Citation Nr: 18145578 Decision Date: 10/30/18 Archive Date: 10/29/18 DOCKET NO. 15-43 321 DATE: October 30, 2018 REMANDED Entitlement to service connection for a right knee disability, to include arthritis, is remanded. REASONS FOR REMAND The Veteran served on active duty from September 1965 to September 1968, and from August 1987 to December 1995. He received the Combat Infantryman’s Badge. This matter is before the Board of Veterans’ Appeals (Board) on appeal from a June 2012 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO). The Agency of Original Jurisdiction (AOJ) also denied in part the Veteran’s claims of increased rating for a left knee disability and increased rating for posttraumatic stress disorder. 09/18/2015, Statement of Case. However, the only claim that has been perfected for appeal is service connection for a right knee disability. See 11/17/2015, Form 9 (marking box 8A and limiting the appeal to only the right knee). Entitlement to service connection for right knee disability is remanded. The Veteran contends that his right knee pain is due to in-service parachute jumps. Specifically, as a jump master, the Veteran completed over 400 jumps in active service and earned the following commendations: Parachutist Badge, 1966; and Jump Master, 1987. 11/20/2015, Certificate of Release. Alternatively, the Veteran contends that his right knee disability has been aggravated by his service-connected left knee disability. The Veteran was afforded a VA examination in June 2015, which noted that the Veteran was diagnosed with tri-compartmental osteoarthritis in his right knee in 2009, his right knee pain had its onset in the 1970s. 06/04/2015, C&P Exam. Upon review of the June 2015 examination, the Board finds this examination to be incomplete as the examiner failed to provide any medical opinion for direct service connection for the Veteran’s right knee disability. Based on the Veteran’s jump record, the Board finds that the record is to be supplemented with a medical opinion concerning direct service connection. The examiner did provide a medical opinion for secondary service connection, concluding that it is less likely than not that the Veteran’s left knee replacement did caused the right knee arthritis. 06/04/2015, C&P Exam. However, the Board also finds this medical opinion to be inadequate. Specifically, the medical opinion is limited to whether the Veteran’s left knee replacement in 2014 aggravated the Veteran’s right knee arthritis, which was diagnosed in 2009; the examiner opined that, because the right knee arthritis existed before the left knee replacement, there is no clear link between the left knee and right knee disabilities. 06/04/2015, C&P Exam. However, the record reflects that the Veteran has been service connected for a left knee disability since a September 2002 rating decision, based on the residuals from a left knee arthroscopy for repair of torn anterior and posterior ligaments in December 1983. 09/17/2002, Rating Decision. Furthermore, the onset of right knee pain for the Veteran occurred as early as the 1970s per the 2015 VA examination report. 06/04/2015, C&P Exam. Considering the foregoing deficiencies in the record, the Board finds that the Veteran should be afforded another VA examination to determine the nature and etiology of any right knee disability, to include an opinion on direct service connection and secondary service connection to any left knee disability. See McLendon, 20 Vet. App. 79, 83 (2006).  This matter is REMANDED for the following actions: 1. Schedule the Veteran for an appropriate VA examination to determine the nature and etiology of all current right knee disabilities. The examiner is asked to review the claims file to become familiar with the relevant medical history related to the Veteran’s right knee. The examiner is to address: (a.) For each current right knee disability, is it at least as likely as not (probability of 50 percent or more) related to an event, disease, or injury in service? **Note: The Veteran’s service records reflect a Parachutist Badge, 1966; and Jump Master, 1987. The examiner is asked to provide a comprehensive rationale for any opinion offered. The examiner must consider lay reports from the Veteran along with pertinent medical evidence, including medical literature submitted by him. If the examiner cannot offer an opinion without resort to speculation, he or she should explain why and state what additional evidence, if any, would be required to offer an opinion. For each current right knee disability, is it at least as likely as not (50 percent or greater) that the Veteran’s right knee was either 1) proximately due to or 2) aggravated by any service-connected disability, to include his left knee. The examiner must consider any service-connected left knee disabilities that had its onset before the Veteran was diagnosed with right knee arthritis. If aggravation is found, the examiner should also state, to the extent possible, the baseline level of disability prior to aggravation. This may be ascertained by the medical evidence of record and also by the Veteran’s statements as to the nature, severity, and frequency of his observable symptoms over time. Paul Sorisio Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD D. Han, Associate Counsel