Citation Nr: 22048728 Decision Date: 08/26/22 Archive Date: 08/26/22 DOCKET NO. 17-02 815 DATE: August 26, 2022 ORDER Entitlement to service connection for a right knee condition is denied. REMANDED Entitlement to service connection for an acquired psychiatric condition, to include posttraumatic stress disorder (PTSD), is remanded. FINDING OF FACT The persuasive weight of the evidence is against finding the Veteran has a current right knee condition. CONCLUSION OF LAW The criteria for service connection for a right knee condition have not been met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served in the United States Marine Corps from January 2003 to August 2012. These matters come before the Board of Veterans' Appeals (Board) on appeal of an April 2014 rating decision from a Department of Veterans Affairs (VA) Regional Office (RO). The Veteran testified before the undersigned Veterans Law Judge in a June 2022 videoconference hearing, and a transcript of this hearing is associated with the claims file. 1. Entitlement to service connection for a right knee condition is denied. The Veteran contends that he has a current right knee condition that is related to his service. The Veteran's service treatment records (STRs) are silent with respect to any symptoms, treatment, or a diagnosis of a right knee condition. The Veteran's VA treatment records are similarly silent regarding a diagnosis of a right knee condition. Service connection may be granted for disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. § 3.303. The three-element test for service connection requires evidence of: (1) a current disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the current disability and the in-service disease or injury. Shedden v. Principi, 381 F.3d 1163, 1166-67 (Fed. Cir. 2004). The question for the Board is whether the Veteran has a current disability that began during service or is at least as likely as not related to an in-service injury, event, or disease. Congress has specifically limited entitlement to service-connected benefits to cases where there is a current disability. See Brammer v. Derwinski, 3 Vet. App. 223, 225 (1992) (holding that "[i]n the absence of proof of a present disability, there can be no valid claim"). After a review of all the lay and medical evidence of record, the Board finds that the weight of the evidence demonstrates that the Veteran does not have a current right knee disability and has not had one at any time during the pendency of the appeal. The available medical evidence shows no current diagnosis of a right knee disability or functionally impairing disabilities in the right knee. See Saunders v. Wilkie, 886 F.3d 1356, 1367-68 (Fed. Cir. 2018) (holding that pain can qualify as a disability where there is evidence of functional impairment of earning capacity). In the Veteran's October 2016 VA examination, he was found to have full range of motion without any objective evidence of pain. The Veteran denied flare-ups of pain and functional loss or impairment of the right knee. Muscle strength was normal, there was no knee instability, and no other impairments were noted. The Veteran himself noted during the June 2022 Board hearing that he injured his right knee during service but has not had it checked out and does not have a current diagnosis. He also mentioned that while his right knee gives him trouble "every now and then," he is able to work through it and does not consider it to be a major issue. Instead, he explained that he filed a claim for his right knee because he wanted it on the record for if and when it becomes an issue in the future. The Board concludes that the Veteran does not have a current right knee condition and has not had one at any time during the pendency of the claim or recent to the filing of the claim. Romanowsky v. Shinseki, 26 Vet. App. 289, 294 (2013); McClain v. Nicholson, 21 Vet. App. 319, 321 (2007). The Board has considered the Veteran's statements that he has a current right knee condition related to service. Although the Veteran is competent to report subjective symptoms of knee pain and locking, he is not shown to have the medical training or experience needed to diagnose a musculoskeletal disorder. See Jandreau v. Nicholson, 492 F.3d 1372, 1377 (Fed. Cir. 2007). Additionally, the Veteran has not presented evidence indicating that he has a limitation of function caused by his claimed right knee condition. Additionally, the VA examiner provided a thorough examination report that considered the Veteran's subjective reports of symptoms and objective medical testing and found there to be no diagnosed right knee disability present. The examination report is considered the most probative evidence with respect to the presence of a current right knee condition. Therefore, as no right knee condition is found, there is no basis upon which service connection can be awarded, and the claim for service connection for a right knee condition is denied. 