04-292 268
04-292 268
| Board of Vet. App. | Mar 31, 2017Background
- Veteran served on active duty in the Navy from June 1951 to June 1955 and sought VA service connection for left knee (primary), and right knee and left hip as secondary to the left knee.
- Service records show a multipartite/bipartite patella on x‑rays in 1951–1952; notes from April–May 1952 document chronic synovitis and quadriceps atrophy but do not document an acute traumatic knee injury from a large fall.
- Veteran and a shipmate later (2002 onward) reported a fall from the 01 deck to the main deck in 1951–1952; private physicians later opined the current arthritis was related to that in‑service trauma.
- VA examinations (March 2010 and March 2016) concluded the multipartite patella is a congenital/developmental defect and that service events were episodic recrudescences of a preexisting condition, not a superimposed injurious event causing current osteoarthritis.
- The Board found the Veteran not a credible historian regarding the alleged 15–20 foot fall because contemporaneous service records contradict a severe traumatic event and show no recurrent or continuous post‑service complaints until decades later.
- Result: Board denied service connection for left knee, and denied right knee and left hip both on direct and as secondary to the left knee; benefit‑of‑the‑doubt rule inapplicable because evidence preponderates against the claims.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Service connection — left knee disability | Veteran: left knee degenerative disease caused or permanently aggravated by an in‑service fall and hospitalization in 1952 | VA: service records show congenital multipartite patella and episodic synovitis; no evidence of a superimposed traumatic injury causing current arthritis | Denied — Board found bipartite patella congenital, no persuasive nexus to service, veteran not credible historian |
| Service connection — right knee (including secondary to left knee) | Veteran: right knee degeneration resulted from altered gait/overuse after left knee injury | VA: no service records showing right knee injury; most probative VA opinion finds right knee unrelated to service or to left knee | Denied — no direct or secondary nexus; primary left knee not service‑connected |
| Service connection — left hip (including secondary to left knee) | Veteran: left hip deterioration followed from altered mechanics after left knee problems | VA: no in‑service left hip evidence and no medical nexus tying hip to service or to left knee | Denied — no direct evidence or persuasive nexus; cannot award secondary benefits where primary claim denied |
Key Cases Cited
- Nieves‑Rodriguez v. Peake, 22 Vet. App. 295 (noting probative value of a medical opinion depends on its factual basis and reasoning)
- Caluza v. Brown, 7 Vet. App. 498 (board may consider consistency with contemporaneous records in assessing credibility)
- Pruitt v. Derwinski, 2 Vet. App. 83 (heightened VA duty when service records are unavailable)
- Kahana v. Shinseki, 24 Vet. App. 428 (discussing use of reasonable inferences where evidence corroborates or contradicts testimony)
- Swann v. Brown, 5 Vet. App. 229 (medical opinion based on an unsubstantiated history is of limited probative value)
- Reonal v. Brown, 5 Vet. App. 458 (Board not bound to accept a physician opinion premised exclusively on rejected lay history)
- Gilbert v. Derwinski, 1 Vet. App. 49 (applicability of benefit‑of‑the‑doubt doctrine)
- Wagner v. Principi, 370 F.3d 1089 (presumption of sound condition on entry to service and effect of preexisting conditions)
- Disabled American Veterans v. Secretary of Veterans Affairs, 327 F.3d 1339 (VCAA notice requirements and timing)