Citation Nr: 18161298 Decision Date: 12/31/18 Archive Date: 12/31/18 DOCKET NO. 17-11 523 DATE: December 31, 2018 REMANDED Entitlement to service connection for a left knee disorder is remanded. Entitlement to service connection for a right knee disorder is remanded. Entitlement to service connection for a back disorder is remanded. Entitlement to service connection for a left eye disorder is remanded. Entitlement to service connection for a right eye disorder is remanded. REASONS FOR REMAND The Veteran served on active duty from September 1971 to December 1975. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a rating decision issued in June 2015 by a Department of Veterans Affairs (VA) Regional Office (RO). The Board notes that the Veteran was previously represented by attorney, Vincent J. Mazzurco. However, in a June 2018 letter, the Veteran revoked such representation. Thus, the Veteran is considered to be unrepresented at the present time. 38 C.F.R. § 14.631(f). 1. Entitlement to service connection for a left knee disorder is remanded. 2. Entitlement to service connection for a right knee disorder is remanded. 3. Entitlement to service connection for a back disorder is remanded. The Veteran contends that his currently diagnosed bilateral knee disorder and back disorder (see June 2015 VA examinations) are directly related to his military service. Specifically, the Veteran alleges that such disorders resulted from the exercises and training he had to endure for basic training. In this regard, the Veteran’s service treatment records (STRs) reveal that in October 1973, the Veteran was given a provisional diagnosis of low back pain. Additionally, in his November 1975 Report of Medical History, the Veteran reported that he had or was then having swollen or painful joints, recurrent back pain, and “trick” or locked knee, and it was noted that he had painful knees and legs after exercising. As an initial matter, the Board finds that a remand is necessary to associate missing VA treatment records with the Veterans claims file. In this regard, the February 2017 statement of the case indicates that VA treatment records dating from August 31, 2015 to January 30, 2017 have been considered. However, such records have not been associated with the record. Thus, while on remand, the Agency of Original Jurisdiction (AOJ) should obtain and associate with the claims file all outstanding VA treatment records dating from August 2015 to present. Furthermore, in June 2015, the Veteran was afforded VA examinations to determine the nature and etiology of his bilateral knee disorder and back disorder. At such time, the examiner diagnosed him with bilateral knee mild osteoarthritis and degenerative disc disease (DDD) of the lumbosacral spine, and opined that such disorders were not at least as likely as not incurred in or caused by knee injuries in service or the lower back strain during service. Specifically, the examiner noted that there was no evidence of continuity of back problems or chronic knee problems while in service and for several years after discharge from military service. Thus, the examiner concluded that the Veteran’s bilateral knee disorder and back disorder were more likely due to wear and tear, and age-related degeneration. However, while the examiner noted the Veteran’s reports of experiencing bilateral knee and back problems during and since his military service, he did not discuss such statements in rendering his opinions. Additionally, the Veteran has submitted several lay statements from family and friends discussing his complaints of bilateral knee and back problems over the years since his discharge from service. A VA clinician also submitted a statement noting that the Veteran reported his bilateral knee and back pains began during basic training and were verified on review of his medical history report. Therefore, the Board finds that a remand is necessary to obtain an addendum opinion that addresses such concerns. 4. Entitlement to service connection for a left eye disorder is remanded. 5. Entitlement to service connection for a right eye disorder is remanded. The Veteran contends that he has a current bilateral eye disorder that began in service or is otherwise related to his military service. See June 2015 Notice of Disagreement; July 2015 Written Statement. He reports that he was issued military glasses in service and that he wears glasses today. In this regard, the Veteran’s September 1971 entrance examination noted that he had a refractive error, but such was not considered disqualifying and no other eye conditions were noted. The Veteran also reported burning of the eyes after being subjected to a gas chamber in service. See August 2015 Written Statement. The Veteran’s records from the Social Security Administration (SSA) reveal that in February 2007, he was diagnosed with macular degeneration. Thus, the Board finds that a remand is necessary to afford the Veteran a VA examination to determine the nature and etiology of his bilateral eye disorder. See McLendon v. Nicholson, 20 Vet. App. 79, 81 (2006). The matters are REMANDED for the following action: 1. Obtain and associate with the Veteran’s claims file all outstanding VA treatment records dating from August 2015 to the present. 2. Obtain an addendum medical opinion(s) addressing the etiology of the Veteran’s bilateral knee and low back disorder. The need for an additional examination of the Veteran is left to the discretion of the clinician selected to write the addendum opinion. Following a full review of the record, the examiner should respond to the following: The examiner should opine as to whether it is at least as likely as not that the Veteran’s bilateral knee and low back disorder had its onset in, or is otherwise related to, the Veteran’s active duty service, to include the exercises and training he went through for basic training. The examiner should consider and discuss the Veteran’s November 1975 Report of Medical History indicating that he had or was then having swollen or painful joints and trick or locked knee. The examiner should also review and discuss the October 1973 STR that noted a provisional diagnosis of low back pain and the Veteran’s November 1975 Report of Medical History indicating that he had or was then having recurrent back pain. The examiner may NOT rely on the absence of a medical record or evidence of medical treatment as the sole rationale for any negative medical nexus opinion. If the examiner determines that the absence of complaints or treatment in the medical records is medically significant, the examiner should explain that significance. The examiner must also consider and discuss the lay statements of record regarding the onset of the Veteran’s bilateral knee and low back disorder and the continuity of symptomatology of such disorders. A rationale for all opinions offered should be provided. 3. The Veteran should be afforded an appropriate VA examination to determine the nature and etiology of any eye disorder. Following a full review of the record, the examiner should respond to the following: (A) Identify all of the Veteran’s eye disorders found since 2014. (B) Identify whether the Veteran had any eye disorder noted at entry into service other than refractive error. If any such eye disorder (other than a refractive error) is found, state whether that disorder worsened during service. (C) For all current eye disabilities found since 2014 (other than a refractive error), state whether it is whether it is at least as likely as not that such disorder had its onset in service or is related to an injury or disease incurred in service, including the Veteran’s reported gas chamber exposure. (Continued on the next page)   A rationale for all opinions offered should be provided. TRACIE N. WESNER Acting Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD K. Clark, Associate Counsel