Citation Nr: 18157203 Decision Date: 12/13/18 Archive Date: 12/11/18 DOCKET NO. 16-60 020 DATE: December 13, 2018 REMANDED Entitlement to service connection for arthritis of the right knee is remanded. REASONS FOR REMAND The Veteran served honorably in the United States Army from September 1981 to September 2001. This case comes before the Board of Veterans’ Appeals (the Board) on appeal from an August 2015 rating decision by a Department of Veteran’s Affairs (VA) regional office (RO). In a prior, final decision issued in September 2012, VA denied the Veteran’s claim of service connection for arthritis of the right knee. Once a decision has become final, new and material evidence must be submitted. In connection with his claim to reopen, the Veteran has submitted a private physician’s statement supporting a link between his service and his current knee disorder. Thus, the Board finds that new and material evidence has been received sufficient to reopen his previously denied claim. 38 C.F.R. § 3.156(a); Shade v. Shinseki, 24 Vet. App. 110, 117-18 (2010); Justus v. Principi, 3 Vet. App. 510, 513 (1992). 1. Entitlement to service connection for arthritis of the right knee VA is obliged to provide an examination when the record contains competent evidence that the claimant has a current disability or signs and symptoms of a current disability, the record indicates that the disability or signs and symptoms of disability may be associated with active service; and the record does not contain sufficient information to make a decision on the claim. 38 U.S.C. § 5103A(d); McLendon v. Nicholson, 20 Vet. App. 79 (2006). The threshold for finding a link between current disability and service is low. Locklear v. Nicholson, 20 Vet. App. 410 (2006); McLendon, 20 Vet. App. at 83. Here, although the RO obtained an opinion in March 2016 regarding the Veteran’s right knee, the Board finds that the March 2016 VA opinion is inadequate. While the examiner did review the claims file, she did not examine the Veteran herself. Further, and more importantly, she failed to specifically and individually address the secondary issues of causation and aggravation, nor did she provide an opinion as to direct service connection. Accordingly, additional evidentiary development is required prior to the Board rendering a decision on the issue currently on appeal. Specifically, further medical evidence is required to determine whether the Veteran’s right knee arthritis is related to his service or, alternatively, whether that right knee arthritis is secondary to the Veteran’s service-connected osteoarthritis of the lumbar spine. The matter is REMANDED for the following action: 1. Obtain any outstanding VA or private treatment records and associate them with the Veteran’s claims file. Any negative response received should be associated with the file. 2. Thereafter, arrange for a VA examination and opinion to address the etiology of the Veteran’s claimed arthritis of the right knee and ask the examiner to respond to the following questions: a) Is it at least as likely as not (50 percent probability or greater) that the Veteran’s right knee arthritis is etiologically related to his service? Please specifically consider the Report of Medical History recorded at the Veteran’s separation from the military. Likewise, note the Veteran’s treatment for his knee on March 1, 1993, July 25, 1998, and August 4, 1998 while in service. b) Is it at least as likely as not (50 percent probability or greater) that the Veteran’s right knee arthritis was caused by a service-connected disability? Please consider and discuss as necessary the Veteran’s service-connected osteoarthritis of the lumbar spine and its expressed symptoms. c) Is it at least as likely as not that the Veteran’s right knee arthritis was aggravated (permanently worsened) by a service-connected disability? Please consider and discuss as necessary the Veteran’s service-connected osteoarthritis of the lumbar spine and its expressed symptoms. The claims file must be made available to and reviewed by the examiner. All indicated tests and studies must be undertaken. The examiner must explain the rationale for all opinions rendered, citing to supporting factual data and/or medical literature, as appropriate. The examiner is informed that aggravation is defined for legal purposes as a chronic worsening of the underlying disorder versus a temporary flare-up of symptoms, beyond its natural progression. If aggravation is present, the examiner should indicate, to the extent possible, the approximate level of arthritis of the right knee (i.e., a baseline) before the onset of the aggravation. CAROLINE B. FLEMING Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD A. Stuedemann, Associate Counsel