Citation Nr: 22018281 Decision Date: 03/28/22 Archive Date: 03/28/22 DOCKET NO. 17-36 403A DATE: March 28, 2022 ORDER Entitlement to service connection for a broken left rib is denied. Entitlement to service connection for a right knee disability is denied. Entitlement to service connection for a left knee disability is denied. Entitlement to service connection for a right ankle disability is granted. Entitlement to service connection for a left ankle disability is granted. Entitlement to service connection for a back disability is granted. Entitlement to service connection for a left hip disability is granted. FINDINGS OF FACT 1. The Veteran does not have currently diagnosed residuals of a broken left rib. 2. The Veteran's claimed right knee disability is not etiologically related to an in-service injury or disease; and arthritis did not manifest to a compensable degree within one year of separation. 3. The Veteran's claimed left knee disability is not etiologically related to an in-service injury or disease; and arthritis did not manifest to a compensable degree within one year of separation. 4. Resolving reasonable doubt in his favor, the Veteran's right ankle disability is related to active duty. 5. Resolving reasonable doubt in his favor, the Veteran's left ankle disability is related to active duty. 6. Resolving reasonable doubt in his favor, the Veteran's back disability is related to active duty. 7. Resolving reasonable doubt in his favor, the Veteran's left hip disability is related to active duty. CONCLUSIONS OF LAW 1. The criteria for entitlement to service connection for a broken left rib have not been met. 38 U.S.C. §§ 1131, 5107; 38 C.F.R. §§ 3.102, 3.303. 2. The criteria for service connection for a right knee disability have not been met. 38 U.S.C. §§ 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309. 3. The criteria for service connection for a left knee disability have not been met. 38 U.S.C. §§ 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309. 4. The criteria for service connection for a right ankle disability have been met. 38 U.S.C. §§ 1131, 5107; 38 C.F.R. §§ 3.102, 3.303. 5. The criteria for service connection for a left ankle disability have been met. 38 U.S.C. §§ 1131, 5107; 38 C.F.R. §§ 3.102, 3.303. 6. The criteria for service connection for a back disability have been met. 38 U.S.C. §§ 1131, 5107; 38 C.F.R. §§ 3.102, 3.303. 7. The criteria for service connection for a left hip disability have been met. 38 U.S.C. §§ 1131, 5107; 38 C.F.R. §§ 3.102, 3.303. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran had active service in the United States Army from August 1980 to August 1984. He is the recipient of the Parachutist Badge. These matters come before the Board of Veterans' Appeals (Board) on appeal from a November 2015 rating decision issued by the Department of Veterans Affairs (VA) Regional Office (RO). The Veteran was scheduled for a virtual tele-hearing before the Veterans Law Judge (VLJ) on December 17, 2021. However, despite having been provided notice of the scheduled hearing in an October 6, 2021, letter, he failed to appear for such. As such, the Board finds that the request for a Board hearing has been withdrawn. 38 C.F.R. §§ 20.603(d); 20.704(d). Service Connection Rib Fracture The Veteran claimed service connection for a broken left rib. The Veteran reported that he sustained a broken rib during a parachute jump during service. He indicated that he still has pain related to the injury and has to use a rib wrap when the rib pops out of place once a month. A review of the Veteran's service treatment reports (STRs) does not reveal any complaints, findings, or treatment for any injuries to the ribs. There is no indication, nor is it contended, that arthritis manifest to a compensable degree within one year of separation. Thus, service connection on a presumptive basis is not for application. 38 C.F.R. §§ 3.307, 3.309. Post service private treatment reports include a March 2014 whole body scan which noted a healed left eighth rib fracture. The records do not include treatment for, or complaints related to the rib fracture. The Board is cognizant of the holding in Saunders v. Wilkie which stated that where pain causes functional impairment, a disability for VA compensation purposes exists, even if there is no underlying diagnosis. Saunders v. Wilkie, 886 F.3d 1356, 1361 (Fed. Cir. 2018). In that regard, the Board emphasizes that the medical records do not reveal a diagnosis of any residuals of a rib fracture. The Board acknowledges that the Veteran has indicated that he has rib pain which requires the use of a rib wrap; however, there is no objective evidence of record, nor has the Veteran otherwise reported, that his reported symptoms produced a functional impairment. For a disability to be service connected, it must be present at the time a claim for VA disability compensation is filed or during or contemporary to the pendency of the claim. McClain v. Nicholson, 21 Vet. App. 319 (2007); Romanowsky v. Shinseki, 26 Vet. App. 289 (2013). In this case, the Veteran does not have a current diagnosis of any residuals related to a broken left rib. Additionally, Congress has specifically limited entitlement to service-connected benefits to cases where there is a current disability. As such, in the absence of proof of a present disability, there can be no valid claim. See Brammer v. Derwinski, 3 Vet. App. 223, 225 (1992). Accordingly, the Board finds that the benefit-of-the-doubt rule is not applicable as the evidence is not in approximate balance, and entitlement to service connection for a broken left rib is not warranted. 