Citation Nr: 21042844 Decision Date: 07/14/21 Archive Date: 07/14/21 DOCKET NO. 13-12 442 DATE: July 14, 2021 ORDER Entitlement to service connection for a left knee condition is denied. FINDING OF FACT The evidence does not show that the Veteran's left knee condition had its onset in service, manifested to a compensable degree within one year of separation, or is otherwise related to service. CONCLUSION OF LAW The criteria for service connection for a left knee condition have not been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309, 3.310. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran had active duty from January 1974 to December 1975. 1. Entitlement to service connection for a left knee condition. To establish service connection for a disability, the evidence 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. Shedden v. Principi, 381 F.3d 1163 (Fed. Cir. 2004). For certain chronic disorders, such as arthritis, service connection may be granted if the disease becomes manifest to a compensable degree within one year following separation from service. See 38 U.S.C. §§ 1101, 1112, 1113, 1131, 1137; 38 C.F.R. §§ 3.307, 3.309. When a disease listed at 38 C.F.R. § 3.309(a) is not shown to be chronic during service or the one-year presumptive period, service connection may also be established by showing continuity of symptomatology after service. See 38 C.F.R. § 3.303(b). However, the use of continuity of symptoms to establish service connection is limited only to those diseases listed at 38 C.F.R. § 3.309(a) and does not apply to other disabilities which might be considered chronic from a medical standpoint. See Walker v. Shinseki, 708 F.3d 1331 (Fed. Cir. 2013). Service connection may also be established on a secondary basis for a disability which is shown to be proximately due to or the result of a service-connected disease or injury. 38 C.F.R. § 3.310(a). Establishing service connection on a secondary basis requires evidence sufficient to show that a current disability exists and that the current disability was either caused by or aggravated by a service-connected disability. 38 C.F.R. § 3.310; Allen v. Brown, 7 Vet. App. 439 (1995). The Veteran claims entitlement to service connection for a left knee condition. He asserts that his left knee condition is related running, jumping, and carrying heavy items in service. See September 2016 Appellate Brief. The Veteran shows a diagnosis of left knee arthritis. See VA Treatment Records. As the Veteran has a current diagnosis, the issue that remains disputed is whether the Veteran's left knee condition had its onset in service or manifested to compensable degree within one year of separation. The preponderance of the evidence is against the claim. Service treatment records are silent for complaints of or treatment for left knee pain. The December 1975 separation clinical evaluation showed normal lower extremities. One the separation report of medical history the Veteran denied cramps in legs and "trick or locked knee." During a January 2017 VA examination report, the Veteran reported that his knee pain had its onset in 2007. He reported that the condition began with sharp swelling, pain, and limited mobility. The Veteran underwent a VA examination in July 2020. The Veteran attributed his knee pain to running in service. He reported that he began to notice pain in service. He reported he experiences swelling and pain often. The examiner opined that the Veteran's left knee condition was not related to service. The examiner reasoned that there is no specific evidence in the Veteran's history or in the medical literature that shows the Veteran's left knee disability was caused by jumping, running in boots, or carrying loads in excess of 50 pounds in service. The records do not show evidence of complaints during service to suggest that his knee pain was an ongoing issue that required medical attention. The examiner also concluded that the Veteran's left knee condition was less likely as not secondary to his service-connected lumbar spine disability. The examiner noted that based on the objective medical evidence, the Veteran first showed complaints and injury to the knees in 2007 consistent with the aging process and injury on a dolly at his workplace. There is no information showing a correlation associated with his back condition. Regarding aggravation, the examiner noted that no baseline can be established since the Veteran was noted to have a back injury around 1975 but began to have knee pain many years after service (in 2007 approximately 32 years after service) and there was no documentation of a knee condition or any level of knee pain or discomfort during service. There is no evidence to show that the Veteran's knee condition was aggravated beyond its natural progression by his service-connected lumbar spine condition; the knee condition is more likely due to the aging process. The Veteran was afforded an additional VA examination in March 2021. The Veteran reported that his knee pain had occurred since service and was related to activities such as running and jumping in war games during training. The Veteran reported that he continued to experience pain and stiffness in the knees since service. The examiner opined that the Veteran's left knee condition was less likely as not related to service. The examiner noted that while the Veteran does have a left knee condition, the medical records do not show a history of injury to the left knee in service. The Board finds the VA examiner's aggregate opinions adequate and probative to the question at hand. The examiners possessed the necessary education, training, and expertise to provide the requested opinions. See Grottveit v. Brown, 5 Vet. App. 91, 93 (1993). The VA examiners provided a rationale for the opinions, which were based on an examination and interview of the Veteran, a review of the service treatment records, post-service treatment records, and the lay statements of the Veteran. The opinion considered an accurate history, were definitive and supported by a detailed rationale that considered the lay and medical evidence. Nieves-Rodriguez v. Peake, 22 Vet. App. 295 (2008). While the examiners did not expressly mention all the Veteran's contentions of continuous symptoms since service in the recitation of their opinions, the Board finds the fact that the Veteran's reports of onset were noted in the examination reports sufficient to show that his statements were considered. Although the Board has carefully considered the Veteran's statements of onset and self-treatment post service, the Board finds the VA medical opinions and the fact that the post service records are silent for complaints of left knee pain for many years after service more probative. Significantly, the Veteran has not presented or identified any contrary medical opinion that supports the claim for service connection. VA adjudicators are not free to ignore or disregard the medical conclusions of a VA physician, and are not permitted to substitute their own judgment on a medical matter. Colvin v. Derwinski, 1 Vet. App. 171 (1991); Willis v. Derwinski, 1 Vet. App. 66 (1991). The Board has also considered whether the service connection is warranted on a presumptive basis. However, the evidence does not show that the Veteran's arthritis of the left knee to a compensable degree within one year of separation. The evidence does not show complaints of knee pain until 2007 over 30 years after separation. See 38 C.F.R. §§ 3.307, 3.309. Thus, service connection on a presumptive basis is not warranted. The only evidence suggesting a relationship between the Veteran's current left knee disability and service are his statements, and the Veteran is not competent to provide an opinion on issues requiring medical expertise. See Jandreau v. Nicholson, 492 F.3d 1372, 1376-77 (Fed. Cir. 2007) (noting general competence to testify as to symptoms but not to provide medical diagnosis). As the preponderance of the evidence is against the Veteran's claim, the doctrine of reasonable doubt does not apply. Gilbert v. Derwinski, 1 Vet. App. 49 (1990). R. FEINBERG Veterans Law Judge Board of Veterans' Appeals Attorney for the Board J.A. Williams, 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.