Citation Nr: 1323702 Decision Date: 07/25/13 Archive Date: 08/06/13 DOCKET NO. 10-03 318 ) DATE ) ) On appeal from the Department of Veterans Affairs Regional Office in Waco, Texas THE ISSUES 1. Entitlement to service connection for a right knee disorder, to include as secondary to the service-connected left knee post-operative traumatic arthritis, left knee limitation of flexion, and left knee instability. 2. Entitlement to service connection for a right eye disorder. REPRESENTATION Appellant represented by: Disabled American Veterans ATTORNEY FOR THE BOARD D. Cherry, Counsel INTRODUCTION The Veteran served on active duty from September 1963 to September 1967. This case comes before the Board of Veterans' Appeals (Board) on appeal of an April 2009 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO) in Waco, Texas, which denied the Veteran's claims. The RO considered the claim of entitlement to service connection for a right knee disorder not only as secondary to the left knee disorders but also on a direct basis. The Veteran in a statement attached to the January 2010 VA Form 9 indicated that he had been sustaining his body weight on the right lower extremity for approximately 45 years, which means this change started during active service. In Schroeder v. West, 212 F.3d 1265, 1271 (Fed. Cir. 2000), the United States Court of Appeals for the Federal Circuit held that VA's duty to assist attaches to the investigation of all possible causes of a current disability, including those unknown to the claimant. Therefore, the Board must consider both the direct and secondary service connection theories of entitlement. 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 The RO obtained a VA medical opinion in March 2009 in which a VA medical professional noted that there is nothing in the orthopedic literature to indicate that arthritis in one knee leads to arthritis or pain in the other knee. The Board finds, however, that this opinion is inadequate to address whether the right knee disorder was caused or aggravated by the service-connected left knee disabilities. Moreover, the Board finds that the Veteran is competent and credible to report the he was sustaining his body weight on the right lower extremity during active service. A medical opinion addressing whether the right knee disorder is related to sustaining his body weight on the right lower extremity during service as well as during the years following service is necessary. The Veteran's currently available service treatment records show no treatment for eye symptomatology as he claims. In a February 2009 VA Form 21-4124, the appellant indicated that he received eye treatment at the hospital at the Naval Air Station in Corpus Christi, Texas in 1964 and 1965. In a May 2009 statement, the claimant indicated that he was inclined to believe that his treatment happened during the spring or summer of 1964. The RO should specifically request any records of either inpatient or outpatient treatment at the hospital at the Naval Air Station in Corpus Christi, Texas in 1964 and 1965 regarding his alleged eye treatment. The medical evidence shows diagnoses of right eye amblyopia and ischemic optic neuropathy. Amblyopia is impairment of vision without detectable organic lesion of the eye. Strabismic amblyopia results from suppression of vision in one eye to avoid diplopia. Traumatic amblyopia is due to injury. Dorland's Illustrated Medical Dictionary, 56 (27th ed. 1988). Amblyopia is impairment of vision without detectable organic lesion of the eye. Satterfield v. Nicholson, No. 03-1504, slip op. (U.S. Vet. App. Dec. 8, 2005). A VA examination is necessary to determine whether the eye disorders may related to service. The RO last obtained records from the Dallas VA Medical Center in April 2009. The AMC should obtain all records from the Dallas VA Medical Center from April 2009 to the present. The Veteran was last asked to identify treatment for his right knee and right eye disorders in October 2008 and February 2009, respectively. The AMC should ask the Veteran to identify all treatment for his right knee and right eye disorders since October 2008 and February 2009, respectively. Although the RO provided the Veteran in a February 2009 correspondence notice regarding direct service connection for the right eye disorder, the Veteran has not been provided notice of the information and evidence needed to substantiate and complete a claim of entitlement to service connection on a direct basis for the right knee disorder, to include notice of what part of that evidence is to be provided by the claimant, and notice of what part VA will attempt to obtain. Such notice must be provided. 38 U.S.C.A. §§ 5103, 5103A (West 2002 & Supp. 2012). Accordingly, the case is REMANDED for the following action: 1. The AMC should provide the Veteran notice of the information and evidence needed to substantiate and complete a claim of direct service connection for a right knee disorder, to include notice of what part of that evidence is to be provided by the claimant, and notice of what part VA will attempt to obtain. 2. The AMC should ask the Veteran to identify all treatment for his right knee disorder since October 2008 and for his right eye disorder since February 2009. The AMC should obtain all identified records, and the appellant's assistance should be requested as needed. Regardless of the claimant's response, the AMC should obtain all records from the Dallas VA Medical Center since April 2009. Any obtained records should be associated with the appellant's claims file. 3. The AMC should take appropriate steps to obtain any additional service treatment records pertaining to either inpatient or outpatient treatment regarding his eye at the hospital at the Naval Air Station in Corpus Christi, Texas in 1964 and 1965. If necessary, the appellant's assistance should be requested as needed. 4. Thereafter, schedule the Veteran for a VA examination to determine the nature and extent of his right knee disorder. The claims folder is to be made available to the examiner to review. The examiner is to provide a detailed review of the appellant's pertinent medical history, current complaints, and the nature and extent of any disability due to a right knee disorder. Whether it is at least as likely as not (50 percent or greater) that the Veteran's right knee disorder is related to his military service, to include sustaining his body weight on the right lower extremity during service. Whether it is at least as likely as not (50 percent or greater) that the Veteran's right knee disorder was caused or aggravated (i.e. permanently worsen beyond the normal progression of the disability) by his service-connected left knee post-operative traumatic arthritis, left knee limitation of flexion, or left knee instability. If the examiner finds that any right knee disorder was aggravated by the service-connected left knee post-operative traumatic arthritis, left knee limitation of flexion, or left knee instability, then he/she should quantify the degree of aggravation. A clear rationale for all opinions would be helpful and a discussion of the facts and medical principles involved would be of considerable assistance to the Board. However, if the requested opinion cannot be provided without resort to speculation, the examiner should so state and explain why an opinion cannot be provided without resort to speculation. 5. Thereafter, schedule the Veteran for a VA examination to determine the nature and extent of his right eye disorder. The claims folder is to be made available to the examiner to review. The examiner is to provide a detailed review of the appellant's pertinent medical history, current complaints, and the nature and extent of any disability due to a right eye disorder. If there are no service treatment records showing eye treatment, the examiner should accept the Veteran's reporting of his in-service eye treatment as credible. Whether it is at least as likely as not (50 percent or greater) that any current right eye disorder is related to his military service, to include the Veteran's reporting of what occurred in service. A clear rationale for all opinions would be helpful and a discussion of the facts and medical principles involved would be of considerable assistance to the Board. However, if the requested opinion cannot be provided without resort to speculation, the examiner should so state and explain why an opinion cannot be provided without resort to speculation. 6. The Veteran is to be notified that it is his responsibility to report for the scheduled examinations and to cooperate in the development of the claims. The consequences for failure to report for a VA examination without good cause may include denial of the claims. 38 C.F.R. §§ 3.158, 3.655 (2012). 7. Thereafter, the AMC must readjudicate the issues on appeal, to include consideration of direct service connection for the right knee disorder. If any benefit is not granted, the Veteran should be furnished with a supplemental statement of the case, with a copy to his representative, and afforded an opportunity to respond before the file is returned to the Board for further appellate consideration. The appellant has the right to submit additional evidence and argument on the matters 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 that are 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. 2012). _________________________________________________ MICHAEL LANE 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) (2012).