38 U.S.C. § 5107(b); Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021) (en banc). Service Connection Bilateral Knees The Veteran contends that he has a bilateral knee disability related to service. A review of the Veteran's STRs does not reveal any complaints, findings, or treatment for the right or left knee. Post service private treatment reports from McLaren Macomb reveals a complaint of left knee pain in February 2014. A March 2014 whole body scan performed for the left knee complaints was reported to be normal. At a VA knee examination in July 2015, the Veteran reported no specific injury to the knees. He endorsed pain lasting a very short time which the examiner noted was not consistent with the examination. The Veteran denied flare-ups of the knee. Clinical evaluation revealed normal range of motion of both knees, normal muscle strength testing, and no muscle atrophy. Joint stability testing was normal bilaterally. There were no meniscal conditions and no surgical procedures to either knee. The examiner indicated that there was no diagnosis for the claimed knee disabilities. X-rays did not reveal any degenerative or traumatic arthritis. The examiner opined that the Veteran's claimed knee disability was less likely than not incurred in or caused by the claimed in-service injury, event, or illness. The examiner's rationale was that the Veteran had full weight bearing without gait abnormality, the joints were stable without laxity, muscle strength was full, and pain was not specific and when checked more than once, seemed to be mobile and not confined to any specific location. Given the above, the Board concludes that the Veteran does not have a right or left knee disability related to his active service, or symptoms which result in a functional impairment in earning capacity. Saunders, supra. The VA opinion is probative evidence because it is based on an accurate history and are accompanied by well-reasoned rationale as well as supporting data. Nieves-Rodriguez v. Peake, 22 Vet. App. 295 (2008); Stefl v. Nicholson, 21 Vet. App. 120, 124 (2007). Moreover, there is no contrary medical opinion on file. To the extent that the Veteran believes his claimed right and left knee disabilities are due to service, he is not competent to provide a nexus opinion in this case. The issue is medically complex, as it requires knowledge of the interaction between multiple organ systems in the body. Jandreau v. Nicholson, 492 F.3d 1372, 1377 n.4 (Fed. Cir. 2007). In short, the Board gives more probative weight to the VA medical opinion of record. Accordingly, the Board finds that the benefit-of-the-doubt rule is not applicable as the evidence is not in approximate balance, and entitlement to service connection for a right and left knee disability is not warranted. 38 U.S.C. § 5107(b); Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021) (en banc). Service Connection Bilateral Ankles, Back, and Left Hip The Veteran contends that he has bilateral ankle, back, and left hip disabilities related to injuries in service. Specifically, he reported that he suffered numerous twisted ankles due to physical training and parachute trainings or jumps. He noted that he still has chronic pain in both ankles. He also indicated that he injured his back when he fell off of a rope bridge in service and fell twelve feet and landed on his back with all of his equipment. He stated that he still has chronic back pain and his back goes out every three or four months. Finally, he reported that he injured his left hip after a parachute jump and still has chronic pain. A review of the Veteran's STRs does not reveal any complaints, findings, or treatment for the ankles, back, or left hip. Post service private treatment reports from McLaren Macomb reveal reports of chronic ankle, low back, and left hip pain. He was assessed with chronic ankle pain, lumbago, and left hip arthralgia in 2014. A July 2013 magnetic resonance imaging (MRI) of the thoracic spine revealed degenerative changes and disc herniations of the lower thoracic and upper lumbar spine. Associated with the claims file is a medical opinion from W. Klimkowski, M.D., of McLaren Macomb Family Medicine dated in April 2015. Dr. Klimkowski opined that the Veteran's back pain, left hip pain, and right and left ankle pain were as likely as not due to military training, including paratrooper training exercises. The Veteran was afforded a VA ankle examination in July 2015. The Veteran reported several ankle sprains during service which had recently become painful. Following a clinical evaluation, the examiner diagnosed the Veteran with chronic/recurrent lateral collateral ligament strain. The examiner opined that the bilateral ankle disability was less likely than not incurred in or caused by the in-service event, injury, or illness. The examiner's rationale was that the Veteran had full range of motion, full strength, and associated pain which is not consistent when tested after usage and seemed to be global without any signs of specific pathology. The Veteran was afforded a VA back examination in September 2015. The Veteran reported chronic low back pain since his service. The examiner assessed the Veteran with degenerative arthritis of the lumbar spine but noted that the Veteran refused X-rays but stated that he would send in his diagnostic reports. No etiology opinion was proffered. The Veteran was afforded a VA hip examination in September 2015. The Veteran reported pain in the left hip since service. Following a clinical evaluation, the examiner diagnosed the Veteran with left hip osteoarthritis but noted that the Veteran would send in his diagnostic reports. No etiology opinion was proffered. Although there is a VA examiner who opined against the Veteran's claim for a bilateral ankle disability, the Board affords lesser probative value to that opinion as the examiner failed to consider the medical records which reference the Veteran's continued complaints of right and left ankle pain since service. As noted, the September 2015 VA examiner failed to proffer any opinion with regard to the claims for the back and left hip. The Veteran's lay statements refer to a continuity of symptomatology since service. The Board finds that the Veteran is competent and credible to report the onset of right and left ankle disabilities, a back disability, and a left hip disability and that those symptoms have persisted since that time. See Charles v. Principi, 16 Vet. App. 370 (lay testimony is competent to establish the presence of observable symptomatology that is not medical in nature). Moreover, a private clinician provided a positive opinion with regard to the claims for bilateral ankle, back, and left hip disabilities. The examiner considered the Veteran's lay statements and linked the disabilities to the Veteran's active service. (Continued on the next page) Consequently, the Board finds that the evidence for and against the claims is in approximate balance. Therefore, the benefit of the doubt must be resolved in favor of the Veteran, and entitlement to service connection for a right and left ankle disability, a back disability, and a left hip disability is warranted. 38 U.S.C. § 5107(b); Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021) (en banc). R. Behlen Acting Veterans Law Judge Board of Veterans' Appeals Attorney for the Board A. Cryan, 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.