Citation Nr: 18148670 Decision Date: 11/08/18 Archive Date: 11/07/18 DOCKET NO. 16-39 055 DATE: November 8, 2018 REMANDED Service connection for left knee patellofemoral syndrome and osteoarthritis, to include as secondary to service-connected right knee, is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Marine Corps from August 1974 to February 1977. 1. Service connection for left knee patellofemoral syndrome and osteoarthritis, to include as secondary to service-connected right knee is remanded. The Veteran asserts that his left knee disorder is secondary to his service-connected right knee due to over compensation. Additionally, the Board notes that his service treatment records (STR) show an entry for swollen knees in September 1975. The Board observes that the Veteran’s claim for service connection for left knee was denied in a February 2016 rating decision. In that decision, VA stated that the Veteran failed to attend a January 2016 VA examination for his knees. However, the evidence of record shows that the Veteran was never notified of a January 2016 examination. When he was notified for the July 2016 examination, he attended. The July 2016 examination was the basis for the grant of service connection for his right knee. However, the examiner’s review of the evidence regarding the left knee omitted his September 1975 STR entry of swelling in both knees and did not provide an adequate opinion. In the opinion, the examiner discussed a post-service injury reported to him by the Veteran, and concluded that the left knee “appears to be distinctly different from his right knee condition and not the result of his previous knee problems which occurred while on active duty.” The exact same rationale was provided for both the direct service connection opinion and the secondary service connection opinion. No further explanation of how the previous knee problems from active duty affected the left knee or how, or if, the Veteran’s service-connected right knee affected his left knee. When VA undertakes to provide a VA examination or obtain a VA opinion, it must ensure that the examination or opinion is adequate. For an opinion to be adequate, it must include consideration of the Veteran’s statements, be based on accurate factual premises, and contain a rationale sufficient to support its conclusions. See Barr v. Nicholson, 21 Vet. App. 303, 311 (2007); see also Kowalski v. Nicholson, 19 Vet. App. 171, 179 (2005) (a VA examination must be based on an accurate factual premise). If an examiner does not consider the Veteran’s history, complaints, and lay statements, any negative opinion is inadequate for rating purposes. See Dalton v. Nicholson, 21 Vet. App. 23 (2007); Nieves-Rodriguez v. Nicholson, 22 Vet. App. 295 (2008). Finally, the Court has determined in Correia v. McDonald, 28 Vet. App. 158 (2016), that the final sentence of 38 C.F.R. § 4.59 requires VA examinations to include range of motion joint testing for pain on both active and passive motion, in weight-bearing and nonweight-bearing and, if possible, with range of motion measurements of the opposite undamaged joint. Based on the foregoing, a remand is necessary to obtain a VA examination which provides a medical opinion regarding the Veteran’s claim for service connection for his left knee and complies with the required testing described in Correia. The matter is REMANDED for the following action: 1. Schedule the Veteran for an examination by an appropriate clinician to determine the nature and etiology of any left knee disability, to include patellofemoral syndrome and osteoarthritis. The examiner must opine whether it is at least as likely as not related to an in-service injury, event, or disease, including the September 1975 STR entry for “mild soft tissue vs bursal swelling.” Regarding any diagnosis for left knee arthritis, the examiner must opine whether it at least as likely as not (1) began during active service, (2) manifested within one year after discharge from service, or (3) was noted during service with continuity of the same symptomatology since service. Regarding secondary service connection, the examiner must opine whether it is at least as likely as not that the Veteran’s left knee disabilities are (1) proximately due to his service-connected disabilities, particularly his right knee, or (2) aggravated beyond its natural progression by any service-connected disability. (Continued on the next page)   2. Then, the record should again be reviewed. If any benefit sought on appeal remains denied, the Veteran and his representative should be furnished with a supplemental statement of the case and be given the opportunity to respond. T. REYNOLDS Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD L. Nelson, Associate Counsel