Entitlement to service connection for right knee strain residuals, meniscal tear residuals, patellofemoral pain syndrome, and instability is granted.

Citation Nr: A26069942 Decision Date: 07/30/26 Archive Date: 07/30/26 DOCKET NO. 210407-151191 DATE: July 30, 2026 ORDER Entitlement to service connection for right knee strain residuals, meniscal tear residuals, patellofemoral pain syndrome, and instability is granted. Entitlement to service connection for left knee patellar tendinitis, meniscal tear residuals, and arthritis is granted. REMANDED Entitlement to service connection for a recurrent lumbar spine disability is remanded. Entitlement to service connection for a recurrent right leg disability to include shin splints is remanded. Entitlement to service connection for a recurrent left leg disability to include shin splints is remanded. FINDINGS OF FACT 1. Service connection has been established for posttraumatic stress disorder (PTSD) with sleep disturbances; bilateral plantar fasciitis; sleep apnea; traumatic headaches; cervical strain with degenerative arthritis, spinal stenosis, and intervertebral disc syndrome; tinnitus; erectile dysfunction; chronic sinusitis; and allergic rhinitis. 2. Right knee strain residuals, meniscal tear residuals, patellofemoral pain syndrome, and instability have been shown to be related to the service-connected bilateral plantar fasciitis. 3. Left knee patellar tendinitis, meniscal tear residuals, and arthritis have been shown to be related to the service-connected bilateral plantar fasciitis. CONCLUSIONS OF LAW 1. The criteria for service connection for right knee strain residuals, meniscal tear residuals, patellofemoral pain syndrome, and instability have been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.310(a). 2. The criteria for service connection for left knee patellar tendinitis, meniscal tear residuals, and arthritis have been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.310(a). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran had active service from June 2005 to June 2009. He served in Iraq and Kuwait. The Veteran had additional duty with the Army Reserve. The Veteran appeared at a July 2024 virtual hearing before the undersigned Veterans Law Judge. The hearing transcript is of record. In March 2020, the Agency of Original Jurisdiction denied service connection for a lumbar spine disability. In August 2020, the Agency of Original Jurisdiction denied service connection for a right knee disability, a left knee disability, right lower extremity shin splints, and left lower extremity shin splints. In November 2020, the Veteran submitted a Decision Review Request: Higher-Level Review, VA Form 20-0996. In March 2021, the Agency of Original Jurisdiction denied service connection for a lumbar spine disability, a right knee disability, a left knee disability, a right lower extremity disability to include shin splints, and a left lower extremity disability to include shin splints. In April 2021, the Veteran submitted a Decision Review Request: Board Appeal (Notice of Disagreement), VA Form 10182, and elected the Hearing docket. Therefore, the Board may only consider the evidence of record at the time of the March 2020 and August 2020 Agency of Original Jurisdiction decisions, which were subject to higher-level review, 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 Agency of Original Jurisdiction 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 the Department of Veterans Affairs (VA) to consider any evidence that was submitted that the Board could not consider, he may file a Supplemental Claim, VA Form 20-0995, and submit or identify this evidence. 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. 38 C.F.R. § 3.2501. Specific instructions for filing a Supplemental Claim are included with this decision. However, as the Board is remanding the claim for service connection for a recurrent lumbar spine disability, any evidence the Board could not consider will be considered by the Agency of Original Jurisdiction in the adjudication of that claim. 38 C.F.R. § 3.103(c)(2)(ii). Service Connection Service connection may be granted for recurrent disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. § 1110; 38 C.F.R. § 3.303(a). Service connection may be granted for any disease diagnosed after discharge, when all the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303(d). Service connection may be granted for disability which is proximately due to or the result of a service-connected disease or injury. 38 C.F.R. § 3.310(a). Service connection shall be granted on a secondary basis under the provisions of 38 C.F.R. § 3.310(b) where it is demonstrated that a service-connected disorder has aggravated a nonservice connected disability. Allen v. Brown, 7 Vet. App. 439 (1995). Service connection has been established for PTSD with sleep disturbances; bilateral plantar fasciitis; sleep apnea; traumatic headaches; cervical strain with degenerative arthritis, spinal stenosis, and intervertebral disc syndrome; tinnitus; erectile dysfunction; chronic sinusitis; and allergic rhinitis. Recurrent Right Knee Disability The Veteran contends that service connection is warranted for a recurrent right knee disability as the diagnosed right knee disability is related to the service connected bilateral plantar fasciitis. The report of an October 2020 knee evaluation from G. Luna, PA-C, states the Veteran was diagnosed with right knee strain, meniscal tear, patellofemoral pain syndrome, and instability. A July 2024 VA treatment record states that the Veteran presented with chronic bilateral knee pain. The treating physician assistant opined that the Veteran's "chronic plantar pain/tension does provoke change in gait which has likely provoked a great portion of this chronic bilateral knee and low back pain." At the July 2024 Board hearing, the Veteran testified that the service-connected foot disability resulted in pain when he was walking and standing. He reported having an altered gait associated with the foot pain. The record is in at least equipoise as to whether the diagnosed right knee strain residuals, meniscal tear residuals, patellofemoral pain syndrome, and instability are related to the service-connected bilateral plantar fasciitis. A VA physician assistant has related the diagnosed right knee disabilities to the service-connected bilateral plantar fasciitis. Upon resolution of all reasonable doubt in the Veteran's favor, the Board concludes that service connection for right knee strain residuals, meniscal tear residuals, patellofemoral pain syndrome, and instability is warranted. 