Case A25106823

Summary

The veteran, who served from June 1984 to February 1990, appealed the denial of service connection for a left knee replacement, left 5th digit amputation, and left hip pain. The Board of Veterans' Appeals (Board) dismissed the appeal for left knee replacement as moot because the agency of original jurisdiction (AOJ) had subsequently granted service connection for this condition for the entire period on appeal. The Board granted service connection for a left 5th digit amputation, finding that the Veteran's service-connected left knee conditions caused mobility issues leading to complications, including an infection in the left toe that resulted in the amputation. This finding was supported by a private physical therapy opinion that provided adequate details and rationale. Similarly, service connection for left hip pain was granted, as VA treatment records indicated the pain caused mobility issues, and the same private physical therapy opinion linked the left knee condition to the development of left hip pain. The Board found persuasive evidence establishing a link between the service-connected left knee condition and both the left 5th digit amputation and the left hip pain, warranting a grant of service connection for both. The Board noted that the AOJ had granted service connection for the left 5th digit amputation after the Veteran's appeal to the Board, but the appeal remained active due to potential benefits related to an earlier effective date.

Full Decision Text

Citation Nr: A25106823
Decision Date: 12/10/25	Archive Date: 12/10/25

DOCKET NO. 250411-536108
DATE: December 10, 2025

ORDER

The appeal regarding entitlement to service connection for left knee replacement is dismissed as moot.

Entitlement to service connection for left 5th digit amputation is granted.

Entitlement to service connection for left hip pain is granted.

FINDINGS OF FACT

1. October 2025 rating decisions granted service connection for left knee replacement for the entire period on appeal, resolving this claim in full.

2. The Veteran's left 5th digit amputation was caused by his service-connected left knee conditions.  

3. The Veteran's left hip pain is caused by his service-connected left knee conditions.

CONCLUSIONS OF LAW

1. The criteria for dismissal of the appeal regarding entitlement to service connection for left knee replacement have been met.  38 U.S.C. § 7105; 38 C.F.R. § 20.205.

2. The criteria to establish service connection for left 5th digit amputation have been met.  38 U.S.C. §§ 1110, 1131, 5103, 5103A, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.310.

3. The criteria to establish service connection for left hip pain have been met.  38 U.S.C. §§ 1110, 1131, 5103, 5103A, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.310.

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Veteran served on active duty from June 1984 to February 1990.  

The rating decision on appeal was issued in April 2025.  The Veteran timely appealed to the Board of Veterans' Appeals (Board) and requested the evidence submission review docket.  See April 2025 VA Form 10182.  The Veteran noted various rating decisions in his appeal which duplicates the various appealed issues.  Since the claims have been continuously pursued, the April 2025 rating decision is best in representing the Veteran's appeal as it allows for the largest evidentiary window while preserving the effective date of the initial filings.  

The Board may only consider the evidence of record at the time of the agency of original jurisdiction (AOJ) decision on appeal, as well as any evidence submitted by the Veteran or his representative with, or within 90 days from receipt of, the VA Form 10182.  38 C.F.R. § 20.303.  If evidence was submitted either (1) during the period after the AOJ issued the decision on appeal and prior to the date the Board received the VA Form 10182, or (2) more than 90 days following the date the Board received the VA Form 10182, the Board did not consider it in its decision.  38 C.F.R. §§ 20.300, 20.303, 20.801.  If the Veteran would like the Department of Veterans Affairs (VA) to consider any evidence that was submitted that the Board could not consider, the Veteran may file a Supplemental Claim (VA Form 20-0995) and submit or identify this evidence.  38 C.F.R. § 3.2501.  If the evidence is new and relevant, VA will issue another decision on the claims, considering the new evidence in addition to the evidence previously considered.  Id.  Specific instructions for filing a Supplemental Claim are included with this decision. 

Regarding left hip pain, an April 2025 rating decision removed this issue from the Veteran's record, indicating the Veteran never formally filed a claim regarding this issue.  However, the issue was initiated through a February 2025 VA Form 20-0995 supplemental claim.  As the claim was initiated by the Veteran on a formal claim form, adjudicated by the AOJ, and ultimately continuously pursued by the Veteran with appealing the issue, the Board finds that it still has jurisdiction to adjudicate the left hip issue.  

The Board notes that following the Veteran's April 2025 appeal to the Board, the AOJ granted service connection for left 5th digit amputation in a July 2025 rating decision.  However, as the present appeal may entitle the Veteran to additional benefits, including the possibility of an earlier effective date, this matter remains in appellate status and is not moot.  Johnson v. Collins, 38 Vet. App. 151 (2025); Concepcion-Maldonado v. Collins, 2025 U.S. Vet. Claims L
 adjudicated by the AOJ, and ultimately continuously pursued by the Veteran with appealing the issue, the Board finds that it still has jurisdiction to adjudicate the left hip issue.  

