Citation Nr: 18141266 Decision Date: 10/11/18 Archive Date: 10/10/18 DOCKET NO. 15-40 735 DATE: October 11, 2018 REMANDED Entitlement to service connection for a right knee disability is remanded. REASONS FOR REMAND The Veteran served on active duty from March 1978 to April 1979. This matter comes to the Board of Veterans’ Appeals (Board) from a September 2012 rating decision which denied service connection for a right knee disability. The Veteran testified in February 2018 before the undersigned Veterans Law Judge (VLJ) at a Board videoconference hearing. A copy of the transcript is of record. Entitlement to service connection for a right knee disability is remanded. The Board cannot make a fully-informed decision on the issue of entitlement to service connection for a right knee disability. The Veteran was afforded a VA examination in July 2012. The examiner noted that the Veteran had a current diagnosis of degenerative joint disease and chondrocalcinosis of the right knee. The examiner noted that the Veteran’s service treatment records reflect that in April 1978, the Veteran was diagnosed with chondromalacia and referred for new boots, and that the Veteran was seen again in May 1978 for right knee pain, where it was noted that he had injured his knee before entering service and was bothering him. The Veteran was diagnosed with chondromalacia and treated conservatively. The Veteran denied a trick or locked knee on a January 1970 separation examination. After reviewing the claims file and examining the Veteran, the examiner found that the Veteran had a preexisting right knee injury, and that the injury recurred during service in 1978. However, the injury resolved by separation in 1979, with no further evidence of chronicity. Thus, the examiner opined that the Veteran’s preexisting chondromalacia, which was treated acutely and resolved in service, was less likely as not related to his current right knee degenerative arthritis. The Board finds the July 2012 examiner’s opinion inadequate, as it is based on an incorrect or incomplete premise. Pre-service medical records reflect that the Veteran fractured his right distal femur in 1973. On his August 1977 induction examination, the Veteran denied having a trick or locked knee, but reported broken bones. The August 1977 induction examiner noted that the Veteran had fractured his right leg prior to service, but that it was not considered disqualifying. It is not clear whether the July 2012 VA examiner considered and/or distinguished that the Veteran fractured his right distal femur prior to service when finding that the Veteran’s right knee disability preexisted service. Furthermore, while the July VA 2012 examiner opined that the Veteran’s preexisting chondromalacia was not related to his current right knee degenerative arthritis, the examiner did not provide an opinion as to whether the Veteran’s preexisting chondromalacia was aggravated by service. The July 2012 examiner also found a lack of chronicity due to a lack of treatment for a right knee disability from service until 2008, when he was diagnosed with right knee degenerative arthritis. During his February 2018 Board hearing, the Veteran testified that his right knee bothered him in service due to the rigors of service, to include jumping from tanks during his military occupational specialty as a tank driver, that his right knee bothered him right after service, and that his right knee has continued to bother him since service. The Veteran indicated that he tried not to focus on the pain, and self-treated his knee with wraps. During the February 2018 Board hearing, the Veteran also identified relevant outstanding private treatment records from the Darlingon Medical Center in the early 1980s. A remand is required to allow VA to obtain authorization and request these records. Therefore, the Board finds that a remand is warranted in order to obtain outstanding medical records and an adequate VA examination and medical opinion as to the nature and etiology of the Veteran’s right knee disability. The matter is REMANDED for the following actions: 1. Ask the Veteran to complete a VA Form 21-4142 for the Darlington Medical Center, to include treatment for his right knee in the early 1980s. Make two requests for the authorized records from the Darlington Medical Center, unless it is clear after the first request that a second request would be futile. 2. Schedule the Veteran for an examination by an appropriate clinician to determine the nature and etiology of any right knee disability. The examiner must opine whether a right knee disability clearly and unmistakably (undebatable) preexisted the Veteran’s service. If the examiner finds it did clearly and unmistakably preexist service, the examiner must opine whether it was clearly and unmistakably not aggravated by service, to include the rigors of service and jumping from tanks. If the examiner finds that a right knee disability either did not clearly and unmistakably preexist service, or was not clearly and unmistakably aggravated by service, the examiner must opine whether a right knee disability at least as likely as not (1) began during active service, to include as due to the rigors of service and jumping from tanks, (2) manifested within one year after discharge from service, or (3) was noted during service with continuity of the same symptomatology since service. 3. After completing the above, and any other development as may be indicated, the Veteran’s claim should be readjudicated based on the entirety of the evidence. If the claim remains denied, the Veteran and his representative should be issued a supplemental statement of the case (SSOC). An appropriate period of time should be allowed for response. Thereafter, the case should be returned to the Board for further appellate consideration, if otherwise in order. K. PARAKKAL Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD S. Owen, Associate Counsel