KNEE IMPAIRMENT OF

JOHN Z. JONES · 2026 · Case ID: A26039796

MIXED

Summary

The veteran, who served in the Marine Corps and Army across multiple periods between 1978 and 1997, appeals the denial of service connection for left lower extremity (LLE) radiculopathy and the Board's decision regarding other conditions. The veteran sought service connection for right knee, left knee, back, right lower extremity (RLE) radiculopathy, LLE radiculopathy, and right hip disabilities. The Board granted service connection for the right knee, left knee, back, RLE radiculopathy, and right hip disabilities. Service connection for LLE radiculopathy was denied. The Board found that the veteran's right knee and left knee disabilities had an onset in service with continuity of symptomatology, citing well-documented injuries and surgeries. For the back disability, the Board found the VA examiner's opinion inadequate due to its reliance on the lack of documented treatment and failure to consider occupational G-forces. A private medical opinion, deemed competent and credible, linked the back disability to G-force exposure during the veteran's career as a fighter pilot, leading to the grant of service connection. The Board granted service connection for RLE radiculopathy as secondary to the service-connected back disability, relying on a competent and credible private medical opinion. However, the Board denied LLE radiculopathy, finding insufficient evidence of a diagnosis and noting the private opinion only addressed RLE radiculopathy. Service connection for the right hip disability was granted secondary to the service-connected back disability, based on a competent and credible private opinion addressing hip-spine syndrome.

Rationale

Favorable finding from AOJ; Documented in-service injury (chondromalacia, patella dislocation); Ongoing treatment and issues across multiple service periods; VA opinion found inadequate due to inconsistency with record

Service Branch

MARINE CORPS

Special Benefit

NO SPECIAL BENEFIT

Docket No.

210810-178386

Full Decision Text

Citation Nr: A26039796
Decision Date: 04/28/26 Archive Date: 04/28/26

DOCKET NO. 210810-178386
DATE: April 28, 2026

ORDER

Service connection for right knee disability is granted.

Service connection for left knee disability is granted.

Service connection for back disability is granted.

Service connection for right lower extremity (RLE) radiculopathy is granted.

Service connection for left lower extremity (LLE) radiculopathy is denied.

Service connection for right hip disability is granted.

FINDINGS OF FACT

1. The Veteran had an onset of right knee disability in active service with continuity of symptomatology thereafter.

2. The Veteran had an onset of left knee disability in active service with continuity of symptomatology thereafter.

3. The Veteran had an onset of back disability in active service with continuity of symptomatology thereafter.

4. The Veteran's RLE radiculopathy is due to his service-connected back disability.

5. The evidence of record persuasively weighs against finding that the Veteran has LLE radiculopathy at any time during or approximate to the pendency of the claim.

6. The Veteran's right hip disability is due to his service-connected back disability.

CONCLUSIONS OF LAW

1. The criteria for service connection for right knee disability are met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303.

2. The criteria for service connection for left knee disability are met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303.

3. The criteria for service connection for back disability are met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303.

4. The criteria for service connection for RLE radiculopathy are met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303.

5. The criteria for service connection for LLE radiculopathy are not met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303.

6. The criteria for service connection for right hip disability are met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303.

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Veteran served on active duty from July 17, 1978, to August 4, 1978; July 16, 1979, to August 25, 1979; December 20, 1980, to April 1, 1985; and June 13, 1997, to October 30, 1997.

This matter is before the Board of Veterans' Appeals (Board) on appeal from a May 2021 rating decision issued by a Regional Office (RO).

In an August 2021 Decision Review Request: Board Appeal (Notice of Disagreement), the Veteran selected the Hearing docket. A Board hearing was held on June 16, 2025.

Therefore, the Board may only consider the evidence of record at the time of the May 2021 agency of original jurisdiction (AOJ) decision on appeal, as well as any evidence submitted by the Veteran or representative 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.

However, "evidence submission limits are claims-processing rules subject to Secretarial waiver." Bolds v. McDonough, 37 Vet. App. 359, 367 (2024). Here, after the rating decision on appeal, personnel and service treatment records encompassing the Veteran's initial period of service in the Marine Corps were associated with the file. To enable the Board to consider the greatest amount of evidence of record, including his personnel and service treatment records, the Board finds it appropriate to waive the
(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.

However, "evidence submission limits are claims-processing rules subject to Secretarial waiver." Bolds v. McDonough, 37 Vet. App. 359, 367 (2024). Here, after the rating decision on appeal, personnel and service treatment records encompassing the Veteran's initial period of service in the Marine Corps were associated with the file. To enable the Board to consider the greatest amount of evidence of record, including his personnel and service treatment records, the Board finds it appropriate to waive the evidence submission window requirements and consider the evidence affiliated with the file following the rating decision on appeal.

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 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.

Service Connection

Generally, service connection will be granted if the evidence demonstrates that current disability resulted from an injury suffered or disease contracted in active military service, even if the disability was initially diagnosed after service. See 38 U.S.C. § 1110; 38 C.F.R. § 3.303. To establish service connection, a claimant 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 in-service disease or injury, the so-called "nexus" requirement. See 38 U.S.C. § 1110; 38 C.F.R. §3.303; see also Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004).

