Citation Nr: 21030152 Decision Date: 05/18/21 Archive Date: 05/18/21 DOCKET NO. 18-35 920 DATE: May 18, 2021 ORDER Service connection for a meniscal tear of the left knee with degenerative joint disease (DJD) is granted. Service connection for right knee DJD is granted. FINDING OF FACT Resolving reasonable doubt in the Veteran's favor, his left and right knee disabilities are related to service. CONCLUSION OF LAW The criteria for service connection for left and right knee disabilities have been 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 served on active duty from February 2003 to May 2004 and additional periods of reserve service. He is the recipient of the Combat Action Ribbon. This matter comes before the Board of Veterans' Appeals (Board) from a September 2017 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO). In May 2021, the Veteran testified at a Board hearing before the undersigned Veterans Law Judge. A copy of the hearing transcript is associated with the claims file. Service connection for the Left and Right Knee The Veteran contends that his knee disabilities are related to the rigors of military service, to include running, carrying heavy loads, parachuting, and the general physical trauma involved in active combat service. The Board will grant the claims. 38 U.S.C. §§ 1110, 1131, 5107(b); Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009); 38 C.F.R. § 3.303(a). The Veteran engaged in combat with enemy forces. The law provides that if the Veteran engaged in combat with the enemy, and it is claimed that a disease or injury was incurred in such combat, VA shall accept as sufficient proof of service connection satisfactory lay or other evidence of service incurrence, if the lay or other evidence is consistent with the circumstances, conditions, or hardships of such service. 38 U.S.C. § 1154 (b); 38 C.F.R. § 3.304 (d). To establish service connection, however, there must be medical evidence of a nexus between the current disability and the combat injury. See Dalton v. Nicholson, 21 Vet. App. 23 (2007); Libertine v. Brown, 9 Vet. App. 521, 523-24 (1996). In such cases, not only is the combat injury presumed, but so are the consequences of that injury at least in service. See Reeves v Shinseki, 682 F.3d 988 (Fed. Cir. 2012). The March 2017 knee VA examination report shows the Veteran has a current diagnosis of meniscal tear and DJD of the left knee and DJD of the right knee. During service, the Veteran was seen for complaints of left knee pain which was diagnosed as a meniscal tear. Thus, the question becomes whether the current disabilities are related to service. On this question there are probative opinions in favor of and against the claims. The evidence against the claim includes the May 2017 VA medical opinion which noted the Veteran's left knee meniscal tear pre-existed service and was not clearly and unmistakably aggravated by service. However, the source of the medical examiner's information is not clear. It appears that the only source of information as to the pre-existence of a left knee disorder, or its severity, is the Veteran's own account. There is no clinical evidence indicating that the Veteran had a preexisting left knee disorder. The law provides that a veteran is presumed to be in sound condition when entering into military service except for conditions noted on the entrance examination or where clear and unmistakable (obvious or manifest) evidence demonstrates that an injury or disease existed prior thereto, and that the disease or injury was not aggravated by service. 38 U.S.C.A. § 1111 ; 38 C.F.R. § 3.304(b) ; Cotant v. Principi, 17 Vet. App. 116 (2003); VAOPGCPREC 3-2003 (2003). The burden is on VA to rebut the presumption of soundness, by clear and unmistakable evidence, both that the disorder at issue pre-existed service, and that it was not aggravated by service. See VAOPGCPREC 3-2003 (July 2003); Wagner v. Principi, 370 F. 3d 1089 (Fed. Cir. 2004). Because there is no "noting" within the meaning of the law, and the examiner did not provide an adequate rationale to his support his conclusion that the Veteran's left knee disability clearly and unmistakably pre-existed service, the opinion has minimal probative value for the purpose of this analysis. The claim as to both disorders then must be analyzed as direct service connection claim. The evidence in favor of the claim includes the March 2017 knee VA examination conducted by the same examiner which noted that the Veteran's knee disabilities had their onset during service. Additionally, as previously stated, the Veteran is in receipt of the Combat Action Ribbon and his statements are consistent with the circumstances, conditions, and hardships of service. (Continued on next page) In sum, the Veteran has demonstrated one or more in-combat service events; the record contains diagnoses of the claimed disorders and there is medical evidence which links the disorders to service. Service connection for a left and right knee disability is granted. 38 U.S.C. § 5107; 38 C.F.R. § 3.102. Vito A. Clementi Veterans Law Judge Board of Veterans' Appeals Attorney for the Board K. McDuffie, 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.