Citation Nr: 18150394 Decision Date: 11/15/18 Archive Date: 11/15/18 DOCKET NO. 12-10 237 DATE: November 15, 2018 REMANDED Entitlement to service connection for low back disability is remanded. Entitlement to service connection for left knee disability is remanded. Entitlement to service connection for left ankle disability is remanded. REASONS FOR REMAND The Veteran served on active duty from September 1960 to August 1963. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from an April 2010 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO). In that decision, the RO denied entitlement to service connection for low back, left knee, and left ankle disabilities. In September 2017, the Board, in pertinent part, denied entitlement to service connection for low back, left knee, and left ankle disabilities. The Veteran appealed the September 2017 Board’s decision to the United States Court of Appeals for Veterans’ Claims (Court). In an April 2018 Joint Motion for Remand, the parties vacated and remanded the portion of the Board’s September 2017 decision that denied entitlement to service connection for low back, left knee, and left ankle disabilities. In an April 2018 Order, the Court granted the April 2018 Joint Motion for Remand. This appeal has been advanced on the Board’s docket pursuant to 38 C.F.R. § 20.900 (c). 38 U.S.C. § 7107 (a)(2). Entitlement to service connection for low back, left knee, and left ankle disabilities is remanded. In an April 2018 Joint Motion for Remand, the parties vacated and remanded the portion of the Board’s September 2017 decision that denied entitlement to service connection for low back, left knee, and left ankle disabilities. The parties agreed that a remand for readjudication is required because the Board’s decision relied upon inadequate medical opinions. Here, the evidence shows current diagnoses of arthritis and in-service injuries of the low back, left knee, and left ankle. While arthritis was not noted upon separation from or many years after service, the Veteran reports having experienced low back, left knee, and left ankle problems continuously since service. The medical opinions of record indicate that the Veteran’s current diagnoses are not related to service as his lack of treatment for many years after service undermines his reported continuity of symptoms since service. The parties to the Joint Motion for Remand highlighted that the fact that the Veteran did not seek medical treatment for several years despite experiencing symptoms does not render his statements as to continuity of symptomatology less probative. See Horn v. Shinseki, 25 Vet. App. 231, 239 n. 7 (2012). The parties further highlighted that the Veteran may have had continuous symptoms and not sought treatment until such time as he believed it was necessary. Accordingly, the parties agreed that the medical opinions of record are inadequate and additional medical opinions should be obtained. Therefore, pursuant to these instructions, the matters are REMANDED for the following action: The claims folder should be referred to an appropriate physician, to determine the etiology of the Veteran’s low back, left knee, and left ankle disabilities, to include arthritis. The claims file, to include a copy of this Remand, must be made available to the physician for review. The physician must opine whether it is at least as likely as not (50 percent probability or more) that the Veteran’s diagnosed low back, left knee, and left ankle disabilities had their onset in service, are otherwise related to service, or whether any arthritis manifested within one year of his separation from service. The physician should not rely solely on the absence of medical records as a basis for the opinion and should consider the Veteran’s statements, particularly his reports of continuity of symptoms. (Continued on the next page)   The physician is advised that the Veteran is competent to report low back, left knee, and left ankle problems in and since service. The physician is further advised that the fact that the Veteran did not report symptoms upon separation from or many years after service does not diminish the credibility of his report of continuity of symptoms, because the Veteran may have had continuous symptoms and not sought treatment until such time as he believed it was necessary. Jonathan Hager Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD A. Castillo, Associate Counsel