Citation Nr: 18148846 Decision Date: 11/08/18 Archive Date: 11/08/18 DOCKET NO. 16-33 183 DATE: November 8, 2018 REMANDED Entitlement to service connection for degenerative arthritis of the spine is remanded. Entitlement to service connection for a left knee condition is remanded. Entitlement to service connection for a right knee condition is remanded. Entitlement to service connection for sinusitis is remanded. Entitlement to service connection for allergic or vasomotor rhinitis is remanded. REASONS FOR REMAND The Veteran served on active duty in the Navy from December 1976 to June 1981. Additionally, the Veteran has had periods of service with the Navy Reserve. These matters are before the Board of Veterans’ Appeals (Board) on appeal from August 2014 and July 2015 rating decisions of a Department of Veterans Affairs (VA) Regional Office (RO). 1. Verifying periods of active duty for training (ACDUTRA) and inactive duty for training (INADUTRA) As indicated above, the Veteran’s record of service includes periods of service with the Navy Reserve. The evidence indicates that the Veteran’s current disabilities of the low back and knees may have been incurred in or aggravated by his Reserve service. When a claim for service connection is based on a period of ACDUTRA a disease or injury must have been incurred or aggravated in the line of duty during the period of ACDUTRA. For a claim based on INACDUTRA, there must be evidence that the claimant became disabled from an injury incurred or aggravated in the line of duty or from an acute myocardial infarction, a cardiac arrest, or a cerebrovascular accident which occurred during such INACDUTRA. See 38 U.S.C. §§ 101(2), (22), (24); 38 C.F.R. § 3.6(a). After reviewing the claims file, the Board finds that remand is warranted to verify the Veteran’s periods of ACDUTRA and INACDUTRA with the Navy Reserve. Currently, the Veteran’s DD Form 214 lists active duty from December 1976 to June 1981, ending on transfer to the Naval Reserve Personnel Center. But the Veteran’s service treatment records also contain records of treatment and examinations from the 1990s. For example, the Veteran’s claims file contains a January 1997 Naval Reserve periodic non-flying physical examination report. Additionally, the Veteran has reported hurting his right knee and back in March 1992 and a service treatment record discusses the injury. However, it is unclear from the record currently whether this injury occurred during a period of ACDUTRA or INACDUTRA. Accordingly, as the Veteran’s ACDUTRA and INACDUTRA dates may be critical to the Veteran’s claims, they must be verified. 2. Entitlement to service connection for degenerative arthritis of the spine is remanded. The Veteran was afforded a VA examination for his thoracolumbar spine in August 2014. The examiner found that it was more likely than not that the Veteran’s current spinal condition was caused by a fracture of the Veteran’s lower spine vertebrae that took place in an auto accident in 1969, prior to the Veteran’s service. In an August 2015 letter, the Veteran stated that he suffered several cracked vertebrae in the 1969 auto collision at age 14, but the condition was not exacerbated until several accidents and incidents related to back strain during his military service. The August 2014 opinion is inadequate as it did not explain whether there was clear and unmistakable evidence of a preexisting back condition and, if so, whether the condition was clearly and unmistakably not aggravated by the Veteran’s service. The Board cannot make a fully-informed decision on the issue of service connection for degenerative arthritis of the spine because no VA examiner has opined whether there is clear an unmistakable evidence of a preexisting condition and, if so, whether there is clear and unmistakable evidence that the preexisting condition was not aggravated beyond its natural progression during active duty service. 3. Entitlement to service connection for left and right knee conditions is remanded. The Board cannot make a fully-informed decision on the issue of service connection for the Veteran’s claimed left and right knee conditions because no VA examiner has opined whether the Veteran has a current disability or disabilities and, if so, whether it is caused by or had its onset during the Veteran’s military service. 4. Entitlement to service connection for sinusitis and allergic or vasomotor rhinitis are remanded. On his October 1976 entrance examination report of medical history, the Veteran reported having hay fever. However, the condition was not clinically noted on entrance into service. In an August 2015 letter, the Veteran acknowledged that he had hay fever prior to his military service but said that after entering service he had more severe chronic allergic rhinitis. The Board cannot make a fully-informed decision on the issue of service connection for the Veteran’s claimed allergic or vasomotor rhinitis because no VA examiner has opined whether allergic rhinitis clearly and unmistakably preexisted the Veteran’s service, and if so, whether such was clearly and unmistakably not aggravated by his service. Also, no examiner has opined as to whether the Veteran has chronic sinusitis that is related to his service. The matters are REMANDED for the following actions: 1. Obtain the Veteran’s complete service personnel records, to include all documents pertaining to his service in the Navy Reserve. Verify all active duty for training (ACDUTRA) and inactive duty training (INACDUTRA) dates for service in the Navy Reserve from June 1981 to the Veteran’s separation from the Navy Reserve. If necessary, a request should be made to the Defense Finance and Accounting Service (DFAS). Document all requests for information as well as all responses in the claims file. 2. Obtain the Veteran’s VA treatment records for the period from September 2015 to the present. 