Citation Nr: 21026498 Decision Date: 05/03/21 Archive Date: 05/03/21 DOCKET NO. 19-26 990 DATE: May 3, 2021 ORDER Service connection for degenerative joint disease (DJD), status post left knee replacement with residual pain and limited range of motion, including as secondary to service-connected lumbar spine disability is granted. FINDING OF FACT The Veteran's left knee disability is related to service. CONCLUSION OF LAW The criteria for service connection for a left knee disability are met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran had active duty service in the Army from January 1960 to February 1966. In January 2020, a videoconference hearing was held before the undersigned Veterans Law Judge (VLJ), the transcript of which is of record. In a March 2020 decision and remand, the Board granted service connection for a right knee disability, then remanded the claim involving the left knee disability. The Board requested another VA opinion on etiology of the left knee condition, to include whether service-connected low back disability caused or aggravated left knee disability. A May 2020 VA negative opinion was obtained. In December 2020, the Board remanded the case again, to request an opinion that discussed the Veteran's lay statements. Another negative opinion was obtained. Service connection for left knee DJD, status post left knee replacement is granted. As the Board discussed in its earlier remands, the earlier VA opinions concluded that because left knee arthritis was diagnosed 2008 which was 40 years post-service, that meant no causation to service. However, the Veteran stated he had actively treated a left knee problem for about 35 years before then. See Buchanan v. Nicholson, 451 F.3d 1331, 1336 (Fed. Cir. 2006) (the Board cannot determine that lay evidence lacks credibility merely because it is unaccompanied by contemporaneous medical evidence). The case was remanded to obtain an adequate opinion. In response, the following opinion was obtained in January 2021. "The diagnosed condition of DJD s/p left TKR is less likely as not related to an in-service injury, event, or disease. .... Although the Veteran stated a history of strenuous occupational duties in service, OTC Tylenol used to alleviate pain after service, there is no documentation of knee DJD until 2008 which was 42 years since discharging from service." As for considering, weighing and explaining the relevance of the Veteran's reported history, such as occupational joint stress and then several years of treatment afterwards, there is not additional information given here to support the view given. In February 2020, Dr. A. C., the Veteran's private physician, stated that during his time in the military the Veteran was a heavy weapons operator, and he had to carry heavy mortars and machine guns. Dr. A. C. stated that "... it would not be unusual for him to develop a service connected problem with his knee as he grew older just due to the amount of heavy activity he was in gated in while in the military." Although this opinion does not provide a more detailed rationale, it is still sufficient to support the claim, especially in light of the fact that VA has been unable to obtain adequate medical opinions that consider the Veteran's lay statements. As the VA opinions are inadequate, the preponderance of the evidence is in favor of a grant of service connection for a left knee disability on a direct basis. Because the claim is being granted on a direct basis, no discussion of the theory of secondary service connection is necessary. D. Martz Ames Veterans Law Judge Board of Veterans' Appeals Attorney for the Board J. Lyons, 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.