Knee Condition VA Claim Grants

Findings of Fact (verbatim from decision)

1. A complete and proper intent to file for VA benefits was received on January 15, 2020, and a formal claim for service connection for the issue on appeal was received within one year. 2. Throughout the period on appeal, the Veteran's GERD is manifested by persistently recurrent epigastric distress with dysphagia, pyrosis, and regurgitation, accompanied by substernal or arm or shoulder pain, productive of considerable impairment of health, or recurrent or refractory esophageal stricture(s) causing dysphagia.

Reasons & Bases (verbatim excerpts from decision)

The Board notes that this matter was previously before the Board in April 2026, but the issue of entitlement to an earlier effective date for the Veteran's right knee and an increased rating for GERD were not addressed in that Board decision. The Board may issue a supplemental decision, remand, or order for correcting an obvious error consisting of the inadvertent failure to address an issue within the Board's jurisdiction in a prior decision, remand, or order. […] 1. An effective date of January 15, 2020, but no earlier for the grant of service connection for right knee instability is granted. […] Records indicate that VA received the Veteran's intent to file on January 15, 2020. On May 18, 2020, a fully developed claim was received from the Veteran for service connection for right knee patellofemoral pain syndrome, among other issues. A completed application form, appropriate to the benefit sought, was received within one year of receipt of the intent to file a claim. Therefore, the date the intent to file a claim was received is considered the date of the completed claim, and an earlier effective date of January 15, 2020, is granted. Id.

Findings of Fact (verbatim from decision)

1. Throughout the appeal period, the Veteran has been unable to secure or follow substantially gainful employment as a result of his service connected instability of the right knee, service connected status post anterior cruciate ligament disruption and reconstruction, patellofemoral syndrome and osteoarthritis, right knee and service connected irritable bowel syndrome. 2. The Veteran's service connected disabilities resulted in the need for aid and attendance as he required care or assistance on a regular basis in order to feed himself, keep himself clean and presentable and protect him from the hazards or dangers inherent in his daily environment.

Reasons & Bases (verbatim excerpts from decision)

Turning to the evidence of record, the Veteran was afforded a VA examination for his right knee in December 2012. The examiner opined that the Veteran had significant contributions to unemployability due to the service connected conditions of the right knee that impaired ambulation and limited the ability to walk long distances, ascend or descend stairs and impaired ability to stand for long periods of time. The examiner noted that the Veteran's right knee anterior cruciate ligament instability increased the risk of falling, especially on uneven terrain. The Veteran reported that his right knee was unstable and gave way. He needed to wear a brace to prevent his knee from buckling and falling. He regularly used a cane. He noted that his right knee flared up after twisting or giving way. […] Accordingly, the Board finds that entitlement to a TDIU due to service connected instability of the right knee, service connected status post anterior cruciate ligament disruption and reconstruction, patellofemoral syndrome and osteoarthritis, right knee and service connected irritable bowel syndrome is warranted. The appeal is granted. C. R. 102; Lynch v. 4th 776 (Fed. Cir. 2021) (en banc).

Findings of Fact (verbatim from decision)

1. Resolving all reasonable doubt in favor of the Veteran, the pre-existing low back disability was aggravated by active-duty service. 2. The Veteran's right ankle, bilateral hip, and left knee disabilities had their onset in service. 3. The Veteran's migraines are secondary to his service-connected tinnitus.

Reasons & Bases (verbatim excerpts from decision)

Bilateral Hip/Left Knee […] In a May 2024 VA knee opinion, the examiner provided a negative nexus opinion. The examiner noted that there were no objective findings of a left knee condition, the examiner indicated that the 2012 and 2019 examinations were negative for a knee diagnosis. The examiner stated that the Veteran's lay statements did not support a knee diagnosis. […] The Board finds the Veteran has been consistent in reporting that he injured his hips and knees in service, as well as in his reports of the circumstances of the injury. He has been consistent in reporting the continuity of symptoms of his hips and left knee pain he had experienced since service. As a lay person he is competent at reporting his symptoms and there is no reason to doubt his credibility. The Veteran repeatedly reported that he experienced pain in service from his helicopter jumps, his paratrooper jumps, and wearing heavy gear throughout his service. The issue was remanded twice by the Board, requesting that the Veteran's lay statements and an adequate rationale be obtained. The Board finds that further attempts to obtain an adequate opinion would be futile. Therefore, the Board finds the Veteran's reports of in-service onset of symptoms and their continuation since service to be credible and probative.

Findings of Fact (verbatim from decision)

1. Left knee disability, now diagnosed as degenerative joint disease, which clearly and unmistakably pre-existed service, was aggravated by service. 2. Lumbosacral strain is secondary to left knee degenerative joint disease.

Reasons & Bases (verbatim excerpts from decision)

The Veteran asserts he is entitled to service connection for his left knee because the preexisting condition was aggravated by his military service. For the reasons discussed below, the Board finds that the preexisting left knee disability was aggravated by military service. Entitlement to service connection for the left knee disability is warranted. […] The Board notes a number of VA medical opinions have been received in connection with the Veteran's claim. In a December 2023 VA medical opinion, the examiner opined that the Veteran's left knee was less likely than not incurred in or caused by service. The examiner stated that the condition preexisted service. The examiner did note that the service treatment records (STRs) note that in 1978 the Veteran had a left knee injury. See December 2023 VA Medical Opinion Disability Benefits Questionnaire (DBQ). In an April 2024 VA medical opinion, the examiner opined that the Veteran's left knee condition was at least as likely as not incurred in or caused by service. The examiner stated that Veteran's condition started during service and was, initially, well controlled without pain medication. The condition became aggravated due to military duties and pain was so elevated that the Veteran needed to use pain medication. See April 2024 VA Medical Opinion DBQ.

Findings of Fact (verbatim from decision)

1. The competent and credible evidence of record persuasively establishes a finding that the lumbar spine disability is related to active-duty service. 2. The competent and credible evidence of record persuasively establishes a finding that the left shoulder disability is related to the service-connected left knee. 3. The competent and credible evidence of record persuasively establishes a finding that the generalized arthritis is related to active-duty service.

Reasons & Bases (verbatim excerpts from decision)

2. Entitlement to service connection for a left shoulder disability secondary to the service-connected chondromalacia with degenerative changes of the left knee […] Regarding the left shoulder disability, in a September 2013 statement, the Veteran asserted that in 1990, the service-connected left knee caused him to fall, and injure his left shoulder. […] In a September 2020 addendum opinion, the examiner noted that there was no basis in medical literature to show that a knee condition can cause or aggravate a low back condition. […] The Board affords low probative value to each of these opinions. The earlier examiners appear to not understand the concept of secondary service connection, which does not require a direct in-service incident, or injury. The Veteran has asserted that his service-connected left knee caused him to fall, which caused him to injure his shoulder. This satisfies the second element of service connection. The March 2025 examiner did not address this theory of entitlement at all. Generally, a medical opinion should address the appropriate theories of entitlement. Stefl v. Nicholson, 21 Vet. App. 120, 123-24 (2007). As with the lumbar disability, rather than remanding yet again, the Board will afford the Veteran the benefit of the doubt and assign greater probative value to his lay statements.