38 U.S.C. § 5107(b); Gilbert v. Derwinski, 1 Vet. App. 49 (1990). REASONS FOR REMAND 1. Entitlement to service connection for an acquired psychiatric condition, to include posttraumatic stress disorder (PTSD), is remanded. The Veteran contends that his psychiatric conditions, to include PTSD, are related to his service. The Veteran underwent a VA examination in July 2015. The examiner found the Veteran had alcohol and opioid use disorders. The examiner further noted the Veteran was prescribed medication for insomnia in 2010 and was diagnosed with adjustment disorder with mixed features and ADHD in 2012. However, the Veteran stated he had no psychiatric treatment following service. The Veteran reported serving two tours in Iraq, although he said he had no problems related to his deployments. His reported stressor was finding his wife on the floor after she attempted to commit suicide while he was still in service; however, the examiner found this did not meet the diagnostic criteria for PTSD. During the June 2022 hearing, the Veteran explained that while he was unsure of his diagnosed conditions, he had been prescribed medication for schizophrenia. He also described how at times he felt like he was losing his mind, as well as experiencing what he described as "wild hallucinations," which led to him checking himself into a VA hospital for treatment. The Veteran said this had occurred four or five times over the past three or four years. He further described how he had times where he did not care if he lived or died and stated he experienced thoughts and feelings that he was afraid to discuss because he worried about being "locked away forever." The Veteran also stated that he was currently receiving treatment for his psychiatric conditions. After reviewing the evidence of record, the Board finds the July 2015 examination to be inadequate. While the examiner found the Veteran only had alcohol and opioid use disorders during the examination, they also noted the Veteran had previous diagnoses of insomnia, adjustment disorder with mixed features, and ADHD. However, the examiner failed to explain why these diagnoses were no longer applicable. Additionally, the examiner noted the Veteran had not received any psychiatric treatment since his separation from service. The Veteran has since provided testimony that he has been in and out of VA psychiatric facilities over the past three or four years, and he is currently receiving psychiatric treatment. While these statements were made after the July 2015 examination, they must still be addressed. Where VA provides the Veteran with an examination in a service connection claim, the examination must be adequate. Barr v. Nicholson, 21 Vet. App. 303, 311 (2007). As such, remand is necessary in order to obtain a new medical opinion. Accordingly, this matter is REMANDED for the following action: 1. Identify and obtain any pertinent, outstanding VA and private treatment records and associate them with the claims file. 2. Schedule the Veteran for a psychiatric examination to determine the nature and etiology of any and all mental health diagnoses found to be present during the period on appeal. The complete claims file must be reviewed. The examiner should respond to the following: (a.) Diagnose any acquired psychiatric disorders, including PTSD, present on examination or during the pendency of this appeal. If there are different diagnoses on examination than those currently of record, the examiner should attempt to reconcile the diagnoses with the evidence of record. If the examiner finds that previously noted diagnoses are no longer warranted, they are to explain why this is the case. (b.) If a diagnosis of PTSD is made, the examiner must identify the specific stressor(s) underlying the PTSD diagnosis. The examiner should state if: each claimed stressor was sufficient to produce PTSD. the diagnostic criteria for diagnosis of PTSD have been satisfied. Please specify each criterion that supports a PTSD diagnosis. there is a link between the current symptoms and one or more of the in-service stressors sufficient to produce PTSD. (c) With respect to each acquired psychiatric disorder other than PTSD found to be present or diagnosed during the pendency of the appeal, the examiner should opine whether it is at least as likely as not that the disorder was incurred in, caused by, or is otherwise related to the Veteran's active service. The examiner must consider and discuss the Veteran's contentions regarding in-service onset and ongoing symptomatology of his claimed psychiatric disorder, as well as his reported in-service stressor of his wife's attempted suicide. A complete rationale should be provided for all opinions offered. Caroline B. Fleming Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Gabrielle Ongies, 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.