Citation Nr: 18149039 Decision Date: 11/08/18 Archive Date: 11/08/18 DOCKET NO. 16-07 831 DATE: November 8, 2018 REMANDED The claim of entitlement to service connection a left knee disorder is remanded. The claim of entitlement to service connection for a right knee disorder is remand. The claim of entitlement to service connection for a lumbar spine disorder is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Navy from September 1986 to September 1990 and in the United States Army from November 2011 to December 2012 and from October 2016 to September 2018. The Veteran also has served in the United States Navy Reserve from September 1990 to June 1998, the Army National Guard from June 1998 to February 1999 and from September 2000 to present time. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a September 2014 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO).   1. Entitlement to service connection for a left knee disorder 2. Entitlement to service connection for a right knee disorder 3. Entitlement to service connection for a lumbar spine disorder For all claims, remand is required for an addendum medical opinion. The Veteran claims he has bilateral knee and low back disorders as a result of his service. The Veteran was placed on a permanent physical profile for his knees and back in May 2013 after he was a diagnosed with degenerative disc disease of the lumbar spine in February 2013 and November 2012 radiographic images showed moderate to severe bilateral and tricompartmental degenerative change of the bilateral knees. VA medical opinions were provided in November and December 2015 that addressed whether bilateral knee and back disorders were etiologically related to any of the Veteran’s periods of active duty or a period of active duty for training. However, as noted above, the Veteran most recently served on a period of active duty service from October 2016 to September 2018. His pre-deployment assessment noted active problems of osteoarthritis of the bilateral knees and intervertebral disc degeneration and spinal stenosis of the lumbar spine. As such, pre-existing back and bilateral knee conditions were noted on his entry into his period of active duty from October 2016 to September 2018. Because the Veteran was noted to have back and bilateral knee disorders on entry into service, the presumption of soundness is not for application. 38 U.S.C. § 1111 (2012). Thus, opinions are necessary regarding whether a preexisting injury or disease was aggravated by service. 38 U.S.C. § 1153 (2012). In a July 2017 Report of Medical History, the Veteran indicated that both of his knees were locking and that he was having a hard time standing, sitting down, and walking. He requested reevaluation for his knees. He also indicated that he was suffering from low back pain that radiated to his leg and hip. The Veteran’s STRs indicate that he underwent physical therapy for his knees and back. A September 2017 memorandum from one of the Veteran’s treatment providers indicated that he Veteran’s bilateral knee symptoms were consistent with osteoarthritis and meniscal tears in the bilateral knees. The treatment provider indicated that the Veteran had a history of back pain and that he was currently suffering from back pain. The Veteran had recently been issued a cane to prevent limping that would exacerbate his low back pain. Examinations for the knees and back were provided in April 2018. However, the VA examiner did not opine whether the Veteran’s back and knee disorders were aggravated by the most recent period of active duty service. The Board finds that remand is required for an opinion that addresses this issue. The matters are REMANDED for the following action: 1. Contact the appropriate VA Medical Center and obtain and associate with the claims file all outstanding records of treatment. If any requested records are not available, or the search for any such records otherwise yields negative results, that fact must clearly be documented in the claims file. Efforts to obtain these records must continue until it is determined that they do not exist or that further attempts to obtain them would be futile. The non-existence or unavailability of such records must be verified and this should be documented for the record. Required notice must be provided to the Veteran and his or her representative. 2. After any additional records are associated with the claims file, obtain an addendum opinion regarding the etiology of the Veteran’s low back and bilateral knee disorders from a VA examiner. The entire claims file must be made available to and be reviewed by the examiner. If an examination is deemed necessary, it shall be provided. An explanation for all opinions expressed must be provided. The examiner must provide an opinion regarding whether it is at least as likely as not (50 percent or greater probability) that the Veteran’s bilateral knee disorders and lumbar spine disorder were aggravated beyond their natural progression during active service from October 2016 to September 2018. The examiner must address the most recent STRs from the 2016 to 2018 period of service, to include the July 2017 Report of Medical History. K. MILLIKAN Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD Steve Ginski, Associate Counsel