38 U.S.C. § 5107; 38 C.F.R. §§ 3.102, 3.310(a). Recurrent Left Knee Disability The Veteran contends that service connection is warranted for a recurrent left knee disability as the diagnosed left knee disability is related to the service-connected bilateral plantar fasciitis. Clinical documentation dated in June 2023 from M. Quesada, M.D., states the Veteran was seen for left knee pain. The Veteran was diagnosed with left knee patellar tendinitis, meniscal tear residuals, and arthritis. A July 2024 VA treatment record states that the Veteran presented with chronic bilateral knee pain. The treating physician assistant opined that the Veteran's "chronic plantar pain/tension does provoke change in gait which has likely provoked a great portion of this chronic bilateral knee and low back pain." At the July 2024 Board hearing, the Veteran testified that the service-connected foot disability resulted in pain when he was walking and standing. He reported having an altered gait associated with the foot pain. The record is in at least equipoise as to whether the diagnosed left knee patellar tendinitis, meniscal tear residuals, and arthritis are related to the service-connected bilateral plantar fasciitis. A VA physician assistant has related the diagnosed left knee disabilities to the service-connected bilateral plantar fasciitis. Upon resolution of all reasonable doubt in the Veteran's favor, the Board concludes that service connection for left knee strain residuals, meniscal tear residuals, patellofemoral pain syndrome, and instability is warranted. 38 U.S.C. § 5107; 38 C.F.R. §§ 3.102, 3.310(a). REASONS FOR REMAND 1. Entitlement to service connection for a recurrent lumbar spine disability is remanded. The Veteran contends that service connection for a recurrent lumbar spine disability is warranted as the claimed disability originated during active service, or in the alternative, is related to the service-connected disabilities. Unfortunately, a remand is required in this case. Although the Board sincerely regrets the additional delay, it is necessary to ensure that there is a complete record upon which to decide the claim. VA's duty to assist includes, in appropriate cases, the duty to conduct a thorough and contemporaneous medical examination which is accurate and fully descriptive. McLendon v. Nicholson, 20 Vet. App. 79 (2006); Green v. Derwinski, 1 Vet. App. 121, 124(1991). The service treatment records reflect that the Veteran was treated for injury sustained in a motor vehicle accident. A June 2007 treatment record states that the Veteran was struck by a motor vehicle accident and complained of road rash on the head and back. The Veteran has not been afforded a VA lumbar spine examination. That is a pre decisional error. 2. Entitlement to service connection for a recurrent right leg disability to include shin splints and a recurrent left leg disability to include shin splints is remanded. Given the awards above of service connection for both right knee strain residuals, meniscal tear residuals, patellofemoral pain syndrome, and instability and left knee patellar tendinitis, meniscal tear residuals, and arthritis, the Veteran should readjudicate the issues of service connection for a recurrent right leg disability to include shin splints and a recurrent left leg disability to include shin splints. The matter is REMANDED for the following action: 1. Schedule the Veteran for a VA lumbar spine examination conducted by a medical doctor to assist in determining the nature of any identified recurrent lumbar spine disability and its relationship to active service and the service-connected disabilities. The examiner must review the record and should note that review in the report. A rationale for all opinions should be provided. The examiner should: (a) Identify all lumbar spine disabilities found. If no lumbar spine disability is diagnosed, the examiner should specifically state that fact. (b) Opine whether it is at least as likely as not (at least an approximate balance of positive and negative evidence) that any identified lumbar spine disability had its onset during active service or is related to any incident of service, including the documented inservice motor vehicle accident. (c) Opine whether it is at least as likely as not (at least an approximate balance of positive and negative evidence) that any identified lumbar spine disability is due to or the result of the bilateral plantar fasciitis, cervical strain and arthritis, and the other service-connected disabilities. Opine whether it is at least as likely as not (at least an approximate balance of positive and negative evidence) that any identified lumbar spine disability has been aggravated by the bilateral plantar fasciitis, cervical strain and arthritis, and the other service-connected disabilities. 2. Readjudicate the issues of service connection for both a recurrent right leg disability to include shin splints and a recurrent left leg disability to include shin splints J. T. HUTCHESON Veterans Law Judge Board of Veterans' Appeals Attorney for the Board K.R. Kardian, 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.