KNEE IMPAIRMENT OF

Summary

The Veteran, an Army Veteran who served from September 1994 to August 1997, appeals the denial of service connection for a torn left Achilles tendon. The Veteran claimed the injury occurred during service due to extensive hiking and activity in the field. The Board acknowledged the Veteran's current disability and her testimony regarding in-service activities, finding her reports credible and consistent with service circumstances. However, the Veteran's service treatment records did not mention any left knee or Achilles tendon issues, although they did note complaints of back pain and a right knee injury. The Board noted the absence of a VA examination for the specific claim at the time of the AOJ decision and that the Veteran's initial claim was too general to warrant one. The Board also highlighted that the Veteran, as a layperson, is not competent to provide a medical opinion linking her current condition to service, as the nexus requires specialized medical knowledge. Consequently, the Board found that the evidence persuasively weighed against service connection, as the record lacked competent evidence establishing the condition began in service or was related to an in-service injury. Service connection for torn Achilles, left knee was denied.

Rationale

No in-service treatment or mention of left knee/Achilles tendon issues in STRs.; Veteran's claim was too general at time of AOJ decision to warrant VA exam.; Veteran is not competent to provide medical opinion linking current condition to service.

Full Decision Text

Citation Nr: A26029128
Decision Date: 03/31/26	Archive Date: 03/31/26

DOCKET NO. 200727-99335
DATE: March 31, 2026

ORDER

Entitlement to service connection for torn Achilles, left knee is denied.

FINDING OF FACT

The most probative evidence persuasively weighs against finding that the Veteran's claimed torn Achilles, left knee disability is related to service.

CONCLUSION OF LAW

The criteria for service connection for torn Achilles, left knee have not been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303.

REASONS AND BASES FOR FINDING AND CONCLUSION

The Veteran had active service in the United States Army from September 1994 to August 1997 and additional service in the Army Reserve. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a March 2020 rating decision issued by a Department of Veterans Affairs (VA) Agency of Original Jurisdiction (AOJ).

In the July 27, 2020 VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement), the Veteran elected the Hearing docket. A Board hearing was held on July 1, 2024. A transcript of the hearing has been associated with the claims file. 

Therefore, the Board may only consider the evidence of record at the time of the March 27, 2020 rating decision on appeal, as well as any evidence submitted by the Veteran at the hearing or within 90 days following the hearing. 38 C.F.R. § 20.302(a). If evidence was submitted either (1) during the period after the AOJ issued the decision on appeal and prior to the Board hearing, or (2) more than 90 days following the hearing, the Board did not consider it in its decision. 38 C.F.R. §§ 20.300, 20.302(a), 20.801. 

If the Veteran would like 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 claim, considering the new evidence in addition to the evidence previously considered. Id. Specific instructions for filing a Supplemental Claim are included with this decision. 

1. Entitlement to service connection for torn Achilles, left knee

The Veteran contends that she is entitled to service connection for torn Achilles, left knee. See January 2020 VA Form 21-526EZ. 

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)).

VA is responsible for determining whether the evidence supports the claim or is in relative equipoise, with a claimant prevailing in either event. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102. The claimant is entitled to the benefit of the doubt when there is an "approximate" (meaning nearly equal) balance of positive and negative evidence regarding any material determination. See Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021); Ortiz v. Principi, 274 F.3d 1361 (Fed. Cir. 2001). If the evidence persuasively weighs against a claim, the claim is denied.

Analysis

In this case, in January 2020, the Veteran submitted a service connection claim for torn Achilles tendon, citing her "time in service" as the source of her disability. Along with her VA Form 21-526EZ, the Veteran submitted private medical records documenting her May 2016 complaint of left ankle pain and a diagnosis of left Achilles tendon rupture. 

In the March 2020 rating decision, the AOJ identified this diagnosis as a
 21 F.4th 776 (Fed. Cir. 2021); Ortiz v. Principi, 274 F.3d 1361 (Fed. Cir. 2001). If the evidence persuasively weighs against a claim, the claim is denied.

Analysis

In this case, in January 2020, the Veteran submitted a service connection claim for torn Achilles tendon, citing her "time in service" as the source of her disability. Along with her VA Form 21-526EZ, the Veteran submitted private medical records documenting her May 2016 complaint of left ankle pain and a diagnosis of left Achilles tendon rupture. 

