KNEE IMPAIRMENT OF

Summary

The veteran, who served from August 1988 to June 1992, appeals the denial of service connection for right and left knee disorders. The veteran claimed knee symptoms during service and hospitalization in 1993 for polyarthritis, with imaging in 1998 showing mild degenerative changes. However, the veteran's service treatment records (STRs) did not document any knee complaints or treatment. Contemporaneous service medical records from 1991 and 1992 examinations were normal for the lower extremities and did not note any knee conditions. The veteran also expressly denied a history of knee symptoms in a 1991 report. While the veteran claimed in-service onset of knee pain in 2020, this was contradicted by the lack of contemporaneous service records and his own denial of knee symptoms during service. Multiple VA examinations from 1998, 2019, 2020, and 2021 consistently found the knee conditions not related to service, citing the lack of in-service documentation and the post-service onset of diagnosed conditions. The veteran refused a scheduled VA examination in January 2024, which the Board considered a withdrawal of that request. The Board found the veteran's claims of in-service knee symptoms not credible due to inconsistencies with the medical evidence. Ultimately, the Board found the evidence persuasively against the claims, determining that the conditions did not manifest during service or were not etiologically related to service, and denied service connection for both right and left knee disorders.

Rationale

No in-service treatment or complaints of knee symptoms documented in STRs.; Veteran expressly denied knee symptoms in 1991 service medical history.; Post-service diagnosis of degenerative changes and tendonitis not linked to service.; VA examinations consistently found conditions not related to service.; Veteran's claims of in-service symptoms found not credible due to inconsistencies.

Full Decision Text

Citation Nr: 26005097
Decision Date: 04/30/26	Archive Date: 04/30/26

DOCKET NO. 16-03 811
DATE: April 30, 2026

ORDER

1. Service connection for a right knee disorder is denied.

2. Service connection for a left knee disorder is denied.

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FINDINGS OF FACT

1. The Veteran's right knee disorder did not have its onset during service or within one year of discharged and is not causally or etiologically related to any disease, injury, or incident during service.

2. The Veteran's left knee disorder did not have its onset during service or within one year of discharged and is not causally or etiologically related to any disease, injury, or incident during service.

CONCLUSIONS OF LAW

1. The criteria for service connection for a right knee disorder are not met.  38 U.S.C. §§ 1101, 1110, 1112, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309.

2. The criteria for service connection for a left knee disorder are not met.  38 U.S.C. §§ 1101, 1110, 1112, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309.

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Veteran served on active duty from August 1988 to June 1992.

The case is on appeal from a June 2012 rating decision.

Most recently, in a September 2023 decision, the Board denied service connection for a right elbow disorder and remanded the claims addressed herein for additional development.

The Veteran requested a Board hearing in the January 2016 VA Form 9 on appeal, but did not specify what type of Board hearing he was requesting.  In a February 2026 correspondence, the Board asked the Veteran to respond within 30 days to communicate what kind of hearing he was requesting and that if no response was received the Board would assume he does not want a hearing.  As no response to this correspondence was received, the hearing request is considered withdrawn.  38 C.F.R. § 20.704(e).

The Board has limited the discussion below to the relevant evidence required to support its findings of fact and conclusions of law, as well as to the specific contentions regarding the case as raised directly by the Veteran and those reasonably raised by the record.  See Scott v. McDonald, 789 F.3d 1375, 1381 (Fed. Cir. 2015); Robinson v. Peake, 21 Vet. App. 545, 552 (2008).

1. Service connection for a right knee disorder.

2. Service connection for a left knee disorder.

Legal Criteria

Service connection may be granted for a disability resulting from a disease or injury incurred in or aggravated by active service.  See 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303.  A veteran seeking compensation under these provisions must establish three elements: "(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 or aggravated during service."  Saunders v. Wilkie, 886 F.3d 1356, 1361 (Fed. Cir. 2018) (quoting Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004)).

In addition, certain chronic diseases, including arthritis, are presumed to be incurred in or aggravated by service if manifest to a compensable degree within one year of separation from service.  See 38 U.S.C. §§ 1101, 1112; 38 C.F.R. §§ 3.307, 3.309(a); Fountain v. McDonald, 27 Vet. App. 258 (2015).

Analysis

The Veteran claims that he has right and left knee disorders due to service.  During a January 2019 RO hearing, the Veteran claimed that he was treated for knee symptoms during service.

