KNEE IMPAIRMENT OF

Summary

The veteran, who served honorably in the U.S. Navy from August 1976 to April 1977, appeals the denial of service connection for bilateral knee strain with arthritis, claimed as secondary to his service-connected bilateral pes planus. The Board reviewed the evidence of record at the time of the February 2025 rating decision. The veteran had current diagnoses of bilateral knee strain with arthritis, and his pes planus was service-connected. However, the Board found no medical nexus linking the knee conditions to the pes planus. Multiple VA medical opinions from September 2021, November 2021, and October 2024 concluded that the knee strain was less likely than not related to pes planus, attributing it instead to obesity and natural aging. These opinions were given great probative weight due to their thorough rationale. A private medical opinion from February 2021 was deemed inadequate due to lack of supporting medical reasons and bases, relying solely on the veteran's statements. The Board also noted the veteran's lay statements but found them incompetent to provide a nexus opinion due to the medical complexity. The Board considered the benefit of the doubt doctrine but found the persuasive evidence against the veteran's claims, thus denying service connection for both the left and right knee conditions.

Rationale

VA opinions found knee strain less likely than not related to pes planus; VA opinions attributed knee strain to obesity and natural aging; Private opinion deemed inadequate due to lack of supporting medical reasons

Full Decision Text

Citation Nr: A26039074
Decision Date: 04/27/26	Archive Date: 04/27/26

DOCKET NO. 251230-619193
DATE: April 27, 2026

ORDER

Entitlement to service connection for left knee strain with arthritis as secondary to pes planus is denied.

Entitlement to service connection for right knee strain with arthritis as secondary to pes planus is denied.

FINDINGS OF FACT

1. The Veteran's left knee strain with arthritis is not secondary to service-connected pes planus and is not otherwise related to an in-service injury or disease.

2. The Veteran's right knee strain with arthritis is not secondary to service-connected pes planus and is not otherwise related to an in-service injury or disease.

CONCLUSIONS OF LAW

1. The criteria for service connection for left knee strain with arthritis as secondary to pes planus have not been met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.310.

2. The criteria for service connection for right knee strain with arthritis as secondary to pes planus have not been met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.310.

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Veteran served honorably on active duty in the United States Navy from August 1976 to April 1977.

This matter comes before the Board of Veterans' Appeals (Board) on appeal from a rating decision issued in February 2025 by a Department of Veterans Affairs (VA) Regional Office (RO).

In the December 2025 VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement), the Veteran elected the Direct Review docket.

Therefore, the Board may only consider the evidence of record at the time of the February 2025 agency of original jurisdiction (AOJ) decision on appeal. 38 C.F.R. § 20.301. Any evidence submitted after the AOJ decision on appeal cannot be considered by the Board. 38 C.F.R. §§ 20.300, 20.301, 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.

SERVICE CONNECTION

Left knee strain with arthritis as secondary to pes planus

Right knee strain with arthritis as secondary to pes planus

The Veteran asserts he is entitled to service connection for bilateral knee strain as secondary to his service-connected bilateral pes planus.

Generally, to establish service connection there must be competent evidence showing: (1) a current disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the present disability and the in-service injury incurred or aggravated during service. 38 U.S.C. § 1110; 38 C.F.R. § 3.303; Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004).

Service connection may be granted on a secondary basis for a disability which is aggravated by, proximately due to, or the result of a service-connected disease or injury under 38 C.F.R. § 3.310. Allen v. Brown, 7 Vet. App. 439 (1995). In order to prevail on the issue of entitlement to secondary service connection, there must be (1) evidence of a current disability; (2) evidence of a service-connected disability; and (3) nexus evidence establishing a connection between the service-connected disability and the current disability. See Wallin v. West, 11 Vet. App. 509, 512 (1998).

When there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, the Secretary shall give the benefit of the doubt to the claimant. 38 U.S.C. § 5107; 38 C.F.R. § 3.102; see also Gilbert v. Derwinski, 1 Vet. App. 49, 53 (1990).

In the February 2025 rating decision, the AOJ made favorable findings of current diagnoses of bilateral knee strain with arthritis and that the primary disabilities (bilateral
 establishing a connection between the service-connected disability and the current disability. See Wallin v. West, 11 Vet. App. 509, 512 (1998).

When there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, the Secretary shall give the benefit of the doubt to the claimant. 38 U.S.C. § 5107; 38 C.F.R. § 3.102; see also Gilbert v. Derwinski, 1 Vet. App. 49, 53 (1990).

