Citation Nr: 18154912 Decision Date: 12/04/18 Archive Date: 11/30/18 DOCKET NO. 14-38 951 DATE: December 4, 2018 REMANDED The appeal for entitlement to service connection for patellofemoral syndrome of the right knee is remanded. REASONS FOR REMAND The Veteran had active service from July 1999 to July 2005. This was followed by additional service in the National Guard. In April 2018, the Veteran was scheduled for a videoconference hearing before a Veterans Law Judge. He failed to report. There is no indication he has requested the hearing be rescheduled, and the Board will proceed with consideration of his appeal. Service Connection for Patellofemoral Syndrome of the Right Knee The Veteran contends that he has a current right knee disability that is the result of an injury he sustained during active service. He states this injury occurred on an obstacle course during basic training in 1999, and notes he also had right knee surgery during service. He asserts that he experiences constant right knee pain that can become severe with any touch or contact to the knee, and that he has experienced these symptoms for the entire 15 years since the initial injury. Although the service treatment records are negative for reports or treatment of a right knee injury during basic training, they do contain several references to this injury. Furthermore, he was seen for right knee pain on several occasions, and eventually underwent arthroscopic surgery for bursa excision in January 2001. He continued to experience right knee pain after this surgery, and in September 2001 he received an injection for treatment of prepatellar bursitis. The current medical evidence includes the report of a June 2013 VA examination. This resulted in a current diagnosis of patellofemoral syndrome of the right knee. However, the June 2013 examiner opined that it was less likely than not the Veteran’s current right knee disability was incurred due to active service. In the reasons and bases for this opinion, the examiner alludes to the vagueness of a lay statement regarding the in-service injury and speculates it may actually refer to a second post-service injury. The examiner adds that there are no post-service medical records that show the development of a chronic right knee disability. He also failed to address the Veteran’s reports at the examination of worsening knee pain ever since active service. The Board finds that the June 2013 opinion is inadequate for three reasons. First, a medical opinion based solely on the absence of in-service treatment or findings will be deemed inadequate. Buchanan v. Nicholson, 451 F.3d 1331 (Fed. Cir. 2006); Jones v. Shinseki, 23 Vet. App. 382, 390 (2010). This opinion seems to rely heavily on both the absence of service treatment records that explain the reason for the 2001 surgery as well as post-service medical records that confirm the existence of a chronic disability prior to 2013. Second, the examiner speculates that the lay statement may refer to a second post-service injury, but the Board finds no credible evidence to support such speculation. Finally, the examiner failed to address the Veteran’s reports of continuous knee pain ever since active service. In light of the foregoing, the Board concludes that the Veteran should be scheduled for an additional examination to obtain a more thorough opinion regarding the etiology of the claimed right knee disability.   The matter is REMANDED for the following action: Schedule the Veteran for an examination by an appropriate clinician to determine the nature and etiology of any right knee disability. If possible, this should be conducted by someone who has not previously examined the Veteran. The examiner is to provide an opinion whether it is at least as likely as not related to an in-service injury, event, or disease, including but not limited to the right knee injury on the obstacle course during basic training and/or the January 2001 surgery. In providing this opinion, the examiner should assume that the Veteran has not had a post-service injury to the right knee unless there is specific medical evidence to the contrary. The lack of in-service confirmation of the obstacle course injury by medical records or the lack of post-service medical records with evidence of a chronic right knee disability may not form the sole basis for any negative opinion. The Veteran’s contention that he has experienced constant right knee pain since active service must also be addressed. (Continued on the next page)   If the examiner is unable to provide any portion of the requested opinion without resort to speculation, the reasons and bases for this is to be provided, and any outstanding evidence that might enable the opinion to be provided should be identified. Paul Sorisio Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD J. L. Prichard, Counsel