The Board notes that following the Veteran's April 2025 appeal to the Board, the AOJ granted service connection for left 5th digit amputation in a July 2025 rating decision.  However, as the present appeal may entitle the Veteran to additional benefits, including the possibility of an earlier effective date, this matter remains in appellate status and is not moot.  Johnson v. Collins, 38 Vet. App. 151 (2025); Concepcion-Maldonado v. Collins, 2025 U.S. Vet. Claims LEXIS 857 (June 23, 2025).  Importantly, the left 5th digit amputation is currently awarded service connection from April 11, 2025.  However, the period on appeal stems from the original claim VA Form 21-526EZ received on September 15, 2023.  In contrast, regarding the left knee, as discussed below, service connection for the left knee condition has already been granted for the entire period on appeal back to the initial date of claim. 

Dismissal

The Board may dismiss any appeal which fails to allege specific error of fact or law in the determination being appealed.  38 U.S.C. § 7105.  Here, the rating decision on appeal denied service connection for left knee replacement.  However, October 2025 rating decisions granted service connection for left knee replacement, awarding service connection back to the initial date of claim which encompasses this entire period on appeal.  As the October 2025 rating decisions granted the benefit sought on appeal, resolving this claim in full, there remain no allegations of error of fact or law for appellate consideration; accordingly, service connection for a left knee condition is dismissed as moot.

Service Connection

A veteran is entitled to VA disability compensation if there is a disability resulting from personal injury suffered or disease contracted in the line of duty in active service, or for aggravation of a preexisting injury suffered or disease contracted in the line of duty in active service.  38 U.S.C. §§ 1110, 1131.

Generally, to establish a right to compensation for a present disability, a veteran must show: (1) a present disability; (2) an 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 or aggravated during service, the so-called "nexus" requirement.  Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004).

Service connection may be granted for any disease diagnosed after discharge, when all of the evidence, including that pertinent to service, establishes that a disease was incurred in service.  38 C.F.R. § 3.303(d).  

Under section 3.310(a) of VA regulations, service connection may be established on a secondary basis for a disability which is due to or the result of service-connected disease or injury.  38 C.F.R. § 3.310(a).  Establishing service connection on a secondary basis requires evidence sufficient to show: (1) a current disability; (2) a service-connected disability; and (3) a nexus between the current disability and the service-connected disability.  See Wallin v. West, 11 Vet. App. 509, 512 (1988).  As to the third Wallin element, the current disability may be either (a) caused by or (b) aggravated by a service-connected disability.  Allen v. Brown, 7 Vet. App. 439, 448 (1995) (en banc).  

1. Left 5th Digit

The Veteran indicated that he had a foot ulcer and had complications during surgery causing amputation of his left foot 5th digit.  See September 2023 VA Form 21-526EZ.  Treatment records indicate such amputation took place in August 2023.  The Veteran is service connected for left knee conditions.  A November 2024 opinion by a doctor of physical therapy indicated the Veteran's left knee problems caused mobility issues, which led to further health complications, such as infections from an abnormal gait in the left toe which resulted in amputation of his left fifth digit.  This private opinion provided adequate details, history, and rationale.  The Board finds the private opinion probative.   

The Board finds that there is persuasive evidence of record establishing a link between the Veteran's left 5th digit amputation and his service-connected left knee condition.  Accordingly, the Board finds that a grant of service connection is warranted for left 5th digit
putation took place in August 2023.  The Veteran is service connected for left knee conditions.  A November 2024 opinion by a doctor of physical therapy indicated the Veteran's left knee problems caused mobility issues, which led to further health complications, such as infections from an abnormal gait in the left toe which resulted in amputation of his left fifth digit.  This private opinion provided adequate details, history, and rationale.  The Board finds the private opinion probative.   

The Board finds that there is persuasive evidence of record establishing a link between the Veteran's left 5th digit amputation and his service-connected left knee condition.  Accordingly, the Board finds that a grant of service connection is warranted for left 5th digit amputation.  See 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102. 

2. Left Hip

The Veteran's VA treatment records throughout the period on appeal note in the problem list left hip joint pain.  Such pain is generally noted to caused mobility issues.  In Saunders v. Wilkie, the Federal Circuit held that pain alone can constitute a disability if it causes functional impairment.  886 F.3d 1356, 1365-68 (Fed. Cir. 2018).  The Federal Circuit further explained that to establish a disability, "the [V]eteran will need to show that his pain reaches the level of a functional impairment of earning capacity."  Id. at 1367-68.  As a result, the Board considers the Veteran's left hip pain amounts to such disabling functional impairment as contemplated in Saunders.  The first Shedden element is met.  The Veteran is service connected for left knee conditions.  A letter by a doctor of physical therapy included an opinion in November 2024 indicating that the Veteran's left knee condition has led to mobility issues, creating further health complications like left hip pain.   

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The Board finds that there is persuasive evidence of record establishing a link between the Veteran's left hip pain and his service connected left knee condition.  Accordingly, the Board finds that a grant of service connection is warranted for left hip pain.  See 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102. 

 

 

DONNIE R. HACHEY

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	Zheng, Andrew

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.