Citation Nr: 18158219 Decision Date: 12/14/18 Archive Date: 12/14/18 DOCKET NO. 16-26 786 DATE: December 14, 2018 REMANDED Entitlement to service connection for a left knee disability is remanded. REASONS FOR REMAND The Veteran served on active duty in the U.S. Army from March 1979 to November 1979, with prior service in the Army National Guard. This matter comes before the Board of Veteran’s Appeals (Board) on appeal from a May 2015 rating decision by the Regional Office (RO). Entitlement to service connection for a left knee disability The Veteran asserts that he has a left knee disability due to his active service. He reports that he has experienced left knee pain since service. See VA examination report, April 2015. A May 1979 service treatment record shows the Veteran reported left knee pain and burning along ridge of tibia, and mild crepitus was found on examination. In an August 1979 discharge physical examination questionnaire, the Veteran denied any “trick or locked knee” or lameness and did not report any on-going knee deficits. The examiner noted no lower extremity abnormalities. The same denials of knee deficits and normal lower extremity examination findings are shown in a March 1988 National Guard enlistment examination and a February 1992 periodic examination. Post-service, none of the Veteran’s VA treatment records are in the claims file. There is only an April 2015 x-ray report relating to the Veteran’s April 2015 VA examination. The Veteran submitted a January 2015 Form 21-4142 authorization in which he identified private treatment at the University of Mississippi Medical Center (UMMC) generally. Subsequently, the RO requested records from UMMC. In January 2015, records were received from UMMC dated from 2014 to 2015, but none of which pertaining to his left knee. In March 2017, after the claim was certified for appeal to the Board, the Veteran submitted a new Form 21-4142 authorization in which he identified treatment at UMMC in August 2013, and from April 2016 to April 2017. In light of all of the above, the Board finds that this matter should be remanded so that the agency of original jurisdiction (AOJ) may make a new request for the Veteran’s private treatment records from UMMC relating to his left knee dated in August 2013, and dated from April 2016 to April 2017. In addition, the Veteran was afforded an April 2015 VA examination. The Veteran reported left knee pain since 1979 (since service). The examiner noted a review of the May 1979 service treatment record, and the fact that the Veteran was employed fulltime as a UMMC police officer and is obese. The examiner noted current findings including, but not limited to, crepitus. The examiner opined that the Veteran’s left knee degenerative joint disease is less likely than not related to his active service. The examiner reasoned that the Veteran’s left knee DJD is more likely a result of his aging, employment, and weight. The examiner also noted that the left knee pain noted in service constitutes “a symptom, not a true diagnosis.” The Board acknowledges that the Veteran’s representative argued in an August 2018 brief that the April 2015 VA examiner’s negative opinion cites to the fact that the Veteran reported left knee pain in service, which pain does not constitute a “true diagnosis,” and that the examiner did not notate that crepitus was found on examination in May 1979. Having considered the above, the Board finds that on remand, the April 2015 VA examiner should be asked to provide an addendum opinion to address the crepitus found on examination back in May 1979. The matter is REMANDED for the following action: 1. Associate with the claims file all of the Veteran’s private treatment records from UMMC dated in August 2013, and from April 2016 to April 2017. 2. After the above development has been completed, obtain an addendum VA medical opinion from the same VA examiner who provided the April 2015 VA examination to address whether it is “at least as likely as not” (probability of 50 percent or more) that the Veteran’s current left knee condition first manifested in service as “crepitus” or is caused by any aspect of his active service. The claims folder must be provided to the examiner for review, including a copy of this remand. Ask the VA examiner to address the notation of crepitus at the time of physical evaluation in May 1979 as well as the subsequent National Guard examinations in 1988 and 1992. See Service treatment records, received February 2015 at p.4 of 17; records received August 2007 at p.19 to 26. Also, Ask the VA examiner to review all new medical evidence associated with the claims file after this remand, such as any relevant UMMC records obtained pursuant to this Board remand. If the same VA examiner who prepared the April 2015 VA examination report is no longer available, obtain a medical opinion from a similarly qualified examiner. Any opinion must be accompanied by a complete rationale. J.W. FRANCIS Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD J. Juliano, Counsel