Citation Nr: 21027252 Decision Date: 05/05/21 Archive Date: 05/05/21 DOCKET NO. 16-27 071 DATE: May 5, 2021 ORDER Entitlement to service connection for a right knee disability is denied. Entitlement to service connection for a pulmonary disability, to include as due to asbestos exposure, is denied. FINDINGS OF FACT 1. The Veteran's right knee disability did not manifest during active service, arthritis did not manifest within one year of discharge from active service, and there is no indication that his current right knee disability is otherwise related to his active service. 2. The Veteran does not have a chronic pulmonary disability. CONCLUSIONS OF LAW 1. The criteria for service connection for a right knee disability are not met. 38 U.S.C. §§ 1101, 1110, 1112, 1131, 1137, 5107 (2018); 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309 (2020). 2. The criteria for service connection for a pulmonary disability are not met. 38 U.S.C. §§ 1101, 1110, 1112, 1131, 1137, 5107 (2018); 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309 (2020). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran had active air service from June 1968 to June 1972. This case comes before the Board of Veterans' Appeals on appeal from an August 2013 rating decision issued by a Regional Office (RO) of the Department of Veterans Affairs (VA). The Veteran was scheduled for a Board hearing in October 2019; however, he failed to report to it. He has not provided good cause for his failure to appear or requested to reschedule the hearing. Therefore, his hearing request has been deemed withdrawn. Service Connection Right Knee The Veteran maintains that his right knee disability was incurred in or is related to his military service. On his March 2013 claim, he stated that he had to work on units on his knees continuously throughout his four years of service. The Veteran's service treatment records are unremarkable for any complaints, treatment, or diagnoses related to the right knee. At his March 1972 separation examination, his lower extremities were normal. His service personnel records indicated that his primary specialty was heating systems repairman. Post service, a December 2006 private treatment record indicated that the Veteran presented with right knee pain and swelling. He stated that he had an over 25-year history of right knee problems. He stated that he was first diagnosed with prepatellar bursitis and it was recommended that he wear knee pads at that point. It was noted he worked as an AC repairman/service technician. X-rays of the knee demonstrated advanced medial compartment arthritis changes with bone-on-bone arthritis in the anterior and the medial compartment. Magnetic resonance imaging (MRI) demonstrated a partial anterior cruciate ligament (ACL) versus complete ACL tear. In December 2011, he underwent a right total knee arthoplasty, i.e., replacement. The Board notes that the Veteran was not provided with a VA examination in conjunction with the claim for service connection. VA must provide a medical examination when there is (1) competent evidence of a current disability or persistent or recurrent symptoms of a disability; (2) evidence establishing that an event, injury, or disease occurred in service or establishing certain diseases manifesting during an applicable presumptive period for which the claimant qualifies; and (3) an indication that the disability or persistent or recurrent symptoms of a disability may be associated with the veteran's service or with another service-connected disability; but (4) insufficient competent medical evidence on file for the Secretary to make a decision on the claim. See 38 C.F.R. § 3.159(c)(4); see also McLendon v. Nicholson, 20 Vet. App. 79 (2006). In this case, however, the evidence does not indicate that the Veteran's right knee disability may be associated with his service. See McLendon, 20 Vet. App. at 83; see also Waters v. Shinseki, 601 F.3d 1274, 1278 (Fed. Cir. 2010). There were no complaints of any right knee problems during service. At his separation examination, his lower extremities were noted as normal and there is no medical evidence otherwise linking his current right knee disability to service. Accordingly, the Board finds that a VA examination is not warranted. In this case, the Board finds the most probative evidence weighs against the claim. The evidence does not indicate that the Veteran's right knee disability manifested during active service or within one year after separation from service. After service, the first documentation of a right knee disability occurred in December 2006. At that time, it was noted he had an approximate 25-year history of right knee problems, i.e., since approximately 1981, nine years after service. The passage of time between discharge from active service and the medical documentation of a claimed disability is a factor that tends to weigh against a claim for service connection. Maxson v. Gober, 230 F.3d 1330, 1333 (Fed. Cir. 2000). The Board has also considered the lay evidence of record. The Veteran is competent to describe what he has personally observed or experienced. However, the ultimate questions of diagnoses and etiology in this case extend beyond an immediately observable cause-and-effect relationship and are beyond the competence of lay witnesses. Accordingly, the Board finds that the preponderance of the evidence is against the claim and entitlement to service connection for a right knee disability is not warranted. 38 U.S.C. § 5107(b); Gilbert v. Derwinski, 1 Vet. App. 49 (1990). Service Connection Pulmonary Disability The Veteran maintains that he has a current pulmonary disability that was incurred in or is related to his active service. On his March 2013 claim, he indicated that he was exposed to asbestos throughout his military service. The Veteran's service treatment records are unremarkable for any complaints, treatment, or diagnoses related to a pulmonary disability. At his March 1972 separation examination, his lungs and chest were normal. A chest X-ray was also normal. It was noted that he had occasional episodes of chest pain, but that he had been asymptomatic since January 1971. Post service, the Veteran submitted private treatment records dated from December 2006 to December 2011. The record to not note any complaints, treatment, or diagnoses related to a pulmonary disability. Furthermore, he has not identified any other records of treatment for a pulmonary disability. In the absence of proof of a present disability (and, if so, of a nexus between that disability and the active military service), there can be no valid claim for service connection. Gilpin v. West, 155 F.3d 1353 (Fed. Cir. 1998); Brammer v. Derwinski, 3 Vet. App. 223, 225 (1992). In this case, there is no competent evidence of a pulmonary disability, to include any resulting chronic functional impairment. See Saunders v. Wilkie, 886 F.3d 1356, 1368 (Fed. Cir. 2018). The Board has also considered the lay evidence of record. The Veteran is competent to describe what he has personally observed or experienced. However, the ultimate question of diagnosis in this case extends beyond an immediately observable cause-and-effect relationship and is beyond the competence of lay witnesses. Accordingly, the Board finds that the preponderance of the evidence is against the claim and entitlement to service connection for a pulmonary disability is not warranted. 38 U.S.C. § 5107(b); Gilbert, 1 Vet. App. at 55. Kristin Haddock Veterans Law Judge Board of Veterans' Appeals Attorney for the Board S. Mishalanie, 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.