3. After completing the development requested in items 1 and 2, schedule the Veteran for an examination by an appropriate clinician to determine the nature and etiology of any lumbar spine condition. (a.) The examiner must opine whether a back condition clearly and unmistakably (undebatable) preexisted the Veteran’s active duty service. (b.) If the examiner finds it did clearly and unmistakably preexist service, the examiner must opine whether it was clearly and unmistakably not aggravated by active duty service, to include falling to the deck of a naval vessel during PT exercises during active duty or treatment for a lumbar strain. (c.) If the examiner finds that it either did not clearly and unmistakably preexist service, or was not clearly and unmistakably aggravated by service, the examiner must opine whether (1) it is at least as likely as not related to an in-service injury, event, or disease, including falling to the deck of a naval vessel during PT exercises during active duty. A complete rationale for all opinions must be provided. If the clinician cannot provide a requested opinion without resorting to speculation, it must be so stated, and the clinician must provide the reasons why an opinion would require speculation. The clinician must indicate whether there was any further need for information or testing necessary to make a determination. Additionally, the clinician must indicate whether any opinion could not be rendered due to limitations of knowledge in the medical community at large and not those of the particular examiner. 4. After completing the development requested in items 1 and 2, schedule the Veteran for an examination by an appropriate clinician to determine the nature and etiology of any left or right knee condition. The examiner must provide opinions on the following: (a.) Is it at least as likely as not that any right or left knee condition is related to an in-service injury, event, or disease, including falling to the deck of a naval vessel during active duty? (b.) If it is determined that the March 1992 injury of the right knee noted in the Veteran’s service treatment records was during a period of ACDUTRA or INACDUTRA, then opine whether it is at least as likely as not that this injury caused the Veteran’s current right knee disability? A complete rationale for all opinions must be provided. If the clinician cannot provide a requested opinion without resorting to speculation, it must be so stated, and the clinician must provide the reasons why an opinion would require speculation. The clinician must indicate whether there was any further need for information or testing necessary to make a determination. Additionally, the clinician must indicate whether any opinion could not be rendered due to limitations of knowledge in the medical community at large and not those of the particular examiner. 5. After completing the development requested in items 1 and 2, schedule the Veteran for an examination by an appropriate clinician to determine the nature and etiology of any sinusitis or allergic or vasomotor rhinitis. (a.) The examiner should clearly identify all current chronic disabilities of the nose, throat, larynx, and pharynx, including chronic sinusitis or allergic rhinitis. (b.) Then, with respect to each such diagnosed disability, other than allergic rhinitis, the physician should render an opinion, consistent with sound medical judgment, as to whether it is at least as likely as not (a 50 percent or greater probability) that any diagnosed condition is related to the Veteran’s service, to include his treatment for upper respiratory infections during service? (c.) With respect to allergic rhinitis, render opinions as to the following: (i.) Did allergic rhinitis clearly and unmistakably (undebatably) preexist the Veteran’s service? (ii.) If the examiner finds it did clearly and unmistakably preexist service, the examiner must opine whether it was clearly and unmistakably not aggravated by service. (iii.) If the examiner finds that allergic rhinitis either did not clearly and unmistakably preexist service, or was not clearly and unmistakably aggravated by service, the examiner must opine whether it is at least as likely as not related to an in-service injury, event, or disease, including treatment received during service? A complete rationale for all opinions must be provided. If the clinician cannot provide a requested opinion without resorting to speculation, it must be so stated, and the clinician must provide the reasons why an opinion would require speculation. The clinician must indicate whether there was any further need for information or testing necessary to make a determination. Additionally, the clinician must indicate whether any opinion could not be rendered due to limitations of knowledge in the medical community at large and not those of the particular examiner. M. SORISIO Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD R. Dean, Associate Counsel