Citation Nr: 1639188 Decision Date: 09/30/16 Archive Date: 10/13/16 DOCKET NO. 12-25 191 ) DATE ) ) On appeal from the Department of Veterans Affairs Regional Office in Jackson, Mississippi THE ISSUE Entitlement to service connection for a right knee disorder, to include as secondary to a service-connected left knee or lumbar spine disability. REPRESENTATION Appellant represented by: The American Legion ATTORNEY FOR THE BOARD B. Thomas Knope, Counsel INTRODUCTION The Veteran served on active duty from February 1986 to July 1992. This matter is on appeal from a May 2011 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO) in Jackson, Mississippi. This appeal is comprised entirely of documents contained in the Virtual VA paperless claims processing system as well as the Veterans Benefits Management System (VBMS). Accordingly, any future documents should be incorporated in the Veteran's VBMS file. The appeal is REMANDED to the Agency of Original Jurisdiction (AOJ). VA will notify the appellant if further action is required. REMAND Unfortunately, additional development is required before the claim may be adjudicated. Specifically, the Veteran underwent a VA examination specifically directed toward his right knee disorder. There, after a physical examination, the examiner stated that he would "find it highly unlikely" that the Veteran's right knee disorder was associated with "any service-connected condition." The examiner later continued that it was "more likely" that the Veteran's chronic right knee symptoms were associated with a patellar tendon rupture in 2006. In the Board's view, while the examiner believes that the Veteran's knee pain is most immediately related to a patellar tendon rupture, he does not address whether the Veteran's patella injury was in and of itself related to his service-connected disabilities. When VA undertakes to provide a VA examination, it must ensure that the examination is adequate. Barr v. Nicholson, 21 Vet. App. 303, 312 (2007). Here, the opinion is insufficient to adjudicate the claim. Therefore, clarification is required. Accordingly, the case is REMANDED for the following action: 1. Obtain all treatment records from the VA Medical Center in Memphis, Tennessee since August 2012, as well as from any VA facility from which the Veteran has received treatment. If the Veteran has received additional private treatment, he should be afforded an appropriate opportunity to submit them. 2. Return the claims file to the VA examiner who examined the Veteran in June 2010. The examiner should review all new evidence of record, including the statements made by the Veteran as well as by friends and family, and provide an addendum to his previous opinion as to whether it is at least as likely as not (i.e. a probability of 50 percent or greater) that the Veteran's right knee disorder is related to his active duty service or to his service-connected left knee or lumbar spine disability. The requested addendum opinion must be accompanied by a thorough reasons and bases for the opinions rendered. If the examiner is unable to provide such an opinion without resorting to speculation or for any other reason, an adequate explanation should be provided as to why such an opinion cannot be provided. Such explanations may include, but are not limited to, limited experience in the specific medical field or the need for additional tests. A new examination is not necessary unless deemed necessary by the examiner, or the examiner who provided the June 2010 opinion is no longer available. 3. After the above action is completed, if the claim is not fully granted, a supplemental statement of the case should be issued on the issue of entitlement to service connection for a right knee disorder, to include as secondary to a service-connected disability, and the claims file should be returned to the Board for further appellate consideration. The appellant has the right to submit additional evidence and argument on the matter or 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 2014). _________________________________________________ JOHN J. CROWLEY Veterans Law Judge, Board of Veterans' Appeals Under 38 U.S.C.A. § 7252 (West 2014), 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) (2015).