Citation Nr: 0005611 Decision Date: 03/01/00 Archive Date: 03/14/00 DOCKET NO. 98-19 846 ) DATE ) ) On appeal from the Department of Veterans Affairs Medical and Regional Office Center in Wichita, Kansas THE ISSUE Entitlement to service connection for a right knee disorder. REPRESENTATION Appellant represented by: Disabled American Veterans ATTORNEY FOR THE BOARD Michelle L. Nelsen, Associate Counsel INTRODUCTION The veteran had active duty from June 1992 to May 1998. The veteran's separation record also shows an additional period of prior active service of 3 months and 20 days, the specific dates of which are unverified. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a June 1998 rating decision of the Department of Veterans Affairs (VA) Medical and Regional Office Center (MROC) in Wichita, Kansas. The Board notes that the VAMROC also initially denied service connection for a back disorder. The veteran's submitted a notice of disagreement with that denial. Subsequently, in October 1998, the VAMROC granted service connection for low back strain. Accordingly, with regard to a back disorder, there has been a complete grant of benefits on appeal and that issue is not before the Board at this time. FINDING OF FACT There is no competent medical evidence of a current right knee disability. CONCLUSION OF LAW The veteran's claim of entitlement to service connection for a right knee disorder is not well grounded. 38 U.S.C.A. § 5107(a) (West 1991); 38 C.F.R. § 3.102 (1999). REASONS AND BASES FOR FINDING AND CONCLUSION Service connection may be granted if the evidence demonstrates that a current disability resulted from an injury or disease incurred or aggravated in active military service. 38 U.S.C.A. § 1110 (West 1991); 38 C.F.R. § 3.303(a) (1999). Service connection requires a finding that there is a current disability that has a definite relationship with an injury or disease or some other manifestation of the disability during service. Rabideau v. Derwinski, 2 Vet. App. 141, 143 (1992); Cuevas v. Principi, 3 Vet. App. 542, 548 (1992). A disability may be service connected if the evidence of record, regardless of its date, shows that the veteran had a chronic disorder in service or during an applicable presumptive period, and that the veteran still has such a disorder. 38 C.F.R. § 3.303(b); Savage v. Gober, 10 Vet. App. 488, 494-95 (1997). Such evidence must be medical unless it relates to a disorder that may be competently demonstrated by lay observation. Savage, 10 Vet. App. at 495. For the showing of chronic disease in service, there is required a combination of manifestations sufficient to identify the disease entity, and sufficient observation to establish chronicity at the time, as distinguished from merely isolated findings or a diagnosis including the word "chronic." 38 C.F.R. § 3.303(b). If the disorder is not chronic, it may still be service connected if the disorder is observed in service or an applicable presumptive period, continuity of symptomatology is demonstrated thereafter, and competent evidence relates the present disorder to that symptomatology. Id. at 496-97. Again, whether medical evidence or lay evidence is sufficient to relate the current disorder to the in-service symptomatology depends on the nature of the disorder in question. Id. Disorders diagnosed after discharge may still be service connected if all the evidence, including pertinent service records, establish that the disorder was incurred in-service. 38 U.S.C.A. § 1113(b); 38 C.F.R. § 3.303(d). However, a person claiming VA benefits must meet the initial burden of submitting evidence "sufficient to justify a belief in a fair and impartial individual that the claim is well grounded." 38 U.S.C.A. § 5107(a); Murphy v. Derwinski, 1 Vet. App. 78, 91 (1990); Gilbert v. Derwinski, 1 Vet. App. 49, 55 (1990). A claim that is well grounded is plausible, meritorious on its own, or capable of substantiation. Murphy, 1 Vet. App. at 81; Moreau v. Brown, 9 Vet. App. 389, 393 (1996). For purposes of determining whether a claim is well grounded, the Board presumes the truthfulness of the supporting evidence. Arms v. West, 12 Vet. App. 188, 193 (1999); Robinette v. Brown, 8 Vet. App. 69, 75 (1995); King v. Brown, 5 Vet. App. 19, 21 (1993). In order for a claim to be well grounded, there must be competent evidence of a current disability (a medical diagnosis); of incurrence or aggravation of a disease or injury in service (lay or medical evidence); and of a nexus between the in-service injury or disease and the current disability (medical evidence). Epps v. Gober, 126 F.3d 1464, 1468 (1997); Caluza, 7 Vet. App. 498, 504 (1995). Where the determinative issue involves a medical diagnosis, there must be competent medical evidence to the effect that the claim is plausible; lay assertions of medical status do not constitute competent medical evidence. Grottveit v. Brown, 5 Vet. App. 91, 93 (1993); Espiritu v. Derwinski, 2 Vet. App. 492, 494 (1992). VA cannot undertake to assist a veteran in developing facts pertinent to his claim until and unless the veteran submits a well grounded claim. Morton v. West, 12 Vet. App. 477, 486 (1999). In this case, service medical records dated in August 1993 showed a diagnosis of acute overuse injury of both knees. Progress notes dated