Citation Nr: 22014775 Decision Date: 03/15/22 Archive Date: 03/15/22 DOCKET NO. 16-60 851 DATE: March 15, 2022 ORDER Entitlement to service connection for a bilateral knee disorder is denied. Entitlement to service connection for a heart disorder is denied. FINDINGS OF FACT 1. The most probative evidence is against a finding that a current bilateral knee disability was caused or aggravated by active duty service, active duty for training (ACDUTRA), or an injury during inactive duty for training (INACDUTRA). 2. The most probative evidence is against a finding that the Veteran's current heart disorder was caused or aggravated by active duty service, ACDUTRA, or an injury during INACDUTRA. CONCLUSIONS OF LAW 1. The criteria for entitlement to service connection for a bilateral knee disorder have not been met. 38 U.S.C. §§ 1110, 1112, 1131, 1137, 5107 (2018); 38 C.F.R. §§ 3.6, 3.303 (2021). 2. The criteria for entitlement to service connection for a heart disorder have not been met. 38 U.S.C. §§ 1110, 1112, 1131, 1137, 5107; 38 C.F.R. §§ 3.6, 3.303. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from July 1968 to July 1970. The Veteran had additional service in the New Jersey Army National Guard from 1973 to 2008. This matter comes before the Board of Veterans' Appeals (Board) from a June 2013 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO). The case was last before the Board in May 2019 and has returned to the Board for further appellate review. Service Connection The Veteran seeks service connection for a bilateral knee disorder and a heart disorder, which he asserts are related to a period of active duty for training (ACDUTRA) during his service in the New Jersey Army National Guard. The Veteran does not contend, and the evidence does not reflect, that his claimed bilateral knee and heart disorders arose during active duty service or within one year after discharge from active duty service. See 38 C.F.R. §§ 3.303, 3.307, 3.309(a). Service connection may be established for a disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303. Generally, to prove service connection there must be: (1) a current disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the current disability and the in-service disease or injury. Shedden v. Principi, 381 F.3d 1163, 1166-67 (Fed. Cir. 2004). Active military, naval, or air service includes active duty, any period of ACDUTRA during which the individual concerned was disabled or died from a disease or injury incurred in or aggravated in the line of duty, or any period of inactive duty for training (INACDUTRA) which the individual concerned was disabled or died from injury incurred in or aggravated in the line of duty. 38 U.S.C. § 101(21), (24); 38 C.F.R. § 3.6(a), (c), (d). In other words, service connection may be granted for injury or disease incurred while on ACDUTRA and for injury incurred while on INACDUTRA, but not disease. 38 U.S.C. § 101(24). For National Guard service, ACDUTRA is defined as full-time duty performed by members of the National Guard of any State under 32 U.S.C. §§ 316, 502, 503, 504, or 505. 38 U.S.C. § 101(22)(C); 38 C.F.R. § 3.6(c)(3). INACDUTRA is defined as duty (other than full-time duty) performed by a member of the National Guard of any State under 32 U.S.C. §§ 316, 502, 503, 504, or 505. 38 U.S.C. § 101(23); 38 C.F.R. § 3.6(d)(4). Thus, in order for National Guard service to be qualifying service for VA compensation purposes, the period of service must have been "federalized," that is to say, his or her unit was ordered into Federal service under 32 U.S.C. §§ 316, 502, 503, 504, or 505. 38 C.F.R. § 3.6(c), (d). Upon review of the record, the Board finds that the most probative evidence is against a finding the Veteran's bilateral knee and heart disorders were incurred during a period of active duty, ACDUTRA, or INACDUTRA. Service treatment records from the Veteran's period of active duty are silent for any complaints and/or treatment related to bilateral knee problems or heart problems. During his service with the New Jersey Army National Guard, the Veteran underwent surgery for a right knee meniscus tear in September 1997, left knee meniscus tear in April 1998, and cardiovascular screening suggested the possibility of a cardiovascular condition in September 1996. However, as previously noted, ACDUTRA and/or INACDUTRA for VA compensation purposes only includes federalized National Guard service under 32 U.S.C. §§ 316, 502, 503, 504, or 505. There is no indication that the Veteran was ordered into federal service under 32 U.S.C. §§ 316, 502, 503, 504, or 505 at any time during his service with the New Jersey Army National Guard. Therefore, as the record does not show that the Veteran was ordered into federal service under 32 U.S.C. §§ 316, 502, 503, 504, or 505, the most probative evidence is against finding that his claimed disabilities were incurred during a period of active duty, ACDUTRA, or INACDUTRA, as defined by applicable law and regulation. See 38 U.S.C. § 101(22), (23); 38 C.F.R. § 3.6(c)(3), (d)(4). Furthermore, other than the Veteran's assertions, there is no indication that the Veteran's bilateral knee disability and heart disability are related to his military service. Although lay persons are competent to report symptoms or other matters within their personal knowledge, and to provide opinions on some medical matters (see Kahana v. Shinseki, 24 Vet. App. 428, 435 (2011)), here, the specific matter of whether the Veteran's bilateral knee disability and heart disability are related to his military service is a complex medical matter that falls outside the realm of common knowledge of a lay person. See Jandreau v. Nicholson, 492 F.3d 1372, 1377 n. 4 (Fed. Cir. 2007) (providing that lay persons are not competent to diagnose cancer). Specifically, the question of causation of a bilateral knee disability and a heart disability involves a medical subject concerning an internal physical process extending beyond an immediately observable cause-and-effect relationship. The Veteran is not shown to have the necessary training and expertise to provide a competent opinion as to the causes of bilateral knee disabilities and heart disabilities. In sum, the Veteran's claimed bilateral knee and heart disorders were not shown during a period of federalized ACDUTRA nor was an injury shown during a period of federalized INACDUTRA. Accordingly, the weight of the competent and probative evidence is against the claims, and service connection is denied. In reaching the above conclusion, the Board has considered the applicability of the benefit of the doubt doctrine; however, as the competing evidence is not in approximate balance, the doctrine is not for application. See 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102. James Springer Acting Veterans Law Judge Board of Veterans' Appeals Attorney for the Board A. Lance, 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.