Citation Nr: 18144911 Decision Date: 10/25/18 Archive Date: 10/25/18 DOCKET NO. 14-25 044 DATE: October 25, 2018 REMANDED Entitlement to service connection for a right knee disorder, including osteoarthritis as secondary to service-connected residuals of a left knee injury with degenerative changes, is remanded. REASONS FOR REMAND The Veteran served on active duty from September 1970 to June 1993. In November 2014, the Veteran and his wife testified under oath at a travel board hearing before the undersigned Veterans Law Judge. A transcript of the hearing is of record. Entitlement to service connection for right knee with osteoarthritis, to include as secondary to his service-connected residuals of left knee injury with degenerative changes disability, is remanded. The Board finds that additional development is needed prior to final adjudication of the issue on appeal. Specifically, the Board finds that a new examination is needed. At the November 2014 hearing, the Veteran testified that in service his duties required him to knee and crawl, and that he was injured in a motorcycle accident while in service. He also indicated that his knee hurt continuously from separation from service until he sought treatment in 2007. The Veteran stated that he was given a diagnosis of osteoarthritis by his treating physicians and that they said that his diagnosis was the result of his work in service and the motorcycle accident. In addition, testimony at the hearing indicated that the Veteran’s service-connected left knee disability, may also have contributed to his right knee disability. For example, the Veteran stated that he found himself favoring his left knee and putting more pressure on the right knee. The Veteran was afforded a VA examination in February 2014, but the examiner did not address the Veteran’s statements about his in-service kneeling and crawling, nor his statements about continuous pain. The examiner also did not provide an opinion that addresses secondary service connection. Accordingly, the Board will remand to afford the Veteran a new VA examination to address his direct and secondary service connection claims. The matter is REMANDED for the following action: 1. After securing any necessary consent forms from the Veteran, obtain any outstanding treatment records, to include any VA and/or private treatment records, pertaining to the issue on appeal. All efforts to obtain these records should be documented in the claim file. If any records could not be obtained, this should be noted in the claim file. 2. Upon completion of the above, schedule the Veteran for a VA examination to address the etiology of his claimed right knee disability. For each disability diagnosed, the examiner is asked to address whether it is at least as likely as not (i.e., a 50 percent or greater probability) that it was caused by the Veteran’s active duty service or, if preexisting service, was aggravated therein. The examiner is asked to specifically address: (a) the Veteran’s in-service duties, which required him to knee and crawl; (b) his injury in a motorcycle accident while in service; (c) his testimony that his knee hurt continuously from separation from service until he sought treatment in 2007; and (d) his testimony that he was given a diagnosis of osteoarthritis by his treating physicians and that they said that his diagnosis was the result of his work in service and the motorcycle accident. In addition, the examiner should provide an opinion as to whether it is at least as likely as not (i.e., a 50 percent or greater probability) that claimed right knee with osteoarthritis is proximately due to, or the result of, or aggravated (permanently worsened) beyond normal progression by the Veteran’s service-connected residuals of left knee injury with degenerative changes disability. For all examinations, all necessary development should be taken. The VA examiner should be given access to the claim file. The examiner should state that a review of the claim file was completed. The examiner must provide a comprehensive report including complete rationales for all opinions and conclusions reached, citing the objective medical findings leading to the conclusions. (Continued on the next page)   A detailed rationale is requested for all opinions provided. KEITH W. ALLEN Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD K. Foster, Associate Counsel