Citation Nr: 21031560 Decision Date: 05/24/21 Archive Date: 05/24/21 DOCKET NO. 13-30 111 DATE: May 24, 2021 ORDER Entitlement to service connection for right knee degenerative joint disease is granted. REMANDED Entitlement to service connection for bilateral hearing loss is remanded. Entitlement to secondary service connection for left knee degenerative joint disease is remanded. FINDING OF FACT Resolving reasonable doubt in the Veteran's favor, her right knee disability was aggravated during active service. CONCLUSION OF LAW The criteria for service connection for a right knee disability are 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 had qualifying active duty service from June 1981 to July 1983 with additional services in the reserves. The Veteran's claims were previously remanded by the Board, most recently, in an August 2020 decision. The Board finds that the RO has substantially complied with the August 2020 Board remand directives. See Stegall v. West, 11 Vet. App. 268 (1998). The Board notes that service connection for tinnitus was granted in a prior decision. 1. Entitlement to service connection for right knee degenerative joint disease The Veteran contends that her right knee condition began during service and required treatment during service. In a March 2021 statement, the Veteran reported that a U.S. Army Major at Moncrief Army Hospital indicated that she would require a knee replacement. The Veteran reported that she has taken "thousands of pain pills I was prescribed for my knees." The Veteran reported her MOS required her to jump from helicopters and reported playing on the Army volleyball team. The Veteran also reported a motorcycle falling on her leg during service. The Veteran also reported that she has been in physical therapy since 1987. The Board concludes that, resolving all reasonable doubt in favor of the Veteran, she has a current disability that was aggravated beyond its natural progression during service. 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's entrance examination indicates the Veteran had a dislocated kneecap prior to service that required surgery. Service treatment records reflect treatment for knee issues during service. Specifically, in September 1981, the Veteran reported multiple instances of right knee pain with reduced flexion and numbness following runs. In October 2020, the Veteran underwent a VA examination for her bilateral knees. The examiner noted diagnoses of bilateral degenerative arthritis since 1981. The Veteran reported she developed bilateral knee pains related to vigorous military physical duties during service. Veteran reported she began to receive bilateral knee injections starting in 1984. The Veteran reported flare ups approximately twice a month lasting about 12 hours. The examination also indicated the Veteran requires regular use of a brace and cane and occasional use of crutches or a walker. The examiner provided a negative opinion regarding service-connection for the Veteran's right knee disability. An addendum opinion was obtained in February 2021. The VA examiner indicated that based on the Veteran's reports of long distance runs, rappelling, jumping from heights, and playing on the Army volleyball team, it was at least as likely as not a knee condition associated with arthritis could be aggravated beyond its natural progression due to her military physical activities. The examiner continued by saying that it was less likely than not that those activities would aggravate a pre-existing patellar dislocation. This opinion is inadequate because it does not consider the Veteran's service treatment records showing complaints of right knee pain during service nor does it consider the Veteran's statement corroborated by the X-ray jacket that she continuously sought treatment for a right knee disability. Thus, an October 2020 VA examination shows the Veteran has a current diagnosis of degenerative arthritis of the knees. During service, the Veteran was seen for complaints of right knee pain. Thus, the question becomes whether the current disability is related to service. Upon review of the record, the Board finds the evidence to at least be in equipoise as to whether the Veteran's current right knee arthritis arose in or is related to service. Accordingly, after resolving all doubt in favor of the Veteran, the Board finds that service connection for a right knee disability is warranted. 38 U.S.C. § 5107; 38 C.F.R. § 3.102. REASONS FOR REMAND 1. Entitlement to service connection for bilateral hearing loss is remanded. In a March 2021 statement, the Veteran reported significant acoustic trauma from various guns, bombs, missiles, grenades, and mines exploding near her without protective equipment. The Veteran also reported she had sought treatment for hearing loss during service. In August 2020, the Board remanded the Veteran's claim for bilateral hearing loss for a new examination noting that acoustic trauma had been conceded. The Veteran underwent a VA examination in November 2020 for bilateral hearing loss, which resulted in a negative nexus opinion. The Board, however, finds this examination inadequate as it did not consider the Veteran's documented reports of hearing difficulties during service. 2. Entitlement to secondary service connection for left knee degenerative joint disease is remanded. As the Board has granted service connection for the Veteran's right knee disability, an addendum opinion is needed as to whether the Veteran's current left knee disability is the result of, related to, or aggravated by the Veteran's right knee disability. The matters are REMANDED for the following action: 1. Obtain an addendum opinion from an appropriate clinician regarding whether the Veteran's bilateral hearing loss is at least as likely as not related to acoustic trauma during service. The examiner is reminded that acoustic trauma has been conceded. The examiner is also directed to consider the Veteran's lay statements and documented reports of hearing difficulties in service. 2. Obtain an addendum opinion from an appropriate clinician regarding whether the Veteran's left knee disability is at least as likely as not proximately due to the service-connected right knee disability or aggravated beyond its natural progression by a service-connected disability. L. M. BARNARD Veterans Law Judge Board of Veterans' Appeals Attorney for the Board M.D. Taylor, Associate 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.