Citation Nr: 18142895 Decision Date: 10/18/18 Archive Date: 10/17/18 DOCKET NO. 16-29 943 DATE: October 18, 2018 REMANDED Entitlement to service connection for a left ankle disorder, as secondary to a right and/or left knee replacement, is remanded. Entitlement to service connection for a right ankle disorder, as secondary to a right and/or left knee replacement, is remanded. REASONS FOR REMAND The Veteran served on active duty in the U.S. Army from August 1969 to March 1972. These matters come before the Board of Veterans’ Appeals (Board) on appeal from an February 2014 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO) in Roanoke, Virginia denying the Veteran secondary service connection for his ankle conditions. Based on the review of the evidence a remand is required in this case to ensure that there is a complete record upon which to decide the Veteran’s claims of service connection. VA has a duty to make reasonable efforts to assist a claimant in obtaining evidence necessary to substantiate the claim for the benefits sought, unless no reasonable possibility exists that such assistance would aid in substantiating the claim. 38 U.S.C. § 5103A(a) (2012); 38 C.F.R. § 3.159 (c), (d) (2017). Entitlement to service connection for a left and right ankle disorders is remanded. The Veteran contends that his current left and right ankle disorders were caused or aggravated by his service connected left and right knee replacements. Specifically, he contends that he development the left and right ankle disorders based on the position of his feet as a result of his knee replacements and that he would not have incurred the left and right ankle disorders without the alignment caused by his knee replacements. In a January 2014 VA treatment note, the Veteran’s treating physician indicated that the position of the Veteran’s fused knees most likely caused and have contributed to the valgus deformity of both feet. However, this physician did not discuss the impact of the Veteran’s fused knees on his left and right ankle disorders. Therefore, an etiology opinion should be obtained. See McClendon v. Nicholson, 20 Vet. App. 79, 83 (2006). Finally, the Veteran should be asked to furnish, or to furnish an authorization to enable VA to obtain, any additional private treatment records from providers who treated him for his claimed disabilities. Finally, given the time that will elapse on remand, updated VA treatment records should be obtained. The matters are REMANDED for the following action: 1. The Veteran should be given an opportunity to identify any outstanding private or VA treatment records relevant to the claim on appeal. After obtaining any necessary authorization from the Veteran, all outstanding records, to include updated VA treatment records dated from April 2018 to the present, should be obtained. For private treatment records, make at least two (2) attempts to obtain records from any identified sources. If any such records are unavailable, inform the Veteran and afford him an opportunity to submit any copies in his possession. For federal records, all reasonable attempts should be made to obtain such records. If any records cannot be obtained after reasonable efforts have been made, issue a formal determination that such records do not exist or that further efforts to obtain such records would be futile, which should be documented in the claims file. The Veteran must be notified of the attempts made and why further attempts would be futile, and allowed the opportunity to provide such records, as provided in 38 U.S.C. § 5103A(b)(2) and 38 C.F.R. § 3.159(e). 2. The Veteran should be afforded an appropriate VA examination to determine the nature and etiology of his claimed right and left ankle disorders. All indicated tests and studies should be undertaken. The claims file, including a complete copy of this remand, must be made available for review of the Veteran’s pertinent medical history. The examiner must provide all examination findings, along with a complete rationale for the conclusions reached. The examiner is asked to furnish an opinion with respect to the following questions: (A) Identify whether the Veteran currently has a disorder in either ankle or has had such a diagnosis at time during the pendency of his May 2013 claim. (B) With respect to the claimed bilateral ankle disorder, was such caused by the Veteran’s service connected left and/or right knee replacements? The examiner should specifically address the Veteran’s contention that his bilateral ankle disorder is the result of the misalignment of his feet due to his knee replacements. (C) With respect to the claimed bilateral knee disorder, was such aggravated by the Veteran’s service connected left and/or right knee replacements? The examiner should specifically address the Veteran’s contention that his bilateral ankle disorder is the result of the misalignment of his feet due to his knee replacements. In offering such opinion, the examiner should consider the Veteran’s statements regarding the incurrence of his bilateral ankle disorder and the misalignment of his feet. The examiner must provide a complete rationale for all opinions and conclusions reached. KRISTY L. ZADORA Acting Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD M. Iglesias, Law Clerk