To establish entitlement to service connection on a secondary basis, there must be (1) evidence of a current disability; (2) evidence of a service-connected disability; and (3) probative evidence establishing a nexus (i.e., link) between the service-connected disability and the current disability. 38 C.F.R. § 3.310(a) and (b); Wallin v. West, 11 Vet. App. 509, 512 (1998).

The Board notes that Service connection may be granted for a disability resulting from a disease or injury incurred in or aggravated while performing active duty for training (ACDUTRA) or from injury (but not disease) incurred in or aggravated while performing inactive duty for training (INACDUTRA). 38 U.S.C. §§ 106, 1110; 38 C.F.R. § 3.303(a). ACDUTRA includes full-time duty performed for training purposes by Reserves and members of the National Guard, under 32 U.S.C. §§ 316, 502, 503, 504, or 505. 38 U.S.C. § 101(22), (24); 38 C.F.R. § 3.6 (c)(3). INACDUTRA is defined as duty (other than full-time duty) under 32 U.S.C. §§ 316, 502, 503, 504, or 505. 38 U.S.C. § 101(23).

Right Knee

The Veteran contends that he is entitled to service connection for a right knee disability.

The rating decision on appeal made favorable findings that the Veteran has a right knee disability. The Board is bound by favorable findings of the AOJ. 38 C.F.R. § 3.104(c). Thus, the first element of service connection has been met.

In his June 2025 Board hearing, the Veteran recounted the history of his knee, which began while he was in college as part of a commissioning program that included attendance at officer candidate school (OCS). At that time, he was running the obstacle course when his knee went out of joint and he collapsed. He had surgery on his knee and completed OCS the following year with some difficulty, particularly with marching and running in boots. His knee then worsened throughout his subsequent military service.

Personnel and service treatment records documented the Veteran's OCS injury, reporting that he had chondromalacia and dislocation of the right patella, which was incurred in the line of duty. He was noted to be in active-duty training from July 17
5 Board hearing, the Veteran recounted the history of his knee, which began while he was in college as part of a commissioning program that included attendance at officer candidate school (OCS). At that time, he was running the obstacle course when his knee went out of joint and he collapsed. He had surgery on his knee and completed OCS the following year with some difficulty, particularly with marching and running in boots. His knee then worsened throughout his subsequent military service.

Personnel and service treatment records documented the Veteran's OCS injury, reporting that he had chondromalacia and dislocation of the right patella, which was incurred in the line of duty. He was noted to be in active-duty training from July 17, 1978, to August 4, 1978. He was released from further medical treatment and advised to avoid heavy physical activity permanently on his right knee in November 1978. June 1979 records noted that the Veteran was not qualified for retention in the Marine Corps reserve because of early degenerative joint disease of the right knee. He subsequently commissioned and served in the Marine Corps from 1980 to 1985. During this period of service, he had a March 1982 right knee injury from a fall. The Veteran had an additional period of service with the Army, which encompassed a June 1998 record in which the Veteran reported that he slipped on stairs and his right knee was stiff and sore. The medical record noted that the injury occurred in the line of duty. In October 1998 the Veteran reported that he was under treatment for a right knee sprain.

The Veteran was afforded an April 2021 VA examination, in which the examiner opined that the Veteran's knee condition was acute only during service with no evidence of chronicity of care, with subjective symptoms only. However, the Board finds that this opinion is inconsistent with the record, which indicates that the Veteran had multiple injuries to his right knee in the line of duty and ongoing treatment and issues across multiple periods of service. Accordingly, the Board finds that the evidence of record supports finding that the Veteran had an onset of his right knee disability in service with continuity of symptomatology thereafter, and service connection is granted.

Left Knee

The Veteran contends that he is entitled to service connection for a left knee disability.

The rating decision on appeal made favorable findings that the Veteran has a left knee disability. The Board is bound by favorable findings of the AOJ. 38 C.F.R. § 3.104(c). Thus, the first element of service connection has been met.

As noted above, the Veteran's right knee injury initially incurred during OCS is well-documented in the Veteran's service treatment records.

September 1979 medical records also note that the Veteran had a left knee injury when jumping over a fence on August 11, 1979. Personnel records indicate that he was in an active duty for training status from July 16, 1979, to August 25, 1979. He was noted to have been to Methodist hospital multiple times as an emergency patient due to difficulty with his knee, and he underwent a medial meniscectomy of the left knee in September 1979.

Subsequently, service treatment records noted that the Veteran had fluid in his left knee for 2 days and a history of knee issues in a May 1981 service treatment record.

The Veteran was afforded an April 2021 VA examination, in which the examiner opined that the Veteran's knee condition was acute only during service with no evidence of chronicity of care, with subjective symptoms only. However, the Board finds that this opinion is inconsistent with the record, which indicates that the Veteran was injured in an ACDUTRA status, to the extent that he required surgery to his meniscus. He had further complaints of left knee issues during active service. Accordingly, the Board finds that the evidence of record supports finding that the Veteran had an onset of his left knee disability in service with continuity of symptomatology thereafter, and service connection is granted.

