Citation Nr: 18146850 Decision Date: 11/01/18 Archive Date: 11/01/18 DOCKET NO. 07-15 905 DATE: November 1, 2018 REMANDED Entitlement to service connection for a spine disability, to include as secondary to a service-connected disability, is remanded. Entitlement to service connection for a left knee disability, to include as secondary to a service-connected disability, is remanded. REASONS FOR REMAND The Veteran served on active duty from May 1979 to May 1983, and from March 1985 to September 1985, with additional time spent in the reserves. This matter is on appeal from October 2005 (left knee) and June 2006 (spine) rating decisions. The Veteran testified before the undersigned Veterans Law Judge during a September 2014 hearing. This matter was remanded by the Board in October 2016. In September 2017, the Board denied the claims. The Veteran appealed the Board’s decision with respect to this issue to the United States Court of Appeals for Veterans Claims (Court). In July 2018, the Court issued an order granting a joint motion to remand (JMR) the appeal of these issues to the Board. The appeal has been returned to the Board for action consistent with the JMR and Court order. In the July 2018 JMR, the parties found that the Board erred when it did not ensure VA complied with its duty to assist to provide adequate medical opinions. Notably, with respect to the spine disability, the parties found that the November 2016 VA examiner did not provide an adequate rationale as to whether the Veteran’s spine disability was aggravated by his service-connected bilateral ankle condition. With respect to the left knee disability, the parties found that the examinations failed to provide adequate rationale regarding eligibility for secondary service connection, specifically whether the Veteran’s left knee disability was caused or aggravated by his service-connected bilateral ankle disabilities or his service-connected pes planus. In this regard, the parties noted that the November 2016 VA examination appeared to rely on the absence of evidence to support its conclusion that the Veteran’s left knee disability was not related to his bilateral ankle disability. Additionally, the parties noted that an August 2005 examiner opined that the Veteran’s pes planus did not aggravate his knee because pes planus would cause, if anything, lateral knee problems, which the Veteran did not show at that time. However, the parties noted that because subsequent examinations showed lateral knee problems, the opinion needed to address whether the left knee disability was aggravated by pes planus since the Veteran began to show lateral knee problems in 2006. In light of the findings in the JMR, addendum opinions are necessary to clarify whether the Veteran’s spine disability was aggravated by his service-connected bilateral ankle condition, and whether the Veteran’s left knee disability was caused or aggravated by his service-connected bilateral ankle disabilities and/or service-connected bilateral pes planus. While on remand, updated VA treatment records should be obtained. The matters are REMANDED for the following action: 1. Obtain the Veteran’s updated VA treatment records. 2. Obtain an addendum opinion from an appropriate clinician regarding whether the Veteran’s spine disability is at least as likely as not aggravated beyond its natural progression by service-connected disability bilateral ankle disability. Any opinion provided must be supported by a complete rationale. 3. Obtain an addendum opinion from an appropriate clinician regarding whether the Veteran’s left knee disability is at least as likely as not proximately due or aggravated beyond its natural progression by his service-connected bilateral ankle and/or pes planus disabilities. The clinician should consider the August 2005 opinion that pes planus would cause, if anything, lateral knee problems. The clinician should also consider the subsequent examinations showing lateral knee problems. See April 2006 VA examination (MRI showing small tear at the body of the lateral meniscus on the left side) and May 2010 VA examination (indicating a diagnosis of tricompartmental osteoarthritis). The Board reminds the clinician that he or she must not rely on an absence of medical evidence in the record to support his or her conclusions. 4. After the above development, and any additionally indicated development, has been completed, readjudicate the issues on appeal. If the benefit sought is not granted to the Veteran’s satisfaction, send the Veteran and his representative a Supplemental Statement of the Case and provide an opportunity to respond. If necessary, return the case to the Board for further appellate review. MICHAEL LANE Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD Department of Veterans Affairs