Citation Nr: 18155465
Decision Date: 12/04/18	Archive Date: 12/04/18

DOCKET NO. 16-41 933
DATE:	December 4, 2018
REMANDED
Service connection for left knee disability is remanded.
Service connection for right knee disability is remanded.
REASONS FOR REMAND
The Veteran served in the Army from August 1968 to August 1970. 
This case comes before the Board of Veterans’ Appeals (Board) on appeal from a rating decision dated November 2013 from the Department of Veterans Affairs (VA) Regional Office (RO) in Chicago, Illinois. 
1. Service Connection for Left and right knee replacement is remanded.
VA is obligated to provide a VA medical examination when there is (1) competent evidence of a current disability or persistent or recurrent symptoms of a disability; (2) evidence establishing that an event, injury, or disease occurred in service, or establishing that certain diseases manifested during an applicable presumptive period for which the claimant qualifies; and (3) an indication that the disability or persistent/recurrent symptoms of a disability may be associated with the Veteran’s service or with another service-connected disability; but (4) insufficient competent medical evidence on file for the Secretary to make a decision on the claim. McLendon v. Nicholson, 20 Vet. App. 79, 81 (2006); see also 38 U.S.C. § 5103A (d)(2) (2012); 38 C.F.R. § 3.159 (c)(4)(i) (2017). 
The Veteran seeks service connection for left and right knee replacements due to bilateral knee arthritis caused by service. In a September 2014 private disability benefits questionnaire (DBQ), the physician indicated the Veteran had a bilateral knee replacement due to arthritis.  The first criterion for a VA examination has therefore been met.
The Veteran contends that his bilateral knee disabilities were caused by running required in basic training. The Veteran recalls having to run daily in full gear, with distances up to 25 miles. The Veteran also stated he has experienced knee pain since his time in service, to include treatment at a private hospital in 1977. The Veteran’s reports of a continuity of symptomatology can satisfy the requirement for evidence that the claimed disability may be related to service, and the threshold for finding that the disability (or symptoms of a disability) may be associated with service is low. McLendon, 20 Vet. App. at 83.  The in-service event and “may be associated” criteria have therefore also been met.  The Board also notes that arthritis is a chronic disease for which service connection is warranted if the disease manifests in service or within the one-year presumptive period.  38 U.S.C. §§ 1101(3), 1112(a)(1); 38 C.F.R. §§ 3.303(b), 3.307(a), 3.309(a).
The Board notes that, although the Veteran submitted the September 2014 DBQ, the DBQ does not contain an opinion as to whether his current bilateral knee disabilities are related to service. Therefore, the Veteran’s claim must be remanded to provide him with a VA examination to determine the etiology of his bilateral knee disabilities.
The matters are REMANDED for the following action:
Schedule the Veteran for a VA examination as to the etiology of his bilateral knee disabilities. The claims file must be sent to the examiner for review.
The examiner should indicate whether it is as least as likely as not (50 percent probability or more) that the Veteran’s knee disabilities are related to his service, to include running daily in full gear with distances up to 25 miles, and whether arthritis manifested in service or within one year of separation from service.
 
Jonathan Hager 
Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD	Laura A. Saracina, Law Clerk