Back

The Veteran contends that he is entitled to service connection for a back disability.

The rating decision on appeal made a favorable finding of degenerative arthritis. The Board is bound by favorable findings of the AOJ. 38 C.F.R. § 3.104(c). Thus, the first element of service connection has been met.

In his June 2025 Board hearing, the Veteran contended that his back disability initially began when he fell off a rope bridge and landed in a creek on a rock while in training at OCS. However, he did not want to get washed out, so he kept going. He subsequently flew the A-4 Skyhawk while in service and was exposed to G-forces. He reported that when getting out of the cockpit after flying he could hardly stand up straight for a few
.

The Veteran was afforded an April 2021 VA examination, in which the examiner opined that the Veteran's back disability was less likely than not due to service as his service treatment records were silent for complaints of back pain while he was in service. However, an examiner cannot base their finding on the lack of documented treatment during service. See Dalton v. Nicholson, 12 Vet. App. 23 (2007) (holding that the lack of documentary evidence during or after service cannot be the sole basis for an opinion against the claim). Consequently, the VA opinion is inadequate for adjudication purposes. Additionally, the examiner did not consider the occupational forces the Veteran was subjected to during service.

During the evidence submission period following his Board hearing, the Veteran submitted a private medical opinion, which noted that the Veteran was a fighter jet pilot and that it was well-documented that G-forces affect the spine and can accelerate the progression of degenerative spinal disease. Additionally, fighter pilots rarely consulted doctors due to fear of losing their airworthy status. The private provider then opined that the Veteran's back disability was more likely than not due to exposure to G-forces during his career as a fighter pilot. This examination is competent, credible, and afforded significant probative weight.

It is the role of the Board as finder of fact to evaluate the credibility of the evidence and to determine the weight that is to be assigned to it. The Veteran is competent to report that he had difficulty standing up straight after flying while in service and that his back pain worsened over time. See Jandreau v. Nicholson, 492 F.3d 1372, 1377 (Fed. Cir. 2007); Buchanan v. Nicholson, 451 F.3d 1331, 1337 (Fed. Cir. 2006).

As the only competent medical opinion of record opined that the Veteran's back disability is more likely than not due to his in-service exposure to G-forces, consistent with the Veteran's report of onset of back pain during service with continuity of symptomatology thereafter, service connection is granted.

Radiculopathy

The Veteran contends that he is entitled to service connection for quad nerve radiculopathy as secondary to his back disability.

The rating decision on appeal made no favorable findings in conjunction with the Veteran's radiculopathy claim.

The Veteran was afforded an April 2021 VA examination, which noted a positive straight leg raising test of the right leg and opined that the Veteran did not have radicular pain or any other signs or symptoms due to radiculopathy.

The Veteran submitted a private medical opinion, which noted that the Veteran's private treatment records noted lumbar radiculopathy, and that he had RLE radiculopathy due to his back disability. This opinion is competent, credible, and afforded significant probative weight.

Accordingly, service connection for RLE radiculopathy is granted.

July and August 2020 private treatment records noted bilateral anterior thigh pain that was "possibly" radiculopathy. However, there is no competent evidence diagnosing LLE radiculopathy, and the Veteran's private opinion addresses only RLE radiculopathy. Therefore, to the extent the Veteran claimed radiculopathy of his LLE or other extremities, the Board finds that the competent evidence of record does not support finding a diagnosis.

Right Hip

The Veteran contends that he is entitled to service connection for a right hip disability.

The rating decision on appeal made a favorable finding that the Veteran had a diagnosis of end-stage degenerative disc disease to the hip with cystic formation. The Board is bound by favorable findings of the AOJ. 38 C.F.R. § 3.104(c). Thus, the first element of service connection has been met.

Right Hip

The Veteran contends that he is entitled to service connection for a right hip disability.

The Veteran was afforded an April 2021 VA examination in which the Veteran reported an onset of pain in 2000 following his left knee replacement and that he had a steroid injection in 2020 and started using a walker. The examiner opined that there was no chronic diagnosis of a right hip condition and the exam was unremarkable with subjective symptoms only. Imaging performed in conjunction with the examination noted narrowing of the right hip with cystic and sclerotic changes of the acetabulum and femoral head consistent with DJD. Although the examiner noted the imaging results, they did not address why a diagnosis was not warranted. Accordingly, the Board finds this opinion to be unsupported by medical rationale, conclusory, and of little probative value. See Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 303-304 (most of the probative value of a medical opinion comes from its reasoning; a medical opinion that contains only data and conclusions is afforded no weight).

The Veteran submitted a private opinion, which noted the Veteran's right hip replacement and opined that due to the Veteran's back disability, he had hip-spine syndrome, in which the spine, hip, and knee are anatomically connected and the compensatory effects from the Veteran's back disability led to his right hip disability. This opinion is competent, credible, and afforded significant probative weight.

Accordingly, service connection for the Veteran's right hip disability secondary to his back disability is granted.

JOHN Z. JONES

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board L. Resor, Associate 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.

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