Citation Nr: 23038457 Decision Date: 07/12/23 Archive Date: 07/12/23 DOCKET NO. 17-67 831 DATE: July 12, 2023 ORDER Service connection for a left knee disorder. FINDINGS OF FACT 1. The Veteran served on active duty from October 1979 to June 1984. He died in March 2021 and his surviving spouse was substituted as the claimant. 2. A left knee disorder, diagnosed as osteoarthritis, was not shown in service, not continuous since service, not shown to a compensable degree within one year of service, and was not causally or etiologically related to service. CONCLUSION OF LAW A left knee disorder was not incurred in service and was not presumed to have been incurred in service. 38 U.S.C. §§ 1131, 5103, 5103A, 5107 (2012); 38 C.F.R. §§ 3.303, 3.307, 3.309 (2023). REASONS AND BASES FOR FINDINGS AND CONCLUSION As a procedural matter, the Veteran testified before the undersigned Veterans Law Judge in June 2020. A copy of the transcript has been associated with the claims file. He died in March 2021 and his surviving spouse was substituted as the appellant. In October 2021, the Board denied the appeal. The appellant appealed to the Veterans Claims Court. In July 2022, the Court Clerk granted a joint motion for partial remand (JMPR) which vacated the Board's decision. The JMPR directed that the Board obtain outstanding private treatment records related to the onset of the Veteran's left knee disability. In December 2022, the Board remanded the issue. Although the appellant was asked to provide private records, she did not respond. The case has now been returned to the Board for further appellate action. Therefore, the Board will again decide the case based on the current record. Turning to the relevant laws and regulations, service connection may be granted on a direct basis as a result of disease or injury incurred in service based on nexus using a three-element test: (1) the existence of a present disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the present disability and the disease or injury incurred in or aggravated by service. See 38 C.F.R. §§ 3.303(a), (d); Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009). Service connection may be granted on a presumptive basis for diseases listed in 38 C.F.R. § 3.309 under the following circumstances: (1) where a chronic disease or injury is shown in service and subsequent manifestations of the same disease or injury are shown at a later date unless clearly attributable to an intercurrent cause; or (2) where there is continuity of symptomatology since service; or (3) by showing that the disorder manifested itself to a degree of 10 percent or more within one year from the date of separation from service. See 38 C.F.R. § 3.307. Turning to the medical evidence, an August 2013 private medical record reflected mild arthritic changes in the left knee and a March 2016 private medical record assessed primary osteoarthritis of the left knee. As such, a left knee disorder was shown and the first element of service connection was met. As to in-service incurrence, the Veteran did not contend, nor do the service treatment records (STRs) show, that a left knee disorder was incurred during service. Rather, he was treated for a right knee injury in service and service connected was granted for a right knee disability in January 2022; however, the evidence does not show any left knee complaints. Therefore, the medical evidence does not support the claim for direct service connection. Turning to presumptive service connection, as noted the Veteran was diagnosed with left knee osteoarthritis during his lifetime, which is entitled to presumptive service connection if shown to be chronic in service, or with continuous symptoms since service, or if it manifested to a degree of 10 percent or more within one year of service separation. The medical evidence, however, does not support presumptive service connection. First, no chronic disease or injury was shown in service. While the Veteran was treated for right knee complaints in service, there was no evidence of complaints of, treatment for, or a diagnosis of a left knee disorder. Significant is the lack of left knee complaints at the time of service separation. Therefore, the medical evidence does not support presumptive service connection on a "chronic disease or injury shown in service" basis. Next, the medical evidence does not support presumptive service connected based on continuity of symptomatology since service. The Veteran was discharged in June 1984 with no complaints of left knee symptoms. Further, the medical evidence does not show complaints of or treatment for left knee symptoms until approximately 2013, almost 30 years after separation from service. As such, the medical evidence does not support service connection on a "continuity of symptomatology" basis. Additionally, the disorder did not manifest to a degree of 10 percent or more within one year from the date of separation of service. Specifically, the Veteran separated from service in 1984 and did not seek treatment for left knee symptoms until 2013. Therefore, this evidence does not support presumptive service connection on a "manifest within one-year from separation" basis. As such, the medical evidence does not support presumptive service connection. The Board has considered the Veteran's lay statements and testimony that this disorder began in service. The appellant has offered no further argument or contentions. He was competent to report symptoms because this required only personal knowledge, as it came to him through his senses; however, he was not competent to offer an opinion as to the etiology of his disorder due to the medical complexity of the matters involved. Such competent evidence was provided by the medical personnel who examined the Veteran during his lifetime and by service records obtained and associated with the claims file. Here, the Board attaches greater probative weight to the clinical findings than to the lay statements. Therefore, the appeal is denied. Finally, neither the Veteran nor the appellant raised any other issues, nor have any other issues been reasonably raised by the record, for the Board's consideration. See Doucette v. Shulkin, 28 Vet. App. 366, 369-370 (2017) (confirming that the Board is not required to address issues unless they are specifically raised by the claimant or reasonably raised by the evidence of record). L. HOWELL Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Grzeczkowicz, Teresa 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.