Citation Nr: 22017108 Decision Date: 03/24/22 Archive Date: 03/24/22 DOCKET NO. 15-22 668 DATE: March 24, 2022 ORDER Entitlement to service connection for left knee arthritis is granted. Entitlement to service connection for residuals of septorhinoplasty is granted. REMANDED Entitlement to an initial rating higher than 10 percent for gastroesophageal reflux disease (GERD) is remanded. Entitlement to an initial rating higher than 10 percent for Meniere's disease with vertigo is remanded. FINDINGS OF FACT 1. The Veteran was diagnosed with left knee degenerative joint disease (arthritis) during his active duty service. 2. The Veteran has credibly reported that he has current residuals of a septorhinoplasty that occurred during his active duty service. CONCLUSIONS OF LAW 1. The criteria for service connection for left knee arthritis have been met. 38 U.S.C. §§ 1110, 1131, 5103, 5103A, 5107; 38 C.F.R. §§ 3.102, 3.159, 3.303. 2. The criteria for service connection for residuals of septorhinoplasty have been met. 38 U.S.C. §§ 1110, 1131, 5103, 5103A, 5107; 38 C.F.R. §§ 3.102, 3.159, 3.303. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from August 1983 to June 1986, and from July 1987 to September 2008. This case comes to the Board of Veterans' Appeals (Board) from a March 2009 rating decision of the Department of Veterans Affairs (VA) Regional Office. In August 2021, the Veteran withdrew his request for a Board hearing. Left Knee Arthritis The Veteran has requested service connection for left knee arthritis, which he contends began during his active duty service. He wrote in August 2021, that he first started having problems with his left knee while he was still in service, including pain and swelling in the early 2000s. Service connection may be established for a disability resulting from disease or injury incurred in or aggravated by service. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303. Evidence of continuity of symptomatology from the time of service until the present is required where the chronicity of a condition manifested during service either has not been established or might reasonably be questioned. 38 C.F.R. § 3.303(b). Regulations also provide that service connection may be granted for any disease diagnosed after discharge, when all the evidence, including that pertinent to service, establishes that the disability was incurred in service. 38 C.F.R. § 3.303(d). Under 38 C.F.R. § 3.303(b), when a chronic disease is shown in service or within the presumptive period under 38 C.F.R. § 3.307, "subsequent manifestations of the same chronic disease at any later date, however remove, are service connected, unless clearly attributable to intercurrent causes." See Walker v. Shinseki, 708 F.3d 1331, 1336 (Fed. Cir. 2013). Chronic diseases include arthritis. 38 C.F.R. §§ 3.307, 3.309. Moreover, when arthritis becomes manifest to a degree of 10 percent within one year from date of termination of service, it is presumed to have been incurred in service. Id. In this case, the Board finds that the evidence shows that the Veteran was diagnosed with left knee arthritis during his active duty service. The Veteran separated from active duty service in September 2008. The Veteran attended a pre-separation VA examination in August 2008. The Veteran reported having left knee pain. The examiner found that February 2008 X-rays showed bilateral degenerative joint disease of the medial femoral tibial joints. He diagnosed the Veteran with bilateral knee mild degenerative joint disease. The Board notes that VA previously denied this claim in part because copies of the actual February 2008 X-rays were not in the record. The Board finds, however, that there is no reason to doubt the August 2008 VA examiner, who apparently did see these X-rays and found that the Veteran had a diagnosis of degenerative joint disease. Furthermore, the record does contain the report of X-rays from March 2009 that show early degenerative joint disease in both knees. These X-rays are within one year of the Veteran's separation from service, so even without the February 2008 X-rays, it can be presumed that his arthritis started in service. 38 C.F.R. § 3.303(b). The medical evidence therefore shows that the Veteran had a diagnosis, established by recorded X-ray findings, of left knee arthritis, while he was still on active duty service. There is no contradictory evidence indicating that arthritis was not first developed and diagnosed during service. As arthritis is a chronic disease, and the Veteran's credible lay statements and medical records also support a continuity of symptomatology from the time to the present, entitlement to service connection for left knee arthritis can be granted. Residuals of Septorhinoplasty The Veteran contends that he has current residuals of the septorhinoplasty he underwent in service. The Veteran wrote in August 2021 that ever since he broke his nose and had surgery for a deviated septum in service, he still has occlusion on the left side of his nostrils, nasal dryness, snoring, and headaches. After reviewing all of the evidence of record, the Board finds that the Veteran had a septorhinoplasty in service, and that he currently has residuals that are related to his septorhinoplasty. There is not actually any question regarding whether the Veteran underwent a septorhinoplasty in service. The Veteran's service treatment records show that in August 1997 he was having snoring, breathing troubles, and nose bleeds, and underwent a septorhinoplasty. The only question at issue is whether the Veteran currently has any residuals of his 1997 septorhinoplasty. While the August 2008 pre-separation VA examination found that the Veteran was currently asymptomatic, the Board finds that the Veteran is competent to report symptoms such as having difficulty breathing through his nose and nasal dryness. The Veteran is competent to report these types of symptoms as he observes them, as this requires only personal knowledge as it comes to him through his senses. See Layno v. Brown, 6 Vet. App. 465, 470 (1994). The Veteran has also submitted a July 2015 treatment record that shows that he complained of chronic rhinitis and difficulty breathing through his nose for years. The Board therefore finds that the Veteran does have symptoms related to his septorhinoplasty which cause him at least some functional impairment, and entitlement to service connection is granted. REASONS FOR REMAND GERD and Meniere's Disease The Veteran has also requested higher ratings for his service-connected GERD and Meniere's Disease. He wrote that he has regular heartburn, nausea, and vomiting, as well as diarrhea and gas. He wrote that his chest pain can be extremely severe, leading to cold sweats and difficulty breathing. He wrote that his Meniere's disease causes dizziness and vertigo that sometimes become severe, leading to rapid pulse, sweating, and nausea. The Veteran has not had a VA examination for these disorders since August 2008, which is almost 14 years ago. The Veteran has asserted that he now has symptoms which are significantly worse than those present at the 2008 examination, and the Board finds that new VA examinations are sorely needed in order to determine the current severity of his disorders. The matters are REMANDED for the following action: 1. Obtain all outstanding VA treatment records or other federal medical treatment records, including all records from Vilseck Army Health Clinic since June 2020. 2. Schedule the Veteran for an examination to determine the current severity of his GERD. The examination may be held via telehealth during social distancing restrictions. The examiner must review all relevant records in the claims file. The examiner should perform all necessary tests to evaluate the current severity of the Veteran's GERD, including consideration of all his reported symptoms, such as chest pain, nausea, vomiting, sleep impairment, and diarrhea. 3. Schedule the Veteran for an examination to determine the current severity of his Meniere's disease. If feasible, the examination may be held via telehealth during social distancing restrictions. The examiner must review all relevant records in the claims file. The examiner should perform all necessary tests to evaluate the current severity of Meniere's disease, including consideration of all his reported symptoms, such as dizziness, rapid pulse, cold sweats, and nausea/vomiting. DELYVONNE M. WHITEHEAD Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Mary E. Rude, 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.