The Veteran's service treatment records (STRs) do not include reports of or treatment for knee symptoms.  In October 1991, the Veteran completed a report of medical history pursuant to the Medical Board that resulted in his discharge from service.  The Veteran expressly denied a history of a trick or locked knee.  He reported medical conditions including headaches and back symptoms, but did
38 C.F.R. §§ 3.307, 3.309(a); Fountain v. McDonald, 27 Vet. App. 258 (2015).

Analysis

The Veteran claims that he has right and left knee disorders due to service.  During a January 2019 RO hearing, the Veteran claimed that he was treated for knee symptoms during service.

The Veteran's service treatment records (STRs) do not include reports of or treatment for knee symptoms.  In October 1991, the Veteran completed a report of medical history pursuant to the Medical Board that resulted in his discharge from service.  The Veteran expressly denied a history of a trick or locked knee.  He reported medical conditions including headaches and back symptoms, but did not report a history of experiencing any knee symptoms or a knee diagnosis.  An October 1991 examination report was marked "normal" for his lower extremities and no knee condition was noted at this time.  The Veteran's February 1992 Medical Board examination also did not note the presence of knee symptoms or any knee diagnosis.

The Veteran was afforded a VA general medical examination shortly after discharge in August 1992.  The Veteran did not report any knee symptoms at this time.  The VA examiner reported a normal walking gait and did not note any knee symptoms or diagnosis.

The Veteran first filed a claim of service connection for knee disorders in November 1997.  He claimed that he was hospitalized in 1993 due to pain in multiple joints with a diagnosis of polyarthritis.  Knee imaging performed in September 1998 was noted as showing mild narrowing of the lateral joint space consistent with degenerative changes.

He was afforded a VA examination in October 1998.  The examiner reported that the Veteran's joints had full ranges of motion and denied the presence of swelling.  

Pursuant to the claim on appeal, the Veteran was afforded a VA knee examination in August 2019.  The examiner reported that a December 2014 treatment record indicates pain radiating from his low back to his knees associated with numbness and tingling in his legs.  The examiner reported a diagnosis of left knee patellar tendonitis and noted nerve pain radiating into the Veteran's knees.  The examiner found that the left knee patellar tendonitis is not related to service because the treatment records document that the condition was incurred after service.  The examiner explained that the condition is usually linked to overuse or stress put on the knees.

The Veteran was afforded another VA examination in August 2020.  The Veteran claimed that he developed knee pain in May 1991 after serving in the Gulf War.  The examiner reported an August 1998 diagnosis of bilateral knee degenerative arthritis and an August 2019 diagnosis of left knee tendonitis.  The examiner found that the knee conditions are less likely than not incurred in or caused by an in-service injury, event, or illness.  The examiner explained that the Veteran's STRs do not indicate a knee diagnosis during service and the 1998 knee imaging was competed 6 years after his discharge from service.  The examiner noted left lower extremity radicular pain is due to a lower back disorder.

Pursuant to a March 2021 Board remand, the RO obtained another VA medical opinion in April 2021.  The examiner found that the knee conditions are less likely than not incurred in or caused by an in-service injury, event, or illness.  The examiner explained that the Veteran's STRs do not document any knee conditions and nothing relevant was noted in his June 1992 separation examination.  The examiner concluded that the evidence does not support a finding that the knee arthritis manifested during service or as a result of service.

In the September 2023 decision, the Board requested an additional VA examination for the claims on appeal.

The RO scheduled the Veteran for an examination for the claims on appeal in December 2023.  However, the Veteran did not attend the examination.  The Veteran spoke with a VA representative in January 2024.  He reported that he cancelled the examination and was not interested in rescheduling the examination.  See 38 C.F.R. § 3.655.  Thus, the Board finds that the RO also substantially complied with the Board's September 2023 remand directives such that a further remand is not warranted.  See D'Aries v. Peake, 22 Vet. App. 97, 104-05 (2008); Stegall v. West, 11 Vet. App. 268 (1998).

The Board finds that the Veteran's present right and left knee disorders did not have their onsets during service or within one year of discharged and are not causally or etiologically related to any disease, injury, or incident during service.  The Veteran was not treated for knee symptoms during service.  In the October 
 § 3.655.  Thus, the Board finds that the RO also substantially complied with the Board's September 2023 remand directives such that a further remand is not warranted.  See D'Aries v. Peake, 22 Vet. App. 97, 104-05 (2008); Stegall v. West, 11 Vet. App. 268 (1998).

