Citation Nr: A19002057 Decision Date: 10/17/19 Archive Date: 10/17/19 DOCKET NO. 190213-11581 DATE: October 17, 2019 REMANDED Service connection for a left knee disability is remanded. REASONS FOR REMAND The Veteran had active service from August 1976 to August 1980. The Board notes that the rating decision on appeal was issued in April 2018. In October 2018, the Veteran elected the modernized review system. 84 Fed. Reg. 138, 177 (Jan. 18, 2019) (to be codified at 38 C.F.R. § 19.2(d)). The Veteran asserts that she has a left knee disability due to basic training. In March 2018, the Veteran underwent a VA examination wherein chondromalacia of the left knee was diagnosed. The examiner opined that her left knee disability was less likely than not due to service. The examiner stated that the in-service condition was acute and there was no evidence of chronicity of care. The examiner stated that records showed a March 12, 1980 clinical note which appeared to show that the Veteran was seen for a left knee chondromalacia and that this is the only entry. Review of the service treatment records, however, reflect multiple instances of left knee complaints. An April 1976 Report of Medical History completed for enlistment purposes reflects that the Veteran denied any orthopedic symptoms. However, in November 1976, she reported that she dislocated her left knee in high school, and the prior day during physical training she felt the knee giving away and popping out. She complained of pain on weight bearing. 02/06/2018 STR-Medical at 81. In June 1978, the Veteran was running during a physical training test and injured her left knee. Her left knee was unstable and she had a possible tear of the left medial meniscus. An x-ray examination was performed which was negative. Id. at 35, 105. In October 1978, she was medically qualified for limited duty due to her left knee condition and placed on medical profile. Id. at 27. A record dated in 1979 (month is illegible?) reflects that she was still having problems with left knee chondromalacia with pain on physical training. Id. at 24. In May 1979, she sought treatment for an injury to the left knee, and she was medically qualified for limited duty due to her left knee condition and placed on medical profile. Id. at 18, 25. In March 1980, she complained of pain in her left knee and an assessment of chondromalacia is reflected. Id. at 5. A June 1980 Report of Medical Examination conducted for separation purposes reflects that her ‘lower extremities’ were clinically evaluated as normal. Id. at 3. An x-ray examination of the left knee conducted on the same day as the separation examination reflects no significant abnormalities. Id. at 13. As the VA examiner erred in finding only a single in-service entry regarding the left knee, an opinion must be sought regarding consideration of the entirety of the Veteran’s in-service complaints. Moreover, in light of the Veteran’s in-service assertions of a left knee injury prior to service, an opinion should be sought as to whether a left knee disability clearly and unmistakably preexisted active service and whether any such preexisting disability was aggravated by service. The matter is REMANDED for the following action: 1. Request that a VA examiner with appropriate qualifications review the claims file and respond to the following: a) whether a left knee disability is at least as likely as not related to an in-service injury, event, or disease; b) whether a left knee disability clearly and unmistakably (undebatable) preexisted the Veteran’s service. If the examiner finds it did clearly and unmistakably preexist service, the examiner must opine whether it was clearly and unmistakably not aggravated by service. An examination should be scheduled if deemed necessary by the examiner. A comprehensive discussion of how the requested opinions were reached would be of assistance to the Board in adjudicating this claim, to include citation to evidence in the record, known medical principles, and medical treatise evidence, where applicable. Eric S. Leboff Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board M.W. Kreindler, Counsel The Board’s decision in this case is binding only with respect to the instant matter decided. This decision is not precedential, and does not establish VA policies or interpretations of general applicability. 38 C.F.R. § 20.1303.