Citation Nr: 22008020 Decision Date: 02/11/22 Archive Date: 02/11/22 DOCKET NO. 17-27 639 DATE: February 11, 2022 ORDER Entitlement to service connection for a right knee disorder is denied. FINDING OF FACT The Veteran's right knee disorder was not shown in service or for many years thereafter and has not been found to be etiologically related to service. CONCLUSION OF LAW The criteria for entitlement to service connection for a right knee disorder have not been met. 38 U.S.C. §§ 1110, 5107(b); 38 C.F.R. § 3.303. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran had active service in the Marine Corps from June 2001 to June 2002 and from January 2004 to April 2007. This matter is before the Board of Veterans' Appeals (Board) on appeal from an October 2014 rating decision issued by a Department of Veterans Affairs (VA) Regional Office (RO). In April 2021, the Veteran testified at a videoconference hearing before the undersigned Veterans Law Judge of the Board. A transcript of the hearing is of record. Service Connection Service connection may be granted for a disability resulting from disease or injury incurred in or aggravated by service. 38 U.S.C. § 1110; 38 C.F.R. § 3.303(a). Service connection requires competent evidence showing: (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, 1167 (Fed. Cir. 2004); 38 C.F.R. § 3.303. The benefit of the doubt rule provides that a veteran will prevail in a case where the positive evidence is in a relative balance with the negative evidence. Therefore, the Veteran prevails in a claim when: (1) the weight of the evidence supports the claim, or (2) when the evidence is in equipoise. It is only when the weight of the evidence is against the claim that the claim must be denied. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102; Gilbert v. Derwinski, 1 Vet. App. 49 (1990). Entitlement to service connection for a right knee disorder is denied. The Veteran contends that he has a right knee disorder that is related to an in-service injury, event, or disease, as he described experiencing right knee pain during his service in Iraq in 2004. The Board notes that the Veteran was not afforded a VA examination for his service connection claim for a right knee disorder. In determining whether the duty to assist requires that a VA medical examination be provided, or medical opinion obtained with respect to a Veteran's claim for benefits, there are four factors for consideration. These four factors are: (1) whether there is competent evidence of a current disability or persistent or recurrent symptoms of a disability; (2) whether there is evidence establishing that an event, injury, or disease occurred in service, or evidence establishing certain diseases manifesting during an applicable presumptive period; (3) whether there is an indication that the disability or symptoms may be associated with service or with another service-connected disability; and (4) whether there otherwise is sufficient competent medical evidence of record to make a decision on the claim. 38 U.S.C. § 5103A(d) and 38 C.F.R. § 3.159 (c)(4). The third factor, in particular, is a low threshold. See McLendon v. Nicholson, 20 Vet. App. 79 (2006). In this regard, the Board finds that the Veteran has not submitted sufficient evidence to indicate that he has a right knee disorder related to an event, injury, or disease that occurred in service. Accordingly, the Board finds that no further development of the claims for service connection for a right knee disorder is required. A review of the Veteran's service treatment records does not reflect any complaints, findings, or treatment for a right knee disorder. According to the Veteran's DD Form 214, Certificate of Release or Discharge from Active Duty, the Veteran served in Iraq from February 2004 to September 2004. A July 2004 service treatment record reported that the Veteran had a back strain and pulled right groin. He was prescribed limited duty for 7 days. A July 2006 report of medical examination did not report any knee problems. A July 2006 report of medical history documented the Veteran's report that he did not have any knee trouble. An August 2006 report of medical assessment documented the Veteran's report that his back was the only condition that limited his ability to work in his primary military specialty. A September 2006 Naval medical evaluation board report indicated that a physical examination of the Veteran did not find any knee problems. A September 2006 service treatment records injured his right foot and sought treatment. A December 2006 post-deployment health reassessment documented the Veteran's report that he was not wounded, injured, or physically hurt during his deployment to Iraq from March 2004 to September 2004. A December 2006 physical evaluation board findings reported only degenerative disc disease of the lumbar spine and gastroesophageal reflux disease (GERD) as the Veteran's medical conditions. A May 2007 VA general medical examination included an examination of the Veteran's spine and joints. An orthopedic assessment reported disorders of the right clavicle, low back, and right toe. No knee complaint or diagnoses were noted. A June 2008 VA primary care note reported a physical examination was performed. The Veteran was diagnosed with chronic back pain, GERD, elevated transaminases, and a skin rash. No knee problems were noted. A February 2013 VA primary care note reported that an examination of the Veteran's extremities and other systems was performed. The Veteran was diagnosed with chronic back pain, tobacco use disorder, and GERD. No knee complaints or problems were noted. A February 2014 VA nursing note documented the Veteran's report that reported that, when he was last seen, he told the provider he experienced right knee pain with light jogging and when applying pressure. He was instructed to wear a knee brace and try over-the-counter medication to see if that would help. He reported that he had been wearing a knee brace and taking Advil but "that is not working." He requested an x-ray of his right knee. An August 2015 VA treatment note reported the Veteran experienced bilateral knee pain. It was reported that he worked as a diesel mechanic, which required him to bend, lift, stoop, and lie on hard concrete. An August 2015 VA orthopedic note reported the Veteran presented with a one-year history of right knee pain. An MRI showed a medial meniscus tear. The knee pain was affecting his ability to work as a diesel mechanic. At the Veteran's April 2021 Board hearing, the Veteran testified that he felt pain in his knee after dismounting from a military vehicle during his service in Iraq. He stated that he did not seek treatment because he did not want to leave his unit. He said he did not want to "get sent to Germany or back to the states." According to the Veteran, he treated his knee with ibuprofen. As previously described, the Veteran's service treatment records show no evidence of treatment for a right knee disorder. A July 2006 report of medical history documented the Veteran's report that he did not have any knee trouble and a report of medical examination did not report any knee problems. After he was discharged from the Navy, the Veteran underwent a VA general medical examination in May 2007. An orthopedic assessment reported disorders of the right clavicle, low back, and right toe. However, no knee complaints or diagnoses were noted. The Veteran's first documented report of right knee pain was in February 2014, when the Veteran reported that he had been experiencing right knee pain with light jogging and when applying pressure. The Board acknowledges the Veteran's belief that his right knee disorder was caused by his military service. However, he is not competent to provide a nexus opinion in this case, as the issue is medically complex and requires specialized knowledge and experience. Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007). As such, the Veteran is not competent to address the etiology of his right knee disorder. Although the Veteran testified that he experienced knee pain during his service in Iraq but did not seek treatment because he did not want to leave his unit, the record shows that the Veteran sought treatment for a back strain and pulled right groin in July 2004, which was during his deployment to Iraq from February 2004 to September 2004. Moreover, a December 2006 post-deployment health reassessment documented the Veteran's report that he was not wounded, injured, or physically hurt during his deployment to Iraq from March 2004 to September 2004. Thus, the Board finds that the Veteran's hindsight recollections from more than 14 years after service are probatively outweighed by the contemporaneous service records that show that the Veteran did not have a right knee disorder in service. For the reasons and bases stated above, the Board finds that service connection for a right knee disorder is not warranted. In reaching this decision, the Board has considered the benefit-of-the-doubt doctrine; however, as the evidence is persuasively against the claim and the positive and negative evidence is not nearly in balance, that doctrine is not applicable. See 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102. Thus, the Veteran's claim for a right knee disorder is denied. KELLI A. KORDICH Veterans Law Judge Board of Veterans' Appeals Attorney for the Board T. Moore, 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.