Citation Nr: 19106914 Decision Date: 01/29/19 Archive Date: 01/29/19 DOCKET NO. 10-34 330 DATE: January 29, 2019 REMANDED Service connection for a left knee disability is remanded.   REASONS FOR REMAND The Veteran served on active duty from September 1962 to September 1965. This case comes before the Board from a July 2009 rating decision. In April 2017, the Veteran testified at a Board video conference hearing. In February 2018, the Board remanded the claim for due process consideration. Service connection for a left knee disability. The Veteran asserts that his left knee arthritis is secondary to his service-connected degenerative joint disease of the left ankle. Although a September 2018 Veterans Health Administration (VHA) opinion references initial left knee symptoms in 2008, in November 2018, the Veteran cited to treatment records reflecting significant left knee symptoms in 2005 (see, e.g., July 2014 VA ankle examination report and August 2017 VA treatment records). He added that pain in his left lower extremity prevented any type of exercise regimen which resulted in the weight gain. In addition, the September 2018 VHA opinion attributes the Veteran’s left knee arthritis to obesity rather than the service-connected left ankle disability. Obesity itself is not a disability that can be compensated. However, obesity may act as an “intermediate step” between a service-connected disability and a current disability if it is found that the service-connected disability caused the Veteran to become obese, that obesity was a substantial factor in causing the secondary disability, and that the secondary disability would not have occurred but for obesity caused by the service-connected disability. See Marcelino v. Shulkin, 29 Vet. App. 155 (2018); VAOPGCPREC 1-2017 (Jan. 6, 2017). As such, VA examination for an opinion in that respect is warranted. The matter is REMANDED for the following action: Schedule the Veteran for a VA examination by an appropriate medical professional. The entire claims file must be reviewed by the examiner. The examiner is to conduct all indicated tests. The examiner should provide an opinion as to whether it is at least as likely as not (a 50 percent or greater probability) that the service-connected left ankle disability caused the Veteran to become obese, and if so, whether the left knee disability would not have occurred but for obesity caused by the service-connected left ankle disability. In rendering the opinion, the examiner should address the medical evidence as well as the Veteran’s statements, to include those reflected in his November 2018 submission. RYAN T. KESSEL Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD M. Taylor