BVA Case 14-1297: Psychiatric

The Board remanded the bilateral knee claim with instructions that VA obtain private treatment records and provide the appellant with a medical examination and opinion as to whether his knee conditions are related to service (medical nexus opinion).

The Board again remanded the bilateral knee claim in August 2009 after a January 2009 VA medical nexus opinion did not address whether the appellant's knee disabilities were secondary to his service-connected flat feet.

at 84,and a further VA medical examination and nexus opinion was provided in March 2011, R.

In September 2011,the Board denied service connection for the bilateral knee claim.

As an initial matter,the Board determined that the appellant was entitled to a legal presumption of sound condition at his entrance to service in December 1979.

The Board found the appellant's reports of having first developed bilateral knee pain in 2001 to be more probative.

Based primarily on the negative VA medical nexus opinions of record,the Board determined that the preponderance of the evidence was against a finding that the appellant's right and left knee disabilities are related to his active service,or related to,or permanently aggravated by,his service- connected flat feet.

Before the Court,the appellant argues that the Board failed to (1)ensure that he was provided with an adequate VA medical examination and nexus opinion;(2)address theories of service connection based on continuity of symptomatology and a congenital bowlegged condition at the time of entry into service;(3)provide adequate reasons or bases for rejecting his testimony that he had progressive knee problems since service;and (4)discuss the private podiatrist's statement that flat feet can cause fatigue,pain,or stiffness in the knees.