Citation Nr: 19129074 Decision Date: 04/16/19 Archive Date: 04/15/19 DOCKET NO. 17-66 627 DATE: April 16, 2019 ORDER Service connection for a back disorder, to include as secondary to and/or aggravated by a service-connected disability, is granted. REMANDED Entitlement to an initial rating in excess of 10 percent for a left knee disability. Service connection for a right foot disorder. FINDING OF FACT Resolving all reasonable doubt in the Veteran’s favor, it is at least as likely as not that the Veteran’s back disorder, to include as secondary and/or aggravated by a service-connected disability, is related to active duty service. CONCLUSION OF LAW The criteria for service connection for a back disorder, to include as secondary to and/or aggravated by a service-connected disability, are met. 38 U.S.C. §§ 1110, 5107(b); 38 C.F.R. §§ 3.102, 3.303(a), 3.304, 3.307, 3.309, 3.310. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from January 2004 to January 2005, February 2008 to January 2009, and April 2012 to December 2012. The Board observes that based upon the Veteran’s November 2017 VA Form 9, he may have had an unconfirmed period of active service after November 2017; however, there is no prejudice to the Veteran in adjudicating his service connection claim for a back disorder as the Board is granting the full benefits sought on appeal for this claim. Service Connection Entitlement to service connection for a back disorder, to include as secondary to and/or aggravated by a service-connected disability The Veteran asserts that his back disorder is related to service, to include as secondary to and/or aggravated by his service-connected bilateral knee disorder. The question for the Board is whether the Veteran has a current disability that began during service or is at least as likely as not etiologically related to, including aggravated by, an in-service injury, event, or disease, including as secondary to and/or aggravated by a service-connected disability. 38 U.S.C. §§ 1110, 5107(b); Shedden v. Principi, 381 F.3d 1163, 1166-67 (Fed. Cir. 2004); 38 C.F.R. §§ 3.303(a), 3.304, 3.306, 3.307, 3.309, 3.310. Based on the evidence of record, the Board determines that service connection is warranted for the Veteran’s back disorder. As an initial matter, the Board observes that the Veteran is service-connected for a bilateral knee disability. Next, the Veteran’s treatment records, in conjunction with his credible statements, reflect that his back disability is secondary to and/or aggravated by his service-connected bilateral knee disability. Specifically, in April 2016 and January 2017, the Veteran’s private treating orthopedic physician opined that his back disorder is related to his service-connected knee disability. In support, his physician noted that the medical literature indicates that “abnormal motion” and gait have resulted from the Veteran’s knee disorder with “instabilities or aberrant motion in the lower kinematic chain,” and thus causes “deterioration of the lower back.” Therefore, the Board finds that the Veteran’s back disorder is related to his service-connected knee disability. In arriving at this conclusion, the Board acknowledges that the evidence includes negative opinions by the November 2016 VA examiner, which indicates the Veteran’s back disorder were not caused by or related to the Veteran’s bilateral knee disorder. In this case, the examiner indicated that there was no evidence that the Veteran’s back disorder was permanently aggravated by his service-connected knee disability, to include a lack of support in the medical literature. As discussed, however, in his January 2017 response, the Veteran’s treating physician discussed and addressed the pertinent literature and medical theories that demonstrated a relationship between these disorders. Therefore, the Board finds that the evidence is in relative equipoise to support service connection. As such, service-connection is warranted. REASONS FOR REMAND 1. Entitlement to an initial rating in excess of 10 percent for a left knee disability 2. Entitlement to service connection for a right foot disorder As discussed, it appears that the Veteran may have had an additional period of active service since November 2017. Therefore, on remand, the Regional Office (RO) should verify any additional periods of active service, and if so, obtain any available service records related thereto. The matters are REMANDED for the following action: 1. The RO should undertake the necessary action in order to attempt to verify all periods of service, to include all periods ACDUTRA and INACDUTRA. All available and outstanding service records should be obtained for any additional periods of verified service. 2. Obtain all treatment records from any VA facility from which the Veteran has received treatment since 2016. If the Veteran has received additional private treatment, he should be afforded an appropriate opportunity to submit them. (Continued on the next page)   3. The RO should undertake any other development deemed necessary in order to adjudicate the claims on appeal, to include obtaining a new VA examination if warranted based upon any new relevant records. If the claims are not fully granted, a SSOC should be issued, and the claims file should be returned to the Board for further appellate consideration. James L. March Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD J. Meyer, Associate Counsel