Citation Nr: 18155454
Decision Date: 12/04/18	Archive Date: 12/04/18

DOCKET NO. 17-33 326
DATE:	December 4, 2018
REMANDED
Entitlement to service connection for a bilateral knee disability, to include as secondary to the Veteran’s service-connected low back disability, is remanded.

REASON FOR REMAND
The Veteran served on active duty in the United States Marine Corps from June 2006 to August 2014.  
This matter comes before the Board of Veterans Appeals (Board) from an October 2014 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO) in Winston-Salem, North Carolina.  
Entitlement to service connection for bilateral knee disability is remanded.
The Veteran contends that he injured his knees in service during a 2009 weight-lifting incident.  He further contends that his service-connected low back disability aggravates his bilateral knee conditions. 
The Veteran was afforded two separate VA examinations.  In April 2015, the VA examiner diagnosed the Veteran with a knee strain in both knees.  In September 2016, another VA examination was conducted to address the possibility of the Veteran’s knee disability being due or caused by his service-connected low back disabilities on a secondary basis.  However, neither examiner provided an opinion as to whether the Veteran’s service-connected low back disability had aggravated his bilateral knee disability.  Accordingly, the Board finds that the evidence of record is incomplete and further development is required for the VA to fulfill the duty to assist the Veteran.  
An addition medical opinion is therefore necessary. 
The matter is REMANDED for the following action:
1. Contact the Veteran in order to have him identify the names and addresses of all health care providers who have treated him for the issues on appeal.  The Veteran should also be notified that he may submit evidence or treatment records to support his claim. The Board is particularly interested any outstanding records of VA medical treatment (generated after the last treatment notes of record). The AOJ should attempt to obtain any such records.  All efforts to obtain such records should be documented in the claims folder.  All available records should be associated with the Veteran’s VA claims folder.
2. Then, schedule the Veteran for a VA examination to determine the nature and likely etiology of the Veteran’s bilateral knee disability.  The Veteran’s claims folder must be made available to the examiner.  All diagnostic testing deemed to be necessary by the examiner should be accomplished.  
The examiner should indicate whether it is at least as likely as not (50 percent probability or greater) that the Veteran’s diagnosed bilateral knee disability had causal origins in service or is otherwise related to the Veteran’s active duty service. 

The examiner should also comment on whether it is at least as likely as not, (50 percent probability or greater), that the bilateral knee disability was (A) caused or (B) aggravated (permanently worsened beyond normal progression) by the service-connected low back disability. 
A clear rationale for all opinions must be provided and a discussion of the facts and medical principles involved would be of considerable assistance to the Board.
 

 
M. Donohue
Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD	T. Jones Council, Associate Counsel