Citation Nr: 18142540 Decision Date: 10/16/18 Archive Date: 10/16/18 DOCKET NO. 16-15 456A DATE: October 16, 2018 REMANDED ISSUES Entitlement to service connection for left knee disability is remanded. Entitlement to service connection for right knee disability is remanded. Entitlement to service connection for bilateral hearing loss is remanded. Entitlement to service connection for respiratory disability, to include a disability manifested by chronic sore throat and sinusitis, is remanded. REASONS FOR REMAND The Veteran served on active duty from October 1996 to July 2002. Notably, the Veteran filed a service connection claim for chronic sore throat in November 2011. A July 2013 VA examination reflects that the Veteran has a current diagnosis of chronic sinusitis. Generally, the scope of a disability claim includes any disability that may reasonably be encompassed by the claimant’s description of the claim, reported symptoms, and any other information of record. See Clemons v. Shinseki, 23 Vet. App. 1 (2009). As such, the Board has re-characterized the Veteran’s claim as service connection for respiratory disability. The Board regrets further delay, but additional development is necessary before adjudicating the claim. A. Bilateral Knee Disability The Veteran underwent a VA examination in July 2013, where he was diagnosed with bilateral knee degenerative joint disease (DJD). The exam also reflects that he had bilateral knee patellofemoral pain syndrome (PPS), which has resolved. The examiner concluded that the medical literature does not show that PPS causes DJD. The examiner, however, did not provide a complete rational to support this conclusion. Therefore, the Board finds this opinion inadequate and a remand is necessary to obtain another examination. B. Bilateral hearing loss The Veteran was not provided a VA examination with respect to his claim for service connection for bilateral hearing loss. An examination was requested in June 2013 and the Veteran did not appear for the exam. In his substantive appeal filed in April 2016, the Veteran’s representative indicated that the Veteran did have sufficient notice that the exam was scheduled. The Board finds that a remand is necessary to afford the Veteran an opportunity to appear for this examination. C. Respiratory Disability The Veteran underwent a VA examination in July 2013, where the examiner diagnosed chronic sinusitis. The examiner concluded that medical literature does not show that chronic sinusitis is caused by upper respiratory infection he experienced during his military service without providing complete rational. Therefore, the Board finds this opinion inadequate and a remand is necessary to obtain another opinion. The matters are REMANDED for the following action: 1. Update VA medical records. 2. After completion of directive #1, schedule the Veteran for an examination by an appropriate clinician to determine the nature and etiology of any bilateral knee disability. The examiner must opine whether it is at least as likely as not related to an in-service injury, event, or disease. The examiner should consider and comment the impact, if any, the bilateral knee patellofemoral pain syndrome, which was diagnosed in service, has on the Veteran’s current condition. Also, the examiner should consider and comment on the Veteran’s lay statement, including his contention that strenuous activities in the military caused his current condition. If the examiner cannot provide the requested opinion without resorting to speculation, it must be so stated, and the examiner must provide the reasons why an opinion would require speculation. The examiner must indicate whether an opinion could not be rendered due to limitations of knowledge in the medical community at large and not those of the particular examiner. 3. After completion of directive #1, schedule the Veteran for a VA examination to determine the etiology of any bilateral hearing loss. The claims file should be made available to the examiner, who should indicate in his/her report that the file was reviewed as part of the examination. The examiner should take a complete history from the Veteran. All indicated tests and studies should be completed. The examiner must describe all pertinent symptomatology. Following the completion of the examination, the examiner should provide an opinion answering the following question: Does the Veteran have bilateral hearing loss for VA purposes? If so, is the Veteran’s hearing loss at least as likely as not (a 50 percent or greater probability) related to his military service? The examiner is asked to address the fact that the Veteran’s military occupational specialty (MOS) was combat engineer, which has high probability of noise exposure. In addressing the plausibility or non-plausibility of delayed onset hearing loss, the examiner must discuss the Institute of Medicine (IOM) Report on noise exposure in the military, contemplating that the IOM report states that it is “unlikely” that the onset of hearing loss begins years after noise exposure occurs, but also states that “an individual’s awareness of the effects of noise on hearing may be delayed considerably after the noise exposure.” The examiner is reminded that the absence of any documented in-service hearing loss is not fatal to a claim for service connection. If the examiner cannot provide the requested opinion without resorting to speculation, it must be so stated, and the examiner must provide the reasons why an opinion would require speculation. The examiner must indicate whether an opinion could not be rendered due to limitations of knowledge in the medical community at large and not those of the particular examiner. 4. After completion of directive #1, schedule the Veteran for a VA examination to determine the etiology of any respiratory disability. The claims file should be made available to the examiner, who should indicate in his/her report that the file was reviewed as part of the examination. The examiner should take a complete history from the Veteran. All indicated tests and studies should be completed. The examiner must describe all pertinent symptomatology. Following the completion of the examination, the examiner should provide an opinion answering the following question: Is the Veteran’s respiratory disability at least as likely as not (a 50 percent or greater probability) related to his military service? The examiner is asked to provide an opinion as to all respiratory disabilities diagnosed. If the examiner cannot provide the requested opinion without resorting to speculation, it must be so stated, and the examiner must provide the reasons why an opinion would require speculation. The examiner must indicate whether an opinion could not be rendered due to limitations of knowledge in the medical community at large and not those of the particular examiner. Nathaniel J. Doan Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD S.SOLOMON