Citation Nr: 21028499 Decision Date: 05/11/21 Archive Date: 05/11/21 DOCKET NO. 20-06 746 DATE: May 11, 2021 ORDER Entitlement to service connection for left knee strain, chondromalacia, and history of left knee meniscal tear status-post meniscectomy is granted. FINDING OF FACT The Veteran's left knee disorder resulted from his active duty service. CONCLUSION OF LAW The criteria for service connection for left knee strain, chondromalacia, and history of left knee meniscal tear status-post meniscectomy are met. 38 U.S.C. § 1110, 1131 (2012); 38 C.F.R. § 3.102, 3.303, 3.304 (2019). REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty in the United States Navy from December 1956 to November 1959. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a July 2018 rating decision issued by a Department of Veterans Affairs (VA) Regional Office (RO). Service Connection A veteran is entitled to VA disability compensation if there is a disability resulting from personal injury suffered or disease contracted in the line of duty in active service, or for aggravation of a preexisting injury suffered or disease contracted in the line of duty in active service. 38 U.S.C. §§ 1110, 1131. Generally, to establish a right to compensation for a present disability, a veteran must show: (1) a present disability; (2) an 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). In Gilbert v. Derwinski, 1 Vet. App. 49, 53 (1990), the United States Court of Appeals for Veterans Claims (Court) stated that "a veteran need only demonstrate that there is an 'approximate balance of positive and negative evidence' in order to prevail." To deny a claim on its merits, the preponderance of the evidence must be against the claim. Alemany v. Brown, 9 Vet. App. 518, 519 (1996) (citing Gilbert, 1 Vet. App. at 54). 1. Entitlement to service connection for a left knee disorder is remanded The Veteran contends that his left knee disorder is the result of his military service. His claim for compensation was received by VA in April 2018. See April 2018 Fully Developed Claim. The Board finds that the Veteran has a left knee disorder. The December 2020 VA examination report included a diagnosis of left knee strain, left knee tendonitis/tendinosis, and left knee meniscal tear. See December 2020 VA Examination. In addition, the Veteran credibly contends that the note of a right knee injury incurred in-service was actually an injury to his left knee See February 2020 Statement; see also September 2020 Board Decision. Thus, the first two Shedden criteria have been met and are not in dispute. The remaining issue, therefore, is whether there is a causal connection between the Veteran's left knee disorder and his military service. The Board finds a preponderance of the evidence to be in favor of the Veteran. As such, his claim of entitlement to service connection is granted. A review of the service treatment records (STRs) reveal one complaint of knee pain. See Service Treatment Records. In December 1958, the Veteran's STRs include a medical note that the Veteran sustained an injury to his right knee. He accidentally injured his knee while trying to prevent stepping on lanyard. However, as stated above, the Veteran contends that the medical treatment record should have indicated that the Veteran injured his left knee instead of his right knee. The November 1959 separation examination also revealed no left knee issues or complaints. See Service Treatment Records. A review of the post-service VA and private treatment records reveal complaints and treatment for left knee issues. Of note, a March 2001 VA treatment record noted that the Veteran's had surgery on his left knee joint, not on his right knee as also improperly mentioned in a January 2001 note. See CAPRI Records. The Veteran underwent a VA examination in December 2020. See December 2020 VA Examination. The examiner determined the Veteran had left knee strain, chondromalacia, and history of left knee meniscal tear status-post meniscectomy. The examiner noted the Veteran's report of onset of left knee pain issues and that while the Veteran worked as a parachuter, he mistepped from a lanyard and twisted his knee. The examiner gave a positive opinion that the Veteran's left knee disorder was the result of military service. See December 2020 VA Opinion. The examiner indicated that the Veteran's history of left knee meniscal tear is related to the 1958 erroneous entry of right knee injury as the Veteran has provided a credible statement and history of the left knee injury. The examiner stated that there is evidence of chronicity and a nexus has been established as the Veteran has continued to be seen throughout the years for left knee pain. An addendum VA opinion was issued in February 2021. See February 2021 VA Examination. The examiner gave a negative opinion that the left knee disorder, specifically regarding osteoarthritis, was the result of active duty service. The examiner found that there is no objective evidence to support a left knee injury during service. In support, the examiner noted that the Veteran's reports of medical history and separation exam are silent for any chronic left knee condition. Additionally, the examiner stated that the medical record was silent for any left knee in treatment or problems until approximately 13 years after service. Therefore, the examiner determined that there is no established medical nexus for the etiology of the osteoarthritis of the left knee, which is more likely than not due to the normal effects of aging. The Board finds the December 2020 VA Opinion to be competent, credible, and probative. The examiner provided detailed rationale that took into consideration the Veteran's lay statements and history, the clinical examination, and the evidence of record, and provided a clear explanation that contained a clear conclusion and supporting data. Barr v. Nicholson, 21 Vet. App. 303, 311 (2007); Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 304 (2008). Moreover, the Board finds no adequate basis to reject the competent medical opinion based on a lack of credibility or probative value. Madden v. Gober, 125 F.3d 1477, 1481 (Fed. Cir. 1997); Evans v. West, 12 Vet. App. 22, 26 (1998). Furthermore, this opinion is the only probative evidence that addresses the issue of medical nexus. The February 2021 VA addendum opinion based their opinion on a lack of medical evidence without consideration of the Veteran's credible symptomology complaints. Opinions based on an inaccurate factual background are without probative value. As such, service connection on a direct basis is warranted. Accordingly, the Veteran's claim for service connection for a left knee disorder diagnosed as left knee strain, chondromalacia, and history of left knee meniscal tear status-post meniscectomy, is granted. G. A. WASIK Veterans Law Judge Board of Veterans' Appeals Attorney for the Board V. Schmidt 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.