Citation Nr: 19190882 Decision Date: 12/03/19 Archive Date: 12/03/19 DOCKET NO. 15-25 362 DATE: December 3, 2019 REMANDED Entitlement to service connection for a low back disability is remanded. Entitlement to service connection for a right hip disability is remanded. Entitlement to service connection for a right knee disability is remanded. Entitlement to service connection for a left knee disability is remanded. Entitlement to service connection for a right ankle disability is remanded. REASONS FOR REMAND The Veteran had active military service from October 1960 to August 1963. Regrettably, the Veteran died in March 2017. His surviving spouse has been substituted as the appellant for purposes of this appeal. See Administrative Decision (March 2019). This matter comes to the Board of Veterans’ Appeals (Board) on appeal from a January 2014 rating decision issued by the Department of Veterans Affairs (VA) Regional Office (RO) in Fort Harrison, Montana. Jurisdiction of this appeal is currently with the St. Paul Pension Center RO. This case was most recently before the Board in March 2019, at which time the appeal was remanded to the Agency of Original Jurisdiction (AOJ) for further development. The case has now been returned to the Board for appellate action. The Board finds that additional development is required before the claims on appeal are decided. Service Connection Claims – Low Back, Right Hip, Right Knee, Left Knee, and Right Ankle Disabilities The Veteran consistently asserted that he had low back, right hip, right knee, left knee, and right ankle disabilities that were etiologically related to his active service. Specifically, the Veteran asserted he fell 60 to 85 feet during a parachuting accident, and felt pain immediately upon landing that had continued since. The Board notes that the Veteran was afforded VA examinations for his claimed disabilities in April 2010 and April 2015. At those times, the VA examiners opined the Veteran’s claimed disabilities were less likely than not as a result of his active service. In that regard, the April 2010 examiner noted the Veteran’s report of a parachute accident in 1963. The examiner noted the Veteran reported the onset of right hip pain in 2003, right knee pain in the 1980’s, and that his right ankle injury during active service was not documented as a result of a parachute accident. Thus, the examiner opined the Veteran’s right hip, right knee, and right ankle disabilities were less likely than not as a result of his active service. Specifically, the examiner opined the Veteran’s right hip and right knee disabilities were not caused by or as a result of his right ankle sprain during active service; there was no evidence that the Veteran’s one sprained ankle resulted in right ankle arthritis; and the Veteran’s right hip, right knee, and right ankle conditions were not aggravated beyond its normal progression by military service. Further, the examiner noted the Veteran’s obesity as a cause of additional burden on his joints, and that obese patients were more prone to osteoarthritis due to the extra weight carried. In April 2015, the examiner noted that there was no evidence of a parachute accident during active service, and indicated that the evidence suggested a strong support for the natural progression of osteoarthritis based on other risk factors. The examiner noted the Veteran’s right ankle injury was noted during active service, but the cause of injury was not noted. Further, the examiner indicated 4 specific risk factors of age, weight, lifestyle, and uncontrolled diabetes as objective evidence that the Veteran’s low back, right hip, right knee, left knee, and right ankle disabilities were less likely than not as a result of his active service. The Board finds the April 2010 and April 2015 VA medical opinions inadequate to decide the claims. In that regard, the examiners failed to adequately consider the lay statements and contentions of the Veteran regarding the onset and continuity of his symptoms, nor did the examiner provide adequate supporting rationale for the conclusions reached. Accordingly, the Board concludes that additional VA medical opinions should be obtained in order to determine the nature and etiology of the Veteran’s low back, right hip, right knee, left knee, and right ankle disabilities. McLendon v. Nicholson, 20 Vet. App. 79 (2006). The matters are REMANDED for the following action: 1. Obtain VA medical opinions by an examiner with sufficient expertise to determine the nature and etiology of the Veteran’s low back disability, right hip disability, right knee disability, left knee disability, and right ankle disability. The examiner should review the claims file and indicate that review in the report. Any indicated studies should be performed. Based upon the examination results and a review of the record, the examiner should provide an opinion as to whether it is at least as likely as not (50 percent or greater probability) that any low back disability, right hip disability, right knee disability, left knee disability, and right ankle disability was etiologically related to service. The rationale for all opinions expressed must be provided. 2. Confirm that the VA examination reports and all opinions provided comport with this remand, and undertake any other development found to be warranted. 3. Then, readjudicate the issues on appeal. If any decision remains adverse to the appellant, issue a supplemental statement of the case and allow appropriate time for response. Then, return the case to the Board. Joshua R. Castillo Acting Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Mariah N. Sim, Associate 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.