Citation Nr: 22028468 Decision Date: 05/13/22 Archive Date: 05/13/22 DOCKET NO. 16-25 969 DATE: May 13, 2022 ORDER Entitlement to service connection for right elbow olecranon bursitis, claimed as right elbow arthritis, is granted. Service connection for a right knee arthritis is granted. FINDINGS OF FACT 1. Resolving all doubt in the Veteran's favor, the competent and credible evidence of record indicates the Veteran sustained a right elbow injury in service which resulted in right elbow arthritis. 2. Resolving all doubt in the Veteran's favor, the competent and credible evidence of record indicates the Veteran sustained a right knee injury in service which resulted in right knee arthritis. CONCLUSIONS OF LAW 1. With resolution of reasonable doubt in the Veteran's favor, the criteria for service connection for a right elbow arthritis are met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.304. 2. With resolution of reasonable doubt in the Veteran's favor, the criteria for service connection for a right knee arthritis are met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.304. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran had active service from February 1973 to January 1976. His Military Occupational Specialty (MOS) was as a field wireman. See DD 214. This case comes to the Board of Veterans' Appeals (Board) from a July 2015 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO). The Veteran testified before the undersigned Veterans Law Judge at a January 2022 Board hearing; a copy of the transcript is of record. During the pendency of this appeal, an August 2019 rating decision granted service connection for migraines. As such, this issue is no longer before the Board. Service Connection Establishing service connection generally requires (1) medical evidence of a current disability; (2) medical or, in certain circumstances, lay evidence of in-service incurrence or aggravation of a disease or injury; and (3) medical evidence of a nexus between the claimed in-service disease or injury and the present disability. Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004). For the chronic diseases listed in 38 C.F.R. § 3.309(a), such as arthritis, service connection may be established with evidence the disease began in service or during a presumptive period following service separation, or by showing continuity of symptoms after service. 38 C.F.R. § 3.303 (b); Walker v. Shinseki, 708 F.3d 1331, 1338 (Fed. Cir. 2012); Fountain v. McDonald, 27 Vet. App. 258, 272 (2015). To establish service connection based on a continuity of symptoms, there must be evidence showing (1) a condition was noted in service; (2) post-service continuity of these symptoms; and (3) causal link between a present disability and the continuous symptoms. See Fountain, 27 Vet. at 263-64. Lay evidence can be competent and sufficient evidence of a diagnosis or establish cause where (1) competent to identify conditions; (2) reporting a contemporaneous medical diagnosis, or (3) lay testimony describing symptoms at the time supports a later diagnosis by a medical professional. See Davidson v. Shinseki, 581 F.3d 1313, 1316 (Fed. Cir. 2009). 1. Service connection for right elbow arthritis 2. Service connection for right knee arthritis The Veteran contends that his right elbow and right knee conditions are related to numerous falls he experienced while in service running communication lines between trees. See January 2022 Board Hearing Transcript, pgs. 3-5. The Veteran has a diagnosis of right knee arthritis. See July 2015 VA Knee and Lower Leg Conditions Disability Benefits Questionnaire (DBQ), pg. 2. The Veteran has a diagnosis of right elbow olecranon bursitis and right elbow arthritis. See July 2015 VA Elbow and Forearm Conditions DBQ, pg. 1. The Veteran competently and credibly testified about injuries he sustained to his right knee and elbow after falling from trees while running communication lines in service. The Board finds that his description of his inservice right knee and right elbow pain symptoms are consistent with the circumstances of his service, as indicated in his official military records. See 38 U.S.C. § 1154(a). Therefore, the Board finds that the first and second elements of service connection are met. The issue is whether there is a nexus between his right elbow and right knee arthritis and his service. A July 2015 VA examiner in providing a negative nexus opinion noted that the Veteran's right knee and right elbow arthritis was diagnosed in 1975. The examiner noted that Service Treatment Records (STRs) documented treatment for right elbow and right knee gonococcal arthritis; improvement was noted on separation. See July 2015 VA Examination Opinion, pg. 2. The examiner noted the Veteran's report of right elbow and right knee pain at the time of the examinations, and that he has continued pain to the point he switched to his left hand to perform his work functions although he is right-handed, and regularly used ibuprofen for right elbow and right knee pain. The examiner also noted that the Veteran reported the less he does, the less pain he feels. See July 2015 VA Knee and Lower Leg Conditions DBQ, pg. 2. Despite this, the examiner stated that the Veteran did not have a functional loss due to right elbow or right knee pain. The examiner noted that the Veteran worked at a steel mill, then later as a delivery man after service. In providing a negative nexus opinion, the examiner relied on a lack of post-service treatment for arthritis and lack of X-ray evidence during and immediately after service. See id. at pg. 7. In January 2022, the Veteran provided private medical nexus opinions from K.S., Family Nurse Practitioner, which was reviewed and affirmed by Dr. Z.F., Board Certified Family Practitioner, citing medical literature from Harvard and Mayo Clinic. Each opined that the Veteran's arthritis developed over time into bone spurs which resulted in the joint damage he suffers from to this day. See February 2021 Private Medical Nexus Opinion, pgs. 2-3. Based on the Veteran's symptoms, medical history and medical records, the clinicians opined that his right elbow and right knee arthritis is at least as likely as not due to service. See id. at pg. 2. The Veteran testified that his right elbow and right knee problems persisted from service to the present. See January 2022 Hearing Transcript, pg. 5. The Board finds that the Veteran has consistently and competently reported that his inservice right elbow and right knee injuries which have persisted to the present. As a lay person, he is competent to report his pain symptoms, and there is no reason to doubt his credibility. The Board finds that the competent medical evidence of record is at least evenly balanced. Therefore, the benefit of the doubt is for application. See Lynch v. McDonough, 21 F.4th 776 (2021). The claims are granted. Cory M. Picton Veterans Law Judge Board of Veterans' Appeals Attorney for the Board K. McKenzie, 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.