Citation Nr: 21027944 Decision Date: 05/07/21 Archive Date: 05/07/21 DOCKET NO. 17-31 985 DATE: May 7, 2021 ORDER Entitlement to service connection for right knee arthritis is granted. Entitlement of service connection for left knee arthritis is granted. FINDINGS OF FACT 1. A medically chronic right knee disability was manifest in service. Arthritis is attributable to service 2. A medically chronic left knee disability was manifest in service. Arthritis is attributable to service. CONCLUSIONS OF LAW 1. Right knee arthritis was incurred in wartime service. 38 U.S.C. §§ 1101, 1110 (2012); 38 C.F.R. § 3.303 (2019). 2. Left knee arthritis was incurred in wartime service. 38 U.S.C. §§ 1101, 1110 (2012); 38 C.F.R. § 3.303 (2019). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from March 1985 to December 1997. The AOJ has accepted prior service which is consistent with the service treatment records. This matter comes before the Board of Veterans' Appeals (Board) from a July 1999 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO). In January 2020, the Veteran testified at a hearing before the undersigned Veterans Law Judge (VLJ). A transcript of this hearing is associated with the claims folder. With respect to the Board hearing, the undersigned VLJ clarified the issue on appeal, enquired as to whether there was additional outstanding evidence and held the file open for 90 days. These actions complied with any duties owed during a hearing. 38 C.F.R. § 3.103. Service Connection 1. Pertinent Legal Criteria Veterans are entitled to compensation from VA if they develop a disability "resulting from personal injury suffered or disease contracted in line of duty, or for aggravation of a preexisting injury suffered or disease contracted in line of duty." 38 U.S.C. § 1110 (wartime service), 1131 (peacetime service). To establish a right to compensation for a present disability, a veteran must show: "(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 or aggravated during service" the so called "nexus" requirement. Shedden v. Principi, 381 F.3d 1163, 1167 (Fed.Cir. 2004). The Board notes that the Veteran has not claimed that his disabilities on appeal are the result of combat with the enemy. Therefore, the combat provisions of 38 U.S.C. § 1154 are not for consideration. The Veteran has been diagnosed with osteoarthritis in the knees according to a August 2014 medical note. Osteoarthritis is a form of arthritis. Arthritis is a "chronic disease" under 38 U.S.C. § 1101 and 38 C.F.R. § 3.309 (a). For a Veteran who served 90 days or more of active service after December 31, 1946, there is a presumption of service connection for certain chronic diseases to include arthritis, if the disability is manifest to a compensable degree within one year of discharge from service. 38 U.S.C. §§ 1101, 1110, 1112, 1113, 1131, 1137; 38 C.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 distinguished from merely isolated findings or a diagnosis including the word "chronic." Continuity of symptomatology after discharge is required where the condition noted during service is not, in fact, shown to be chronic or where the diagnosis of chronicity may be legitimately questioned. 38 C.F.R. § 3.303 (b); See Walker v. Shinseki, 708 F.3d 1331 (Fed. Cir. 2013) (the theory of continuity of symptomatology can be used only in cases involving those conditions explicitly recognized as chronic as per 38 C.F.R. § 3.309 (a)). After the evidence is assembled, it is the Board's responsibility to evaluate the entire record. See 38 U.S.C. § 7104(a) (2012). When there is an approximate balance of evidence regarding the merits of an issue material to the determination of the matter, the benefit of the doubt in resolving each issue shall be given to the claimant. See 38 U.S.C. § 5107 (2012); 38 C.F.R. §§ 3.102, 4.3 (2019). 2. Service Connection The Board has reviewed the record to include the service records, the testimony, and the recent VA opinion. We are impressed with a phenomenal number of knee complaints during service and the diagnoses were amended over time. In a problem list, there was a notation of chronic bilateral patellar bursitis. The record further established that Veteran filed a claim immediately after service reflecting continuity and his belief that he had pathology attributable to service. The recent negative nexus opinion appears to be based on what was described as the initial normal X-ray examination. However, further review reflects that the examiner stated that there were no significant abnormalities. This creates a factual issue. X-ray examinations are either normal or abnormal. A statement that there are no significant abnormalities tens to establish that there are abnormalities. We are presented with a Veteran who had lengthy service and voiced consistent complaints involving the knees during and immediately after service. The X-ray examination immediately after service may only be viewed as showing an abnormality of some kind. Eventually arthritis was clearly identified. In this case, we are presented with continuity of symptomatology and credible lay evidence. Service connection for bilateral knee arthritis is granted. H. N. SCHWARTZ Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Konieczny, Adam 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.