The Board finds that the Veteran's present right and left knee disorders did not have their onsets during service or within one year of discharged and are not causally or etiologically related to any disease, injury, or incident during service.  The Veteran was not treated for knee symptoms during service.  In the October 1991 report of medical history, he expressly denied a history of a trick or locked knee and did not report anything related to his knees while also documenting medical conditions including headaches and back symptoms.  In addition, the Veteran has not submitted and his VA treatment records do not include any reports of or treatment for knee symptom within the year after his discharge from service.  The diagnosed bilateral knee degenerative conditions were first documented in August 1998, more than six years after his discharge from service.  Furthermore, the April 2021 VA examiner found that the knee disorders are incurred in or caused by an in-service injury, event, or illness.  The examiner explained that the Veteran's STRs do not document any knee conditions and nothing relevant was noted in his June 1992 separation examination.  The examiner concluded that the evidence does not support a finding that the knee arthritis manifested during service or as a result of service.

In rendering a decision on appeal, the Board must analyze the credibility and probative value of the evidence, account for the evidence which it finds to be persuasive or unpersuasive, and provide the reasons for its rejection of any material evidence favorable to the claimant.  See Gilbert v. Derwinski, 1 Vet. App. 49, 57 (1990).  The Veteran claimed that he was treated for knee symptoms during service during the January 2019 RO hearing and that he experienced the onset of symptoms in 1991 during the August 2020 VA examination.  However, the Veteran's STRs do not include any reports of or treatment for knee symptoms.  In addition, he expressly denied a history of knee conditions in October 1991.  The Veteran's later claims of experiencing in-service knee symptoms are contradicted by the contemporaneous medical evidence showing he expressly denied experiencing knee symptoms during service.  Therefore, the Board does not find the Veteran's claims of experiencing knee symptoms during service to be credible.  In this regard, in weighing credibility, VA may consider inconsistency, bias, and self-interest in weighing the credibility of evidence.  See Caluza v. Brown, 7 Vet. App. 498 (1995).

The only evidence of record relating the Veteran's current knee conditions to service is his claim of experiencing the onset of knee symptoms during service.  As the Veteran's claim is not credible, the Board finds that the evidence of record does not support a finding that the knee disorders had their onset during service or within one year of discharged or are causally or etiologically related to any disease, injury, or incident during service.

The Board notes that the Board has previously found that another VA examination was necessary to adjudicate these claims after the April 2021 VA medical opinion discussed herein.  However, the Veteran expressly refused to attend or reschedule a VA examination for these claims in January 2024.  While a VA compensation examination may have provided support for this claim, the Veteran bears the evidentiary burden to establish all material elements of a claim.  See 38 U.S.C. § 5107(a); Fagan v. Shinseki, 573 F.3d 1282, 1287-88 (Fed. Cir. 2009).  In this case, although the Veteran hase expressly reported that he is unwilling to attend another examination in the future.  See Wood v. Derwinski, 1 Vet. App. 190, 193 (1991) (stating that the duty to assist is not a one-way street and that Veterans should provide information or materials relevant to their claim to VA so that VA may assist in development of the claim).  Therefore, the Board finds that another remand to obtain a VA examination is not warranted.  Moreover, in further consideration, the Board finds that the prior VA medical opinions have at least some probative evidentiary value.

Accordingly, the evidence is persuasively against these claims.  As there is not an approximate balance of positive and negative evidence, the benefit-of-the-doubt doctrine is not applicable and service connection for a right or left knee disorder is not warranted.  See 
. 190, 193 (1991) (stating that the duty to assist is not a one-way street and that Veterans should provide information or materials relevant to their claim to VA so that VA may assist in development of the claim).  Therefore, the Board finds that another remand to obtain a VA examination is not warranted.  Moreover, in further consideration, the Board finds that the prior VA medical opinions have at least some probative evidentiary value.

Accordingly, the evidence is persuasively against these claims.  As there is not an approximate balance of positive and negative evidence, the benefit-of-the-doubt doctrine is not applicable and service connection for a right or left knee disorder is not warranted.  See 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102.

 

 

RYAN T. KESSEL

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	D. Jimerfield

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.