In the February 2025 rating decision, the AOJ made favorable findings of current diagnoses of bilateral knee strain with arthritis and that the primary disabilities (bilateral pes planus) are service connected. Despite these findings, the AOJ denied the Veteran's claim because there was no medical nexus linking the Veteran's bilateral knee disabilities to his service connected bilateral pes planus. 

Upon reviewing the relevant evidence of record, the Board finds that service connection for left knee strain and right knee strain is not warranted. In this regard, the competent medical evidence of record does not establish that the Veteran's bilateral knee disabilities are at least as likely as not proximately due to, or aggravated beyond its normal progression by, his service-connected pes planus.

The September 2021 VA examiner opined that the Veteran's bilateral knee strain was less likely than not related to his pes planus because there was insufficient clinical evidence to suggest that pes planus contributes to any alterations in gait; instead, the examiner found that the Veteran's bilateral knee strain was more likely related to obesity and natural aging.

A November 2021 VA examiner opined that the Veteran's pes planus less likely than not caused obesity; noting that although pes planus can impact the ability to perform high impact activities, there are many activities that can be performed that are low impact or do not involve impact of the feet.

The October 2024 VA examiner also opined that the Veteran's bilateral knee strain was less likely than not due to his pes planus. Instead, the examiner stated that his condition was more likely due to obesity and natural aging. The examiner also opined that the Veteran's bilateral knee strain was not aggravated by his pes planus. The examiner explained that, upon examination, the Veteran's pes planus does not alter his gait; thus, the conditions are unrelated to each other. The examiner also noted that many factors were the cause of the Veteran's obesity and could not state that pes planus alone caused obesity.

The Board finds that the September 2021, November 2021, and October 2024 VA medical opinions are entitled to great probative weight as such considered all of the pertinent evidence of record and provided a complete rationale, relying on and citing to the records reviewed. See Nieves-Rodriguez v. Peake, 22 Vet. App. 295 (2008); Stefl v. Nicholson, 21 Vet. App. 120, 124 (2007) ("[A]medical opinion... must support its conclusion with an analysis that the Board can consider and weigh against contrary opinions"). 

The Board acknowledges the February 2021 private medical opinion; however, the Board finds that it is inadequate for adjudication purposes. In this regard, the February 2021 private medical opinion is not supported by adequate medical reasons and bases or a review of the record. See Nieves-Rodriguez v. Peake, 22 Vet. App. 295 (2008); Stefl v. Nicholson, 21 Vet. App. 120, 124 (2007) ("[A]medical opinion... must support its conclusion with an analysis that the Board can consider and weigh against contrary opinions"). The private medical opinion is based solely on statements made by the Veteran and is not supported by contemporaneous evidence of record. Thus, it is afforded little probative weight.

While the Board also acknowledges the Veteran's lay statements, the Veteran in this case is not competent to provide a nexus opinion regarding this issue as it is medically complex. Therefore, it is outside the competence of the Veteran in this case because the record does not show that he has the medical training or credentials to make such a determination. Jandreau v. Nicholson, 492 F.3d 1372, 1377 n.4 (Fed. Cir. 2007); see also Kahana v. Shinseki, 24. Vet. App. 428 (2011). Consequently, the Board gives more probative weight to the competent medical evidence of record.

Accordingly, the Board finds that entitlement to service connection for left knee strain with arthritis and right knee strain with arthritis is not warranted. 

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In reaching such decision, the Board has considered the applicability of the benefit of the doubt doctrine.
 case because the record does not show that he has the medical training or credentials to make such a determination. Jandreau v. Nicholson, 492 F.3d 1372, 1377 n.4 (Fed. Cir. 2007); see also Kahana v. Shinseki, 24. Vet. App. 428 (2011). Consequently, the Board gives more probative weight to the competent medical evidence of record.

Accordingly, the Board finds that entitlement to service connection for left knee strain with arthritis and right knee strain with arthritis is not warranted. 

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In reaching such decision, the Board has considered the applicability of the benefit of the doubt doctrine. However, the persuasive evidence of record is against the Veteran's claims for service connection for left knee strain with arthritis and right knee strain with arthritis. As such, that doctrine is not applicable in the instant appeal, and his claims must be denied. 38 U.S.C.A. § 5107; 38 C.F.R. § 3.102; Gilbert, supra.

 

 

JOHN Z. JONES

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	C. K. Hall, Counsel

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.