10-12 603
10-12 603
| Board of Vet. App. | Oct 31, 2017Background
- Veteran served active duty Jan 2002–Apr 2003 and May 2014–Aug 2015; claim for service connection for a right knee disability (including secondary to left knee or other service-connected conditions) appealed to the Board.
- Initial RO denial (Dec 2008); claim reopened and remanded by the Board in Sept 2016 for additional development including a secondary causation opinion; VA examinations were performed in 2008, 2016, and 2017.
- Medical record: no right-knee complaints or documented right-knee condition during the first service period; VA notes an “asymptomatic right knee” in 2005; right knee pain appears in records around 2007–2008 with left knee issues more prominent; right knee arthroscopy occurred circa 2010.
- VA medical opinions (2008 and 2016–2017) concluded the right knee meniscal tear/arthralgia was not caused or aggravated by service or by the service-connected left knee or other service-connected conditions (no abnormal gait or overuse documented).
- No contemporaneous documentation of right knee problem during the second service period (2014–2015); no competent lay or medical evidence showing in-service incurrence or aggravation during that period.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Direct service connection for right knee | Right knee disability was incurred in or linked to service (or manifested within one year) | Record shows no in-service right-knee injury or symptoms; first documentation years after service | Denied — no in-service incurrence or continuity of symptomatology shown |
| Secondary service connection (to left knee) | Right knee worsened/occurred due to overuse/weight shift from service-connected left knee | Medical opinions: different anatomy/pathophysiology, no abnormal gait, typical meniscal tear mechanism not overuse | Denied — medical evidence rejects causal link to left knee |
| Secondary connection to other service‑connected conditions | Right knee caused or aggravated by other service‑connected disabilities | Medical opinions found unrelated pathophysiology and no evidence of aggravation | Denied — insufficient medical nexus or aggravation evidence |
| Aggravation during second service period (2014–2015) of preexisting right-knee condition | May have been aggravated during 2014–2015 active duty | No documentation or competent history of right-knee problems during that period; presumption of soundness not rebutted by evidence of aggravation | Denied — no evidence of aggravation in the 2014–2015 service period |
Key Cases Cited
- Scott v. McDonald, 789 F.3d 1375 (Fed. Cir.) (Board need not raise procedural arguments not asserted by veteran)
- Dickens v. McDonald, 814 F.3d 1359 (Fed. Cir.) (applies Scott to duty-to-assist issues)
- Davidson v. Shinseki, 581 F.3d 1313 (Fed. Cir.) (elements required to establish service connection)
- Walker v. Shinseki, 708 F.3d 1331 (Fed. Cir.) (limits continuity-of-symptomatology principle)
- Baldwin v. West, 13 Vet.App. 1 (Vet. App.) (weighing probative value of medical and lay evidence)
- Barr v. Nicholson, 21 Vet.App. 303 (Vet. App.) (continuity of symptomatology can substantiate in-service incurrence)
- Kahana v. Shinseki, 24 Vet.App. 428 (Vet. App.) (scope of veteran’s competence to offer lay etiology opinions)