Citation Nr: 18147657 Decision Date: 11/06/18 Archive Date: 11/05/18 DOCKET NO. 14-41 308A DATE: November 6, 2018 REMANDED Entitlement to service connection for a left knee disability is remanded. REASONS FOR REMAND The Veteran served on active duty from November 1980 to November 1983. This appeal to the Board of Veterans’ Appeals (Board) is from a June 2013 rating decision by a Department of Veterans Affairs (VA) Regional Office (RO). Entitlement to service connection for a left knee disability is remanded. The Veteran reported that his left knee pain began in service while being in a cold climate and is related to his service-connected left first metatarsal disability. See May 2013 VA examination; December 2014 substantive appeal. Military records reflect he was a warehouse clerk during service. See DD 214. While a VA examiner opined it was less likely than not that the Veteran’s left knee osteoarthritis was related to his primary foot condition, her opinion did not discuss aggravation or a direct relation to his military service. As a result, remand for a new examination is necessary. The matter is REMANDED for the following action: 1. The AOJ should obtain copies of VA treatment records from May 2016 to the present. 2. After the above development has been completed, the AOJ should arrange for a VA examination of the Veteran to determine the nature and likely cause of his left knee disability. The examiner should review the claim file (including this remand) and note such review was conducted. Based on review of the record and examination of the Veteran, the examiner should provide an opinion with detailed rationale that responds to the following: (a.) Please identify, by diagnosis, left knee disabilities present during the appeal period (from April 2013). (b.) For each disability diagnosed, the examiner should provide an opinion and explanation as to whether it is at least as likely as not (50% or greater probability) that the disability was either caused or aggravated by the Veteran’s service-connected left first metatarsal disability. The examiner must discuss the Veteran’s report that he had pain related to the onset of his left foot disability in service. The opinion must address whether the disability increased in severity beyond its natural progression (i.e., was aggravated). If aggravation is found, please identify to the extent possible the baseline level of disability prior to the aggravation. (c.) For each disability diagnosed, the examiner should provide an opinion and explanation as to whether it is at least as likely as not (50% or greater probability) that the disability was incurred in or otherwise related to the Veteran’s military service. The examiner must discuss the Veteran’s report that he had pain in service related to the onset of his left foot disability and being in a cold climate as a warehouse clerk. Rationales merely listing facts or relying solely on the absence of evidence will not be considered adequate and may result in the claim file being returned to the examiner. 3. If upon completion of the above action the issue remains denied, the case should be returned to the Board after compliance with appellate procedures. E. I. VELEZ Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD J. Sandler, Associate Counsel