In the March 2020 rating decision, the AOJ identified this diagnosis as a favorable finding. The Veteran therefore has a current disability for service connection purposes. 

As to an in-service injury, at her July 2024 hearing, the Veteran testified that her injury occurred in service from long hikes on pavement in boots and walking in the sand in Egypt. She stated that her unit stayed active in the field in their gear. She stated that she sought treatment in service for her lower back for sure, and treatment after service, including shortly after service in 1997 or 1998. The Veteran reported no issues prior to service.

The Board notes that the Veteran's service treatment records (STRs) contain complaints of and treatment for back pain and a right knee injury. See, e.g., June 1997 separation examination (back problems included in Veteran's report of medical history); June 1997 STR (complaint of back pain from heavy lifting); May 1995 STR (complaint of sore right knee from bumping into a pole). There are no STRs that mention the left knee or left Achilles tendon, nor are the left knee or the left Achilles tendon identified on the Veteran's June 1997 separation examination. However, the Veteran is competent to make the reports in her July 2024 hearing that she went on long hikes on pavement in boots, walked in the sand in Egypt, and stayed active in the field in her gear with her unit. The record shows the Veteran participated in "Bright Star 95" from September 22, 1995, to December 7, 1995. Therefore, the Board finds the Veteran's reports of hiking, walking in sand, and being active in field gear credible, consistent with the circumstances of her service, and probative.

Regarding a nexus, the Board notes that the Veteran has not received a VA examination for her torn Achilles, left knee claim. However, at the time of the March 27, 2020, rating decision, the Veteran had provided no statements in support of direct service connection other than the notation on her July 2018 claim, "time in service", as the source of her injury and, as noted above, the Veteran's STRs did not reference any left Achilles tendon or left knee issues in service. The Board finds the Veteran's claim at that time was simply too general and vague to meet the standard for requiring a VA examination. Colantonio v. Shinseki, 606 F.3d 1378, 1382 (Fed. Cir. 2010) (the Board must evaluate a claimant's statements, including their factual basis, and determine whether they satisfy the requisite standard for a VA examination or whether they are too general and conclusory). Thus, the Board will proceed with adjudication of the claim. As the duty to assist does not apply at the Board level in the AMA system, the Board cannot remand for a VA examination or opinion in the absence of a pre-decisional duty to assist error on the part of the AOJ. The Veteran may, however, file a supplemental claim within one year of this decision to have her hearing testimony considered by the AOJ.

The record currently does not contain competent evidence that establishes that the Veteran's left knee torn Achilles disability began in service or is otherwise related to an in-service injury or disease. While the Veteran asserted that she believes her left knee torn Achilles disability began in service or was caused by hiking, walking in sand, and being active in field gear, the record does not establish that the Veteran is competent to provide a medical opinion in this case. The question of a nexus requires specialized knowledge, education, and training regarding clinical diagnosis and the etiology of musculoskeletal disability. See Jandreau v. Nicholson, 492 F.3d 1372, 1377 (Fed. Cir 2007) (noting general competence of laypersons to testify as to symptoms but not medical diagnoses). The Veteran has not asserted, and the record does not show, that she has the necessary education, training, or knowledge to provide an opinion in this case linking her service to her 2016 tendon rupture injury. 

Accordingly, the Board finds that the most probative evidence
 gear, the record does not establish that the Veteran is competent to provide a medical opinion in this case. The question of a nexus requires specialized knowledge, education, and training regarding clinical diagnosis and the etiology of musculoskeletal disability. See Jandreau v. Nicholson, 492 F.3d 1372, 1377 (Fed. Cir 2007) (noting general competence of laypersons to testify as to symptoms but not medical diagnoses). The Veteran has not asserted, and the record does not show, that she has the necessary education, training, or knowledge to provide an opinion in this case linking her service to her 2016 tendon rupture injury. 

Accordingly, the Board finds that the most probative evidence persuasively weighs against finding that the Veteran's torn Achilles, left knee disability began in service or is otherwise related to service. The evidence is not at least in approximate balance and service connection is not warranted. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303.

 

 

Marissa Caylor

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	J.B.

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.