’ Appeals (Board) on appeal from an April 2016 rating decision issued by the Department of Veterans Affairs (VA) Regional Office in Denver, Colorado. In April 2021, the Veteran testified at a virtual Board hearing before the undersigned Veterans Law Judge. 1. Entitlement to service connection for a right knee disability is remanded. 2. Entitlement to service connection for a left knee disability is remanded. Service connection is warranted where the evidence of record establishes that a particular injury or disease resulting in disability was incurred in the line of duty in the active military service or, if pre-existing such service, was aggravated thereby. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303(a). Generally, in order to prove service connection, there must be competent, credible evidence of (1) a current disability, (2) in-service incurrence or aggravation of an injury or disease, and (3) a nexus, or link, between the current disability and the in-service disease or injury. See, e.g., Davidson v. Shinseki, 581 F.3d 1313 (Fed. Cir. 2009); Pond v. West, 12 Vet. App. 341 (1999). Here, the Board notes that the Veteran’s service treatment records contain no entries reflecting a diagnosis of or treatment for any knee problems. Further, her lower extremities were clinically evaluated as normal at the time of a July 1990 service department examination, prior to her separation. The first medical evidence of knee problems is dated years after service. See Mense v. Derwinski, 1 Vet. App. 354 (1991). The Veteran’s service records confirm that her military occupational specialty (MOS) was that of a medical specialist. That background must be taken into account when evaluating her statements. See Goss v. Brown, 9 Vet. App. 109, 114-15 (1996); YT v. Brown, 9 Vet. App. 195, 201 (1996); Rucker v. Brown, 10 Vet. App. 67, 74 (1997). In that regard, the Board notes that while the Veteran has clearly had some medical training and experience, there is no indication on the record that she has the specialized knowledge or training of the type necessary to offer competent opinions with respect to the etiology of orthopedic disabilities. At the April 2012 Board hearing, the Veteran testified that she experienced bilateral knee pain after strenuous activity during service. She further indicated that because of her position as a medical specialist, she self-treated the condition rather than seeking formal care. She also testified that she experienced recurrent knee pain after service until the time that she ultimately sought formal medical treatment. In light of the Veteran’s testimony, the Board finds that a medical examination and opinion is warranted. See, e.g., McLendon v. Nicholson, 20 Vet. App. 79, 83 (2006). A remand is required. This matter is REMANDED for the following action: 1. Ask the Veteran to identify, and provide appropriate releases for, any care providers who may possess new or additional evidence pertinent to the issues on appeal. If she provides the necessary release(s), assist her in obtaining the records identified, following the procedures set forth in 38 C.F.R. § 3.159. Any new or additional (i.e., non-duplicative) evidence received should be associated with the record. If any of the records sought are not available, the record should be annotated to reflect that fact and the Veteran and her representative should be notified. 2. After the foregoing development has been completed to the extent possible, arrange to have the Veteran scheduled for an examination by an appropriately qualified clinician to address the nature and etiology of her claimed knee disabilities. For any chronic knee disability found to be present, the examiner should express an opinion as to whether it is at least as likely as not (i.e., whether it is 50 percent or more probable) that it was incurred in or is otherwise the result of the Veteran's active service. The examiner’s opinion should reflect consideration of the Veteran’s account of self-treatment during active service in her capacity as a medical specialist, as well as her statements to the effect that she experienced recurrent symptomatology for years after service before seeking formal medical treatment. A complete rationale for any opinions expressed must be provided. 3. After completing the above, and any other development as may be indicated by any response received as a consequence of the actions taken in the preceding paragraphs, the issues on appeal should be readjudicated based on the entirety of the evidence. If any benefit sought remains denied, the Veteran and her representative should be issued a supplemental statement of the case. An appropriate period of time should be allowed for response. DAVID A. BRENNINGMEYER Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board John Kitlas, 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.