Citation Nr: 0813563 Decision Date: 04/24/08 Archive Date: 05/01/08 DOCKET NO. 06-17 480 ) DATE ) ) On appeal from the Department of Veterans Affairs Regional Office in Waco, Texas THE ISSUE Entitlement to service connection for a left knee strain, post-op meniscal tear and anterior collateral ligament deficiency. REPRESENTATION Appellant represented by: Texas Veterans Commission ATTORNEY FOR THE BOARD Nicole Klassen, Associate Counsel INTRODUCTION The veteran served on active duty from April 13 to June 15, 2005. This matter comes to the Board of Veterans' Appeals (Board) on appeal from an October 2005 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO) in Waco, Texas, which denied the above claim. The appeal is REMANDED to the RO via the Appeals Management Center (AMC), in Washington, DC. VA will notify the appellant if further action is required. REMAND 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 veteran's claim so that he is afforded every possible consideration. In this case, the veteran contends that he either incurred a left knee condition in service, or a left knee condition existed prior to service and was aggravated by service. The veteran's pre-entrance exam performed by the Military Entrance Processing Station (MEPS) in March 2005, a month prior to service, indicated that he sustained a left knee injury that required ACL reconstruction in November 2003; recovery was uneventful and the veteran was able to resume full activities. The MEPS examiner stated that the veteran had a functionally normal left knee. A left knee surgical scar was noted on the veteran's entrance examination. In his June 2005 statement in support of his claim and his April 2006 notice of disagreement, the veteran consistently reported chronic left knee pain as a result of an in-service fall in May 2005. The veteran's service medical records indicate that, in May 2005, his left knee suddenly locked up and then buckled, causing him to fall and to have left knee pain. The veteran was treated for patellofemoral syndrome and knee joint pain, and was placed on a permanent profile that prohibited him from running, jumping, road marching, and standing for prolonged periods of time. Post-service, the veteran sought VA treatment in June 2005 for knee pain. The VA doctor noted that the veteran arrived on crutches and complained of medial and lateral left knee pain. The doctor reported that the veteran had normal range of motion and x-rays showed no fracture. The veteran was diagnosed with knee pain. The veteran underwent a VA orthopedic examination in September 2005. Unfortunately, the examiner failed to acknowledge the veteran's account of continued symptomatology since service, and instead relied on a lack of treatment since separation from service to reach the conclusion that any opinion regarding permanent worsening of the left knee would be mere speculation. As such, the examination report is not adequate for rating purposes, and this matter must be remanded. See Dalton v. Nicholson, 21 Vet. App. 23 (2007) (holding that an examination was inadequate where the examiner did not comment on the veteran's report of an in- service injury, but instead relied on the service medical records to provide a negative opinion); see also 38 C.F.R. § 4.2 (2007) (stating that if the findings on an examination report do not contain sufficient detail, it is incumbent upon the rating board to return the report as inadequate for evaluation purposes). The veteran has consistently reported, as he is competent to do, that he hurt his left knee when he fell in service. Washington v. Nicholson, 19 Vet. App. 362 (2005); Barr v. Nicholson, 21 Vet. App. 303, 307-08 (2007) (holding that lay testimony is competent to establish the presence of observable symptomatology); see also 38 C.F.R. § 3.159(a)(2). Based on the medical evidence showing an ACL surgery prior to service with a very satisfactory result, a functional knee upon entry to service, and the veteran's reports of severe left knee pain since the May 2005 fall and resulting inability to perform life activities, the Board finds that VA is required to provide the veteran with a medical examination and to request a medical opinion as to whether the veteran either incurred a left knee condition, or has permanently worsened his left knee condition, as a result of military service. See McLendon v. Nicholson, 20 Vet. App. 79 (2006). Accordingly, the case is REMANDED for the following action: 1. Schedule the veteran for a VA orthopedic examination. The claims file and a copy of this remand must be made available to and reviewed by the examiner in conjunction with the examination. All necessary tests should be conducted. The examiner should identify any disability of the left knee. If a disability is found, the examiner should provide an opinion as to the nature and date of onset of the disability. The examiner should also provide an opinion as to whether the veteran's left knee disability existed prior to service. If the disability is found to have existed prior to service, the examiner should provide an opinion as to whether it increased in severity during service, and if so, whether the increase in severity was beyond the natural progression of the disability. The examiner must provide a comprehensive report including complete rationales for all opinions and conclusions reached, citing the objective medical findings leading to the conclusions. 2. Thereafter, readjudicate the veteran's claim on appeal. If the claim remains denied, provide the veteran and his representative with a supplemental statement of the case and allow an appropriate time for response. The appellant has the right to submit additional evidence and argument on the matter the Board has remanded. Kutscherousky v. West, 12 Vet. App. 369 (1999). This claim must be afforded expeditious treatment. The law requires that all claims remanded by the Board of Veterans' Appeals or by the United States Court of Appeals for Veterans Claims for additional development or other appropriate action must be handled in an expeditious manner. See 38 U.S.C.A. §§ 5109B, 7112 (West Supp. 2007). _________________________________________________ L.M. BARNARD Acting Veterans Law Judge, Board of Veterans' Appeals Under 38 U.S.C.A. § 7252 (West 2002), only a decision of the Board of Veterans' Appeals is appealable to the United States Court of Appeals for Veterans Claims. This remand is in the nature of a preliminary order and does not constitute a decision of the Board on the merits of your appeal. 38 C.F.R. § 20.1100(b) (2007).