Citation Nr: 21029403 Decision Date: 05/13/21 Archive Date: 05/13/21 DOCKET NO. 17-14 733 DATE: May 13, 2021 ORDER Service connection for a low back disorder is denied. Service connection for a left knee disorder is denied. FINDINGS OF FACT 1. The Veteran had active duty from August 2010 to August 2014. 2. The Veteran reported low back pain in service; however, symptoms were not shown to be chronic; a current low back disorder, diagnosed as scoliosis, spondylosis, and a lumbosacral strain, is not casually or etiologically related to service. 3. The Veteran reported left knee pain in service; however, symptoms were not shown to be chronic; a current left knee disorder, diagnosed as patellofemoral syndrome and patellar tendonitis, is not casually or etiologically related to service. CONCLUSIONS OF LAW 1. A low back disorder was not incurred in service. 38 U.S.C. §§ 1110, 5103, 5103A, 5107 (2012); 38 C.F.R. §§ 3.303 (2020). 2. A left knee disorder was not incurred in service. 38 U.S.C. §§ 1110, 5103, 5103A, 5107 (2012); 38 C.F.R. §§ 3.303 (2020). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran testified before the undersigned Veterans Law Judge in November 2019. A copy of the transcript has been associated with the claims file. Service connection may be granted on a direct basis as a result of disease or injury incurred in service based on nexus using a three-element test: (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 in or aggravated by service. See 38 C.F.R. §§ 3.303(a), (d); Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009). Low Back Disorder As to a current disorder, in a June 2015 VA examination, the examiner marked that the Veteran had been diagnosed with scoliosis in 2014. A January 2015 X-ray showed mild scoliosis. Further, he was diagnosed with spondylosis in 2015 and a lumbosacral strain in 2020. Therefore, the first element of service connection is met. As to an in-service incurrence, in February 2011, the Veteran complained of back pain with an onset of two weeks and was diagnosed with low back pain. Further, he reported back pain at separation. As he reported back pain in service, the second element of direct service connection is met. As to nexus, at a June 2015 VA examination, the Veteran complained of pain since 2014 that worsened with prolonged sitting or standing. Upon examination, the examiner opined that a back disorder was less likely than not incurred in service. He reasoned that a current back disorder was caused by scoliosis, a normal body habitus, and that there was no evidence of major injuries to the spine in service. At the hearing, the Veteran testified that, prior to service, he was a school athlete and underwent physicals at school; however, he explained that he had never been diagnosed with scoliosis prior to service. Moreover, the service treatment records (STRs) showed that he did not report scoliosis or any other low back disorder at enlistment. Therefore, the Board remanded the claim to determine if he had a pre-existing low back disorder, if it had been aggravated by service, and, if there was no pre-existing low back disorder, whether a current low back disorder was due to service. In a September 2020 VA examination, the Veteran complained of constant low back pain. Upon examination, the examiner wrote that the Veteran did not have spondylosis or scoliosis but rather a lumbosacral strain. He opined that a current low back disorder was less likely than not incurred in service. He reasoned that a September 2020 MRI showed no diagnosis of scoliosis. Further, he reasoned that the Veteran had an isolated incident of back pain in service in 2011 and that there was no continuity of care. This evidence weighs against the claim. In a January 2021 VA opinion, the clinician opined that a low back disorder was less likely than not incurred in service. The clinician reasoned that the Veteran had a single note of low back pain in service with no reoccurrence. Further, the clinician noted that the Veteran did not report low back issues until 2019 when he reported experiencing back pain as a result of working as an iron worker. In addition, the clinician explained that if the Veteran's back condition was as debilitating as alleged, he would not have been able to perform a welding occupation. This evidence weighs against the claim. Based on the above, the medical evidence does not support the claim for direct service connection. While the Veteran did not have a low back disorder that clearly and unmistakably existed prior to service, STRs reflect that he had one isolated incident of low back pain in service and that there was no continuity of care in service between the date he reported back pain and separation from service. There is no contradictory medical evidence. Therefore, the medical evidence does not support the claim of service connection. Left Knee Disorder As to a current disorder, the Veteran was diagnosed with left patellofemoral syndrome in 2015 and patellar tendonitis in 2020. Therefore, the first element of service connection is met. As to an in-service incurrence, in May 2012, the Veteran complained of left knee pain and was diagnosed with patellar tendonitis. Further, in June 2012, he complained of left knee pain. In addition, he reported knee pain at separation. Therefore, an in-service incurrence of complaints related to the left knee is shown. As to nexus, in a June 2015 VA examination, the Veteran complained of left knee pain while running and squatting. Upon examination, the examiner opined that a left knee disorder was less likely than not incurred in service. He reasoned that a current left knee disorder was due to an Osgood Schlatter deformity beginning in adolescence. Further, he noted that there was no evidence of knee injuries in service. At the hearing, the Veteran testified that, prior to service, he had never been diagnosed with a left knee disorder. Rather, he explained that he hurt his knees in service due to running long distances. Moreover, STRs showed that he did not report a left knee disorder at enlistment. Therefore, the Board remanded the claim to determine if he had a pre-existing left knee disorder, if it had been aggravated by service, and, if there was no pre-existing left knee disorder, whether a current left knee disorder has due to service. In a September 2020 VA examination, the examiner wrote that the Veteran did not have an Osgood Schlatter deformity but rather a left knee strain. Further, he opined that a left knee strain was less likely than not incurred in service; however, no supporting rationale was provided. In a January 2021 VA opinion, the clinician opined that a left knee disorder was less likely than not incurred in service. The clinician reasoned that STRs showed full range of motion in the left knee without pain. The clinician also noted that the Veteran had a history of working in iron work which was a physically laborious occupation and that STRs did not suggest that a current left knee disorder was due to service. This evidence weighs against the claim. Based on the above, the medical evidence does not support the claim for direct service connection. While the Veteran did not have a left knee disorder that clearly and unmistakably existed prior to service, STRs reflect that he had one isolated incident of left knee pain in service and that there was no continuity of care in service between the date he reported left knee pain and separation from service. There is no contradictory medical evidence. Therefore, the medical evidence does not support the claim of service connection. The Board has considered the Veteran's lay statements and testimony that these disorders began in service. While he is competent to report symptoms because this requires only personal knowledge as it came to him through his senses, he is not competent to offer etiologies of these disorders. Such competent evidence has been provided by the service records, clinical evidence, and examinations obtained and associated with the claims file. Here, the Board attaches greater probative weight to the clinical findings than to his statements. In light of the above, the preponderance of the evidence is against the claims and there is no doubt to be otherwise resolved. As such, the appeals are denied. Finally, the Veteran has not raised any other issues, nor have any other issues been reasonably raised by the record, for the Board's consideration. See Doucette v. Shulkin, 28. Vet. App. 366, 369-370 (confirming that the Board is not required to address issues unless they are specifically raised by the claimant or reasonably raised by the evidence of record). L. HOWELL Veterans Law Judge Board of Veterans' Appeals Attorney for the Board D. Ragofsky, Attorney Advisor 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.