Citation Nr: 18150749 Decision Date: 11/15/18 Archive Date: 11/15/18 DOCKET NO. 16-52 001 DATE: November 15, 2018 REMANDED Entitlement to service connection for a left knee disorder is remanded. REASONS FOR REMAND The Veteran served on active duty from April 1965 to April 1967, with service in Vietnam. He served in the United States Army. Entitlement to service connection for a left knee disorder First, remand is required to attempt to obtain additional records. VA has a duty to assist claimants to obtain evidence needed to substantiate a claim. 38 U.S.C. § 5103A (2012); 38 C.F.R. § 3.159(c) (2018). This includes making as many requests as are necessary to obtain relevant records from a Federal department or agency. 38 C.F.R. § 3.159(c)(2). This also includes making reasonable efforts to obtain relevant private medical records. 38 C.F.R. § 3.159(c)(1). In a 2016 VA PTSD VA examination, it was noted that the Veteran was status-post knee replacement. In a March 2016 VA record, it was noted that the Veteran underwent a left knee replacement in 2004 with a history of left tibial plateau scraping in 2002. VA treatment records indicated that the Veteran had a left total knee replacement (TKR) in 2005. In his July 2016 Notice of Disagreement (NOD), the Veteran indicated that he underwent knee replacement in 2004. No records of left knee treatment, total knee replacement, or left tibial plateau scraping are associated with the claims file. The VA treatment records associated with the claims file are from November 2007 to November 2010, and from February 2016 to May 2016. There are no private treatment records. Therefore, it appears there may be missing records. Second, remand is required for an examination. 38 U.S.C. § 5103A(d); 38 C.F.R. § 3.159(c)(4). An examination is necessary in a service connection claim where the information and evidence of record does not contain sufficient competent medical evidence to decide the claim, but contains: (1) competent evidence of diagnosed disability or symptoms of disability, (2) establishes that the Veteran suffered an event, injury or disease in service, or has a presumptive disease during the pertinent presumptive period, and (3) indicates that the claimed disability may be associated with the in-service event, injury, or disease, or with another service-connected disability. 38 C.F.R. § 3.159(c)(4); McLendon v. Nicholson, 20 Vet. App. 79, 83-86 (2006) (noting that the third element requires only that the evidence “indicates” that there “may” be a nexus between the current disability or symptoms and active service, including credible lay evidence of continuous symptoms). Here, there is a diagnosis of status post left knee replacement. In his July 2016 notice of disagreement, the Veteran stated that he worked on his knees often during service and that this left knee bothered him for years. In a January 2016 statement, the Veteran reported while he was stationed in Vietnam he had problems with his knees due to the constant kneeling and working on helicopters. Thus, there is a current diagnosis, with evidence of in-service symptoms and symptoms after service. Accordingly, remand is required for an examination. The matter is 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, to include all records dated prior to November 2007 from 2010 to 2016, and on and after May 2016. 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 representative. 2. Contact the Veteran and afford him the opportunity to identify by name, address and dates of treatment or examination any relevant medical records. Subsequently, and after securing the proper authorizations where necessary, make arrangements to obtain all the records of treatment or examination from all the sources listed by the Veteran which are not already on file. All information obtained must be made part of the file. All attempts to secure this evidence must be documented in the claims file, and if, after making reasonable efforts to obtain named records, they are not able to be secured, provide the required notice and opportunity to respond to the Veteran and his representative. 3. After any additional records are associated with the claims file, schedule the Veteran for a VA examination to assist in determining the etiology of all left knee disorders. The entire claims file must be made available to and be reviewed by the examiner. Any indicated tests and studies must be accomplished and all clinical findings must be reported in detail and correlated to a specific diagnosis. An explanation for all opinions expressed must be provided. The examiner must elicit from the Veteran a full history and/or description of his active service. (a.) For each currently diagnosed left knee disorder, the examiner must opine whether is it at least as likely as not (a 50 percent or greater probability) that the disorder manifested in or is otherwise related to the Veteran’s military service. The examiner must consider the Veteran’s lay statements describing his in-service symptoms, in-service duties as a helicopter mechanic, and his post-service symptoms. K. MILLIKAN Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD P. Nguyen, Associate Counsel