Citation Nr: 18145071
Decision Date: 10/26/18	Archive Date: 10/25/18

DOCKET NO. 16-32 931
DATE:	October 26, 2018
REMANDED
Entitlement to service connection for a left shoulder disorder as secondary to the service-connected bilateral knee disabilities is remanded.
Entitlement to service connection for a right shoulder disorder as secondary to the service-connected bilateral knee disabilities is remanded.
Entitlement to service connection for a cervical spine disorder as secondary to the service-connected bilateral knee disabilities is remanded.
REASONS FOR REMAND
The Veteran had active military service from February 1969 to March 1971.  This matter is on appeal from February and April 2014 rating decisions.
1. Entitlement to service connection for bilateral shoulder and cervical spine disorders as secondary to the service-connected bilateral knee disabilities is remanded.
The Board of Veterans’ Appeals (Board) cannot make a fully-informed decision on the issues of service connection for bilateral shoulder and cervical spine disorders as secondary to the service-connected bilateral knee disabilities, because no VA examiner has opined whether such are due to the use of crutches as asserted by the Veteran in his July 2014 notice of disagreement (NOD), or whether the bilateral knee disabilities aggravate the Veteran's shoulders and cervical spine. 
The matters are REMANDED for the following action:
1. In accordance with the provisions of 38 C.F.R. § 3.159(c)(1), make efforts to obtain all records identified by the Veteran, including any outstanding VA treatment records. 
2. Obtain an addendum medical opinion from the February 2014 VA neck and shoulder and arm conditions examiner (or, if unavailable, from a medical professional with appropriate expertise) to determine the etiology of any diagnosed bilateral shoulder and cervical spine disorders.  The examiner is requested to review the record and offer an opinion as to whether it is at least as likely as not (i.e., probability of approximately 50 percent) that any diagnosed bilateral shoulder and cervical spine disorders are caused or aggravated by the service-connected bilateral knee disabilities.  (If a bilateral shoulder and/or cervical spine disorder is found to have been aggravated by the service-connected bilateral knee disabilities, the examiner should quantify the approximate degree of aggravation.)  

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The examiner should consider the Veteran's assertion in his February 2014 NOD that the use of crutches for his bilateral knee disabilities caused his bilateral shoulder and cervical spine disorders.  A complete rationale should be given for all opinions and conclusions expressed.
 
A. C. MACKENZIE
Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD	L. Barstow, Counsel