Citation Nr: 18159583 Decision Date: 12/19/18 Archive Date: 12/19/18 DOCKET NO. 17-02 200 DATE: December 19, 2018 REMANDED Entitlement to service connection for left knee disability, to include as secondary to service-connected right knee condition, is remanded. Entitlement to service connection for radiculopathy of the left lower extremity, to include as secondary to service-connected right knee condition, is remanded. Entitlement to service connection for radiculopathy of the right lower extremity, to include as secondary to service-connected right knee condition, is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Air Force from July 1972 to July 1976. Left Knee and Bilateral Radiculopathy of the Lower Extremities The Veteran contends that his left knee condition, and radiculopathy of the right and left lower extremities are related to his active military service, to include being caused by or aggravated by his service-connected right knee condition. In September 2016, the Veteran received a VA examination for his claimed conditions. The examiner noted the Veteran had joint osteoarthritis in his left knee. The examiner then provided it was only recently that the Veteran was favoring his right knee and putting more wear and tear on his left knee. The examiner explained it was only a few years ago that the Veteran put more stress on his left knee. The examiner then stated that imaging performed in 2012 showed degenerative joint disease (DJD) in both knees and thus his left knee DJD is due to his weight and aging. The examiner further stated it appears he had mild DJD on the right knee and less on the left. Regarding the Veteran’s claims for lower extremity radiculopathy, also claimed as chronic lumbosacral radiculitis, the examiner opined that the Veteran’s bilateral chronic lumbosacral radiculitis is less likely due to or the result of the Veteran’s service-connected right knee osteoarthritis. The examiner rationalized that there were no clear findings of lumbosacral radiculopathy. The examiner further stated that osteoarthritis is associated with degenerative joint disease or “wear and tear” arthritis, which can occur more with degenerative changes related to aging. The Board finds the September 2016 VA opinions are inadequate to fairly adjudicate the Veteran’s claims for service connection. Although the examiner stated that the Veteran’s DJD of the left knee was due to weight and aging, the examiner also provided that the Veteran was putting more “wear and tear” as a result of his right knee, and thus, an opinion on whether the Veteran’s right knee disability aggravates his left knee DJD should have been provided. Further, the Veteran’s service treatment records show multiple complaints for left knee pain and therefore, an opinion regarding whether his left knee condition is directly related to his service should have also been provided. Regarding the Veteran’s bilateral radiculopathy, the Board notes that in December 2016, the Veteran’s private physician provided a letter that states he had been treating the Veteran for chronic lumbosacral radiculitis. Additional private medical records also show treatment for lower extremity radiculopathy. Therefore, the Board finds the medical evidence appears to show that the Veteran now has a current diagnosis of chronic lumbosacral radiculitis and/or bilateral lower extremity radiculopathy, and a remand is needed for consideration of the December 2016 private medical record. Given all of the above, the Board finds that a remand is required in order to obtain new examinations and opinions addressing the nature and etiologies of the claimed conditions. See McLendon v. Nicholson, 20 Vet. App. 79 (2006). The matters are REMANDED for the following action: 1. Obtain and associate with the Veteran’s electronic claims file any outstanding VA treatment records and private medical records relevant to the Veteran’s claims. 2. After all outstanding records have been associated with the file, schedule the Veteran for a VA examination to determine the etiology of the Veteran’s left knee condition and bilateral radiculopathy of the lower extremity conditions. The record and a copy of this Remand must be made available to the examiner. Following a review of the entire record, the Veteran’s competent lay statements, as well as the Veteran’s report regarding the onset and progression of his current symptomatology, the examiner should opine as to the following: a) Whether it is at least as likely as not (50 percent probability or more) that the Veteran’s left knee condition is due to his service-connected right knee disability. b) Whether it is at least as likely as not (50 percent probability or more) that the Veteran’s left knee condition is aggravated by his service-connected right knee disability. “Aggravation” is defined as any worsening beyond the natural progression of the disability. c) If the Veteran’s left knee condition is NOT due to or aggravated by his service-connected right knee disability please opine whether it is at least as likely as not (i.e., a 50 percent or greater probability) that the Veteran’s left knee condition had its onset during, or is otherwise related to, his active duty service, to include his October 1974 complaint of bilateral knee pain and left knee giving out, and his February 1975 complaint of left knee pain. d) Whether it is at least as likely as not (50 percent probability or more) that the Veteran’s bilateral lower extremity radiculopathy is due to his service-connected right knee disability. e) Whether it is at least as likely as not (50 percent probability or more) that the Veteran’s bilateral lower extremity radiculopathy is aggravated by his service-connected right knee disability. “Aggravation” is defined as any worsening beyond the natural progression of the disability. f) If the Veteran’s bilateral lower extremity radiculopathy is NOT due to or aggravated by his service-connected right knee disability please opine whether it is at least as likely as not (i.e., a 50 percent or greater probability) that the Veteran’s bilateral radiculopathy of the lower extremity had its onset during, or is otherwise related to, his active duty service. In offering any opinion, the examiner must consider the full record, to include the lay statements regarding in-service incurrence, and the opinion should reflect such consideration. A clearly-stated rationale for any opinion offered should be provided and must not be based solely on the lack of any in-service records. If the examiner is unable to provide an opinion without resort to speculation, he or she should explain whether the inability is due to the limits of the examiner’s medical knowledge, medical knowledge in general or there is evidence that, if obtained, would permit the opinion to be provided. JENNIFER HWA Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD J. Negron, Associate Counsel