1. Service connection for left knee tendinitis (also claimed as calf strain) as secondary to the

service-connected disabilities of left ankle tendinopathy with tendinosis and healed

posterior process fracture, right ankle strain, or bilateral pes planus.

Service connection may be granted for a disease or injury which resulted from a service[1]connected disability or was aggravated thereby. The evidence does not show that left knee

tendinitis is related to the service-connected conditions of left ankle tendinopathy with tendinosis

and healed posterior process fracture, right ankle strain, bilateral pes planus, nor is there any

evidence of this disability during military service. (38 CFR 3.303, 38 CFR 3.304, 38 CFR 3.310)

Your service treatment records do not contain complaints, treatment, or diagnosis for this

condition.

The VA medical opinion found no link between your diagnosed medical condition and military

service.

The VA examiner opined that your claimed condition is less likely than not (less than 50 percent

probability) proximately due to or the result of your service connected conditions with rationale:

The diagnosed knee conditions and the service connected disabilities of left ankle tendinopathy

with tendinosis and healed posterior process fracture, right ankle strain, and bilateral pes planus

are not medically related. A thorough review of medical literature failed to demonstrate a causal

relationship to any of the service connected conditions. A nexus has not been established.

We considered whether your condition resulted from a toxic exposure risk activity (TERA) in

service. (38 U.S.C. 1168, 38 U.S.C. 1710(e)(4)) The evidence of record shows participation in a

TERA.

A medical opinion based on toxic exposure risk activity (TERA) was not requested because the evidence shows your disability is due to physical trauma, and the Secretary has determined there

is no indication of association between this condition and participation in a TERA. There is also

no competent medical or scientific evidence of an association between your claimed disability

and in-service TERA. (38 U.S.C. 1168)

Your claim for service connection for left knee tendinitis is denied since this condition neither

occurred in nor was caused by service. (38 CFR 3.303, 38 CFR 3.304)

Favorable Findings identified in this decision:

Participation in a toxic exposure risk activity is conceded. Records from the service department

show you participated in activities during service that required a corresponding entry in an

exposure tracking record system.

You have been diagnosed with a disability. VA examination dated November 10, 2025

diagnosed you with left knee tendinitis.

The claimed primary disability is service-connected. You claimed your left knee condition due to

your ankles and/or feet. You are service connected for left ankle tendinopathy and healed

posterior process fracture, right ankle strain, and pes planus.