Citation Nr: 18151127 Decision Date: 11/19/18 Archive Date: 11/16/18 DOCKET NO. 16-38 965 DATE: November 19, 2018 REMANDED Entitlement to service connection for a right knee disability is remanded. REASONS FOR REMAND The Veteran had active service in the United States Army from September 1987 to September 1991. This matter is before the Board of Veterans’ Appeals (Board) on appeal from a November 2014 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO). Entitlement to service connection for a right knee disability is remanded. The Veteran has a current right knee disability of degenerative joint disease. The Veteran’s service treatment records contain left knee complaints. They are absent for right knee injuries or complaints. However, in a statement received in April 2015, the Veteran asserts that it was his right knee that was injured in service rather than his left knee. The Board notes that the Veteran had service in Southwest Asia, and finds his testimony regarding his right knee injury credible as it is internally consistent with his statements in the claims file and highly plausible in light of his in-service duties. 38 U.S.C. § 1154(a). Moreover, the Veteran’s medical records are inconsistent regarding his knees, when surgeries may have been performed, and whether the Veteran had any knee injuries or diseases that pre-existed service. The Veteran’s December 1986 report of medical examination for enlistment does not reflect any right knee problems and none were reported on the corresponding report of medical history. Additionally, his service records indicate a left knee surgery. Yet, his private medical records document right knee surgery. The Board also acknowledges a VA examination was performed in November 2014, but it only addressed the Veteran’s left knee disabilities. As such, the Board finds that a new VA examination is warranted to accurately assess the Veteran’s right knee disabilities and the relationship to service. The matter is REMANDED for the following actions: 1. Obtain any outstanding VA treatment records. All requests and responses for the records must be documented. If any identified records cannot be obtained, notify the Veteran of the missing records, the efforts taken, and any further efforts that will be made by VA to obtain such evidence, and allow him an opportunity to provide the missing records. 2. After associating any outstanding records with the claims file, schedule the Veteran for a VA examination to assess the Veteran’s right knee and identify all current disorders of the right knee. Note: the questions below are divided into two categories – pre-existed service (08/22/16 Med Treatment Record – Non-government) and did NOT pre-exist service. Please answer, as appropriate. If a disability is diagnosed that undebatably pre-existed the Veteran’s service, the examiner should state whether such condition constitutes a congenital or developmental defect or a disease (per VAOPGCPREC 82-90, in general, a congenital abnormality that is subject to improvement or deterioration is considered a disease). (a.) If the disability is considered a defect, was there additional disability due to disease or injury superimposed upon such defect during service? If so, please identify the additional disability and state whether it began during the Veteran’s active service. (b.) If the Veteran’s disability is a disease, was it aggravated beyond the natural progression during his military service? (c.) If the disability is NOT a congenital or developmental defect or disease, provide an opinion whether the disorder did NOT increase in severity in service? For each currently diagnosed right knee disability that did NOT that pre-existed service, opine as to whether it is at least as likely as not (50 percent or greater probability) that such is related to a disease or injury in service; (Continued on the next page)   A comprehensive rationale for all opinions must be provided. All pertinent evidence, including both lay and medical, should be considered. If an opinion cannot be provided without resorting to speculation, the examiner must explain why this is so and state whether the need to speculate is due to a deficiency in the state of general medical knowledge (no one could respond given medical science and the known facts), the record (additional facts are required), or the examiner (does not have the knowledge or training). Paul Sorisio Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD G. Morales, Associate Counsel