BVA Case 22-3013: Ptsd

As for secondary service connection,the examiner found that [t]he two conditions are not medically related, [t]he claimed disorder is a separate entity entirely from the service[-]connected condition and unrelated to it, [t]he medical literature does not support a medical relationship, and thus [a]nexus has not been established.

As for the left knee,the examiner also provided a negative nexus opinion,explaining that [n]o complaints were noted in service []or for many years after, the non-union of the patella is consistent with a congenital finding and not related to [s]ervice trauma, and the appellant was unaware of this condition until .

In a subsequent July 2019 VA medical opinion,a different clinician provided a negative nexus opinion as to the issue of secondary service connection of the appellant's right knee, reasoning that the appellant has service-connected right ankle and foot disabilities and that a secondary problem will typically occur on the contralateral (left)side.

Parties'Arguments Regarding his PTSD claim,the appellant argues that VA failed in its duty to assist because VA did not request that the Military Records Research Center attempt to verify his claimed MST, even though he supplied sufficient information to trigger VA's duty to do so.

He also argues that the Board erred by relying on insufficient medical opinions to deny compensation for his bilateral knee conditions.

In that regard, he contends that the May 2017 medical examiner did not offer any rationale for her negative nexus opinion as to direct service connection other than pointing to a 27-year gap without treatment and suggesting that she could not opine on direct causation without resorting to speculation.

He argues that the examiner's opinion as to secondary service connection is likewise inadequate because it was based upon a [f]inding that the medical literature does not support a nexus without reasoning provided by the examiner herself as to whether the bilateral foot condition could possibly cause the right knee condition or cites to the medical literature relied upon.

As for the February 2019 VA opinion,the appellant maintains that the examiner also focused on the gap in treatment between service and his current complaints and failed to address whether a congenital left knee condition was a disease or defect or was aggravated by service.