Citation Nr: 18157851 Decision Date: 12/13/18 Archive Date: 12/13/18 DOCKET NO. 12-04 787A DATE: December 13, 2018 REMANDED Entitlement to service connection for a back disability, to include as secondary to a service-connected right knee disability is remanded. Entitlement to service connection for a right leg disability, to include as secondary to a service-connected right knee disability is remanded. REASONS FOR REMAND The Veteran served on active duty from October 1978 to December 1978. This matter was most recently before the Board in August 2015 and was remanded for additional development. In the interim, service connection was granted for sclerotic change of medial femoral condyles with flattening of articular surface, as well as unicompartment arthroplasty of the right knee. See November 2016 rating decision. For the reasons that follow, the remaining issues must be remanded for additional development. 1. Entitlement to service connection for a back disability, to include as secondary to a service-connected right knee disability is remanded. In August 2015, this issue was remanded to have a VA examiner comment on whether any diagnosed back condition was caused or aggravated by a right knee disability. In October 2016, the Veteran was afforded a VA examination in which he was noted to have diagnoses of degenerative arthritis of the spine and intervertebral disc syndrome. However, the examiner does not address whether the Veteran’s diagnosed back disabilities were aggravated by his now service-connected right knee disabilities. As such, remand is needed for an addendum opinion. 2. Entitlement to service connection for a right leg disability, to include as secondary to a right knee disability is remanded. The October 2016 VA examination notes that the Veteran has no diagnosable condition regarding his right leg beyond his now service-connected right knee disabilities. However, the examiner found that the Veteran had bilateral numbness and weakness with prolonged walking that improved with flexion and sitting. Remand is needed to afford the Veteran a new VA examination to determine whether any numbness or weakness may be related to the claimed back disability. If not related to the back, the examiner should also address what, if any, functional impairments result from the Veteran’s reports of right leg numbness and weakness. An opinion is also needed on whether any functional impairments, even if not formally diagnosed, are related to active duty service or secondary to the Veteran’s service-connected right knee or claimed back disabilities. Saunders v. Wilkie, 886 F.3d 1356 (Fed. Cir. 2018). Since the claims file is being returned it should be updated to include any outstanding VA treatment records. See 38 C.F.R. § 3.159 (c)(2); see also Bell v. Derwinski, 2 Vet. App. 611 (1992). The matters are REMANDED for the following action: 1. Obtain and associate with the claims file all outstanding treatment records regarding the Veteran. 2. Return the claims file to the October 2016 VA examiner, or another appropriate clinician if unavailable, for clarifying addendum opinions on the nature and etiology of the Veteran’s diagnosed degenerative arthritis of the spine and intervertebral disc syndrome. The examiner must opine whether it is at least as likely as not that either diagnosed condition was related to an in-service injury, event, or disease. The examiner must also opine on whether either diagnosed condition was caused or aggravated by (defined as any increase in disability) the Veteran’s now service-connected right knee disabilities. 3. Schedule the Veteran for an examination by an appropriate clinician to determine the nature and etiology of his reports of right leg numbness and weakness. The examiner is asked to delineate all functional impairments related to the Veteran’s reports of right leg numbness and weakness, and if appropriate, provide a formal diagnosis and likely etiology. The examiner must opine whether it is at least as likely as not that any right leg functional impairment is related to an in-service injury, event, or disease. The examiner must also opine on whether any right leg functional impairment was caused or aggravated by (defined as any increase in disability) the Veteran’s now service-connected right knee disabilities. M. E. Larkin Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD Jack S. Komperda, Counsel