in September 1996 showed findings of a three-centimeter cyst on the proximal gastrocnemius and a diagnosis of Baker's cyst. A January 1997 orthopedic consultation report indicates that there was no mass palpable at that time. The diagnosis was possible popliteal cyst behind the right knee. Notes dated in July 1997 revealed a finding of slight laxity of the anterior cruciate ligament. A May 1998 separation examination report showed that an examination of the extremities was negative. However, the examiner made the notation "Bakers cyst right knee." On the report of medical history, the veteran indicated that a cyst frequently occurred but did not cause much pain. (The Board notes that, in his May 1999 Informal Hearing Presentation, the veteran's representative referred to X-ray studies dated in February 1996 as pertaining to the right knee. Although the X-ray report does state "RIGHT KNEE SERIES," the interpretation itself indicates that the studies are of the left knee. Associated medical and physical therapy records confirm that the disorder evaluated at that time concerned the left knee.) The veteran was afforded a VA orthopedic examination in August 1998. She stated that the Baker's cyst recurred intermittently and she had knee pain only when the cyst was present. Physical examination was negative for any abnormalities. Specifically, there was no ligamentous laxity and no abnormality in the popliteal area. There was no dislocation or subluxation. There was no painful motion, edema, effusion, weakness, tenderness, redness, heat, or abnormal motion. There was no abnormal posturing of the bones or of the knee joint. There was no lateral laxity or drawer sign. The veteran was able to squat with no difficulty. The veteran stated that her right knee was not a current problem to her lifestyle. X-rays of the right knee were negative. The diagnosis was Baker's cyst, not found, with normal X-rays. After reviewing the claims folder, the Board finds that the veteran's claim for service connection for a right knee disorder is not well grounded. Initially, the Board finds that, because service medical records reflect only one instance of Baker's cyst in service, the evidence does not establish the presence of a chronic disorder in service. 38 C.F.R. § 3.303(b); Savage, 10 Vet. App. at 495. However, the Board will assume that the veteran's statements as to the recurrence of symptoms in the right knee after service are indicative of continuous symptomatology. Savage, 10 Vet. App. at 496-97. In any event, the claim is not well grounded because there is no competent medical evidence showing that the veteran suffers from a current right knee disability. As stated above, the August 1998 VA examination yielded no evidence of current right knee pathology and no diagnosis of a current disorder. A claim is not well grounded if there is no present disability. Brammer v. Derwinski, 3 Vet. App. 223, 225 (1992). Moreover, even accepting the veteran's statements as to recurring or continuous symptomatology under 38 C.F.R. § 3.303(b), a well grounded claim still requires competent medical evidence that established as relationship between the claimed symptomatology and a current disability. Voerth v. West, 13 Vet. App. 117 (1999); McManaway v. West, 13 Vet. App. 60, 66 (1999). There is no such evidence of record in this case. The veteran has not submitted any evidence to suggest that she is a trained medical professional. As a lay person, she is competent to relate and describe symptoms, as she did during the VA examination. However, she is not competent to offer an opinion on matters that require medical knowledge, such as questions of medical diagnosis or medical causation. Grottveit, 5 Vet. App. at 93; Espiritu, 2 Vet. App. at 494. Her statements thus do not serve to make her service connection claim well grounded. Under these circumstances, the Board finds that the veteran has not submitted a well grounded claim for service connection for a right knee disorder. 38 U.S.C.A. § 5107(a); 38 C.F.R. § 3.102; Epps, 126 F.3d at 1468. Therefore, the duty to assist is not triggered and VA has no obligation to further develop the veteran's claim. Epps, 126 F.3d at 1469; Morton, 12 Vet. App. at 486; Grivois v. Brown, 5 Vet. App. 136, 140 (1994). On a related point, the Board notes that the veteran's service medical records include records from 1988 to 1992. Although the veteran's separation record shows a three-month period of active duty in addition to service from 1992 to 1998, the VAMROC failed to verify all periods of the veteran's active duty service and inactive duty service. However, as there is no current medical evidence of a chronic right knee disorder, any error in failing to verify other periods of active service is harmless and not prejudicial to the veteran. If the veteran wishes to complete her application for service connection for a right knee disorder, she should submit competent medical evidence showing that she has a current diagnosis of a right knee disorder and that a current right knee disability is related to service. 38 U.S.C.A. § 5103(a); Robinette, 8 Vet. App. at 77-80. ORDER A well grounded claim not having been submitted, service connection for a right knee disorder is denied. JAMES A. FROST Acting Member, Board of Veterans' Appeals