Citation Nr: 22017252 Decision Date: 03/24/22 Archive Date: 03/24/22 DOCKET NO. 20-03 661 DATE: March 24, 2022 ORDER Entitlement to service connection for right knee osteoarthritis, to include as secondary to service-connected left knee disability, is granted. FINDING OF FACT Resolving all reasonable doubt in the Veteran's favor, his right knee osteoarthritis is proximately due to or aggravated by his service-connected left knee disability. CONCLUSION OF LAW The criteria for entitlement to service connection for right knee osteoarthritis have been met. 38 U.S.C. §§ 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.304, 3.310. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty in the United States Army from October 1976 to April 1984. This matter comes before the Board of Veterans' Appeals (Board) on appeal from December 2018 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO). The Veteran offered testimony at a Board hearing before the undersigned Veterans Law Judge (VLJ) in March 2022. This decision is being prepared under the Board's "one-touch" program, and a transcript of the Veteran's hearing is not yet available. The transcript will be added to the Veteran's file under the normal course of business. Because the appeal is being granted, there is no prejudice to the Veteran. To more accurately reflect the scope of the Veteran's claim, the issue has been recharacterized as shown on the title page. Entitlement to service connection for right knee osteoarthritis, to include as secondary to service-connected left knee disability Upon review of the evidence of record, resolving all reasonable doubt in the Veteran's favor, the Board finds that service connection is warranted. Under the relevant laws and regulations, service connection may be granted for a disability resulting from disease or injury incurred in or aggravated during active service. 38 U.S.C. § 1131; 38 C.F.R. § 3.303(a). Generally, to establish service connection, there must be competent, credible evidence of 1) a current disability, 2) in-service incurrence or aggravation of an injury or disease, and 3) a nexus, or link, between the current disability and the in-service disease or injury. See Davidson v. Shinseki, 581 F.3d 1313 (Fed. Cir. 2009). In addition to service connection on a direct basis, service connection may also be granted for a disability that is proximately due to or aggravated by a service-connected disease or injury. 38 C.F.R. § 3.310; see also Allen v. Brown, 7 Vet. App. 439 (1995). Where there is a chronic disease shown as such in service or within the presumptive period under 38 C.F.R. § 3.307, so as to permit a finding of service connection, subsequent manifestations of the same chronic disease at any later date, however remote, are service-connected, unless clearly attributable to intercurrent causes. If there is no showing of a resulting chronic condition during service, then a showing of continuity of symptomatology after service is required to support a finding of chronicity. 38 C.F.R. § 3.303(b). Service connection may be established for chronic diseases, to include arthritis, manifesting to a compensable degree within a year after service. 38 U.S.C. §§ 1112, 1113, 1137; 38 C.F.R. §§ 3.303, 3.304, 3.307, 3.309(a). When there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, the Secretary shall give the benefit of the doubt to the claimant. 38 U.S.C. § 5107; 38 C.F.R. § 3.102; see also Gilbert v. Derwinski, 1 Vet. App. 49, 53 (1990). Turning to the evidence of record, a review of the Veteran's STRs does not show any compliant, treatment or diagnosis of a right knee condition. However, the Board notes that the Veteran's DD Form 214 shows that his military occupational specialty (MOS) was infantry officer, and he was awarded the Parachutist Badge and Ranger Tab. The Veteran worked as a dock foreman, janitorial supervisor, and a computer technician since his separation from service. See July 2016 VA examination. The Veteran initially underwent a VA examination for his right knee condition in July 2016. At that time, the examiner diagnosed the Veteran with bilateral knee ostarthritis. The examiner opined that the Veteran's condition was less likely than not incurred in or a result of in-service injury, event, or illness because his service treatment records (STRs) are silent for any knee condition and his post-discharge records do not show a knee condition until 30 years after separation from service. The Veteran underwent another VA examination for his right knee condition in November 2018, during which he reported experiencing right knee pain for many years and attributed his condition to compensating for his left knee disability. The examiner diagnosed the Veteran with right knee osteoarthritis and opined that his condition was less likely than not proximately due or a result of his service-connected condition. The examiner explained that the Veteran's right knee ostearthritis is likely multifactorial with combination of age, rheumatoid arthritis affecting both knees, and left knee disability impacting the right knee. The examiner was unable to single out the Veteran's left knee disability as the major cause for his right knee ostearthritis. A review of the Veteran's post-service treatment records shows that he has been treated for right knee pain. See e.g., October 2017 and January 2018 private treatment records; see also July and August 2018 VA treatment records. The Veteran underwent a total left knee replacement in December 2017. See VA and private treatment records. He subsequently underwent a right knee arthoplasty in December 2019. See private treatment records. A December 2017 letter from Dr. C. J. and July 2018 and August 2019 letters from Dr. C. M. are also of record. Dr. C. J. noted that the Veteran has been receiving ongoing treatment for rheumatoid arthritis in both knees and attributed his condition to his military service, to include heavy weightbearing exercises during parachute drops and ranger training. In the July 2018 letter, Dr. C. M. noted that the Veteran has been having the same symptoms in the right knee as his left knee and he has been overcompensating with right knee while his left knee was healing from the surgery. In the August 2019 letter, Dr. C. M. noted the Veteran's ranger training and parachute drops during his military service. Dr. C. M. also noted that the Veteran's post-service employment was much less physically demanding. Dr. C. M. opined that it is reasonable to conclude that the Veteran's heavy training and high impact activities during his military career are a significant factor in the development of right knee arthritis, which predates the development of rheumatoid arthritis. The Board finds Dr. C. M.'s opinion probative as it is consistent with the evidence of record. Although the July 2016 and November 2018 VA examiners provided negative nexus opinions as to the Veteran's right knee ostearthritis, the Board finds these opinions less probative. Specifically, the July 2016 VA examiner relied on the lack of evidence in the rationale and the November 2018 VA examiner noted the impact of left knee disability on the Veteran's right knee as one of the factors contributing to his condition. Thus, the examiner's comments were inconsistent. Based on the foregoing, resolving all reasonable doubt in the Veteran's favor, the Board finds that his right knee ostearthritis is proximately due to or aggravated by his service-connected left knee disability. See 38 U.S.C. § 5107; 38 C.F.R. §§ 3.102, 3.310; see also Gilbert, supra. Accordingly, the appeal is granted. C. CRAWFORD Veterans Law Judge Board of Veterans' Appeals Attorney for the Board A. Kuzniar, 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.