Citation Nr: 22018807 Decision Date: 03/30/22 Archive Date: 03/30/22 DOCKET NO. 17-53 525 DATE: March 30, 2022 ORDER Service connection for left knee osteoarthritis (left knee disability) is granted. FINDING OF FACT Resolving reasonable doubt in the Veteran's favor, the Veteran's left knee disability is related to her military service. CONCLUSION OF LAW The criteria for service connection for a left knee disability have been met. 38 U.S.C. §§ 1110, 1131, 1154 (a), 5107; 38 C.F.R. §§ 3.102, 3.303. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from October 1982 to July 1983 and January 1991 to April 1991. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a March 2016 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO). In November 2019, the Board remanded the appeal for additional development. Service Connection Service connection will be granted if the evidence demonstrates that current disability resulted from an injury suffered or disease contracted in active military, naval, or air service. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303(a). Establishing service connection generally requires competent evidence of (1) current disability; (2) in-service injury or disease; and (3) a relationship between the two. Saunders v. Wilkie, 886 F.3d 1356, 1361 (Fed. Cir. 2018). Consistent with this framework, service connection is warranted for a disease first diagnosed after service when all the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303(d). Service connection for a left knee disability. The Veteran seeks service connection for a left knee disability. For the following reasons, service connection for a left knee disability is warranted. A January 2020 VA knee examination report shows a current diagnosis of left knee osteoarthritis. Therefore, the current disability element has been established. As to the in-service disease or injury element, the Veteran claims that her left knee disability is due to an in-service left knee injury and the result of repetitive use of her left knee during service. See, e.g., Veteran's statement (June 2020). Specifically, she asserts that during service, her military occupational specialty (MOS), as a medical service technician performing medivac, required her to lift and carry patients on stretchers. See, e.g., VA examination report (January 2020). Further, the Veteran explained that during her military service in 1982 to 1983 and in 1991, she continually lifted patients on stretchers and that such activity resulted in an in-service left knee injury and required her to use her knees repetitiously, causing her current disability. Id. In a March 2013 statement, E.G., a former servicemember who served with the Veteran, indicated that during the Veteran's military service, she loaded aircraft carrying many patients on stretchers and that the Veteran lifted patients on and off aircrafts. E.G. indicated that the Veteran also had to kneel to lift patients on stretchers to lower them in stanchions, in preparation for takeoff. Although the Veteran's service treatment records (STRs) do not appear to document a left knee injury or treatment thereof, she is competent to report a left knee injury and the over-use of her left knee in service. See Jandreau v. Nicholson, 492 F.3d 1372, 1377 (Fed. Cir. 2007); see also Buchanan v. Nicholson, 451 F.3d 1331, 1337 (Fed. Cir. 2006). Indeed, the Veteran's DD Form 214 shows that her MOS was a medical service specialist for, a combined, 11 months. There is nothing contradicting the Veteran's reports of an in-service left knee injury or the over-use of her left knee during service. In fact, the Veteran's statements regarding her military duties are corroborated by E.G.'s March 2013 statement. Also, the Veteran's reports of an in-service left knee injury and the over-use of her left knee during service are consistent with her circumstances of service, as her MOS was a medical service specialist. Therefore, the Veteran's reports of an in-service left knee injury and the over-use of her left knee during service are credible and such injury is conceded. 38 U.S.C. § 5107 (b); 38 C.F.R. § 3.303 (a) (each disabling condition for which a veteran seeks service connection must be considered on the basis of the places, types, and circumstances of his service, as shown by the evidence). Therefore, the in-service disease or injury element has been met. As to the etiology of the Veteran's left knee disability, in a private June 2020 treatment report, a private physician documented the Veteran's current left knee complaints, documented her left knee history, and indicated that he was informed of the Veteran's military service and military duties, and opined that the Veteran's left knee disability was "in large part due to her service in the military." The private physician indicated that the Veteran's MOS was a medivac and that her civilian job is sedentary. Although brief, the private physician's opinion is entitled to high probative value, given that the private physician's opinion was based on the Veteran's left knee medical history and her military duties. See Monzingo v. Shinseki, 26 Vet. App. 97, 106 (2012) (the fact that the rationale provided by an examiner "did not explicitly lay out the examiner's journey from the facts to a conclusion," did not render the examination inadequate); Acevedo v. Shinseki, 25 Vet. App. 286, 294 (2012) (medical reports must be read as a whole and in the context of the evidence of record). The Board notes that the June 2020 private physician indicated that the Veteran served 15 years as a medivac; to this extent, the Veteran served several years in the reserve service. Although the private physician considered the Veteran's reserve service, the Board finds that the private physician's opinion is still highly probative as to the etiology of the Veteran's left knee disability, as the Veteran's MOS during her active duty service and her reserve service was the same. (Continued on the next page) There is one negative VA opinion of record, dated in January 2020, in which the VA examiner opined that the Veteran's left knee disability was less likely than not due to her military service. The January 2020 VA opinion is afforded little probative value, as the favorable medical opinion of record was not addressed or considered. See Gabrielson v. Brown, 7 Vet. App. 36, 40 (1994). Moreover, the negative opinion is primarily, and impermissibly, based on the lack of documentation in the Veteran's service treatment records. In sum, the Board finds that the January 2020 VA medical opinion is outweighed by the June 2020 positive nexus opinion, which was based on a review of the Veteran's pertinent medical history and her military service. Accordingly, service connection for a left knee disability is granted. Tiffany Dawson Veterans Law Judge Board of Veterans' Appeals Attorney for the Board A. Castillo, 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.