Citation Nr: 20002604 Decision Date: 01/14/20 Archive Date: 01/13/20 DOCKET NO. 19-02 037 DATE: January 14, 2020 REMANDED Entitlement to service connection for a back disability, to include as secondary to the service-connected disabilities, is remanded. Entitlement to service connection of a left hip strain, to include as secondary to the service-connected disabilities, is remanded. Entitlement to service connection for a right knee strain, to include as secondary to the service-connected disabilities, is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Navy from January 1985 to May 1988; October 2000 to September 2001; February 2003 to August 2003; and November 2004 to March 2005. 1. Entitlement to service connection for a back disability, to includes as secondary to service-connected disabilities. 2. Entitlement to service connection of left hip strain, to includes as secondary to service-connected disabilities. 3. Entitlement to service connection for right knee strain, to includes as secondary to service-connected disabilities. The Veteran claims he has back, left hip and right knee disabilities that are either directly related to service or caused or aggravated by his service-connected disabilities. The Veteran is service-connected for status post bunionectomy of the left foot and right ankle strain and right hallux valgus, as secondary to the status post bunionectomy. Service connection is also in effect for a related scar and a left shoulder disability. The Veteran and his representative contend that the claimed back, left hip and right knee disabilities are related to his altered gait which is the result of the service-connected foot disabilities. VA medical opinions obtained to date are inadequate as to secondary service connection. The rationale for secondary causation is incomplete and there is no opinion on aggravation. The claims are remanded for new examinations and medical opinions. 38 C.F. R. § 3.159 (c)(4). The matters are REMANDED for the following action: 1. Obtain any of the Veteran’s update VA and private treatment records. 2. After completion of the above, schedule the Veteran for an examination to determine the nature and etiology of all diagnosed back, hip, and knee disabilities. Following a review of the record, including a copy of this remand, and examination of the Veteran, the examiner should answer the following questions: (a.) Identify all diagnoses related to the Veteran’s claimed back, hip, and knee disabilities. (b.) Is it at least as likely as not that any currently diagnosed back, hip, and knee disability is (i) directly due to service; (ii) proximately due to the Veteran’s service-connected right foot condition, or (iii) aggravated by (any increase in disability) the Veteran’s service-connected right foot condition? The examiner must consider the Veteran’s reports that (i) the pain in his claimed disabilities began after the bunionectomy of his right foot in August 2014, (ii) adjustment to his gait and misalignment of his body post-bunionectomy, (iii) and that the right foot condition creates a burning sensation, knee buckling and popping, and hip and lower back pain. A complete rationale must be included for any opinion offered. If the examiner cannot provide any of the requested opinions without resorting to speculation, he or she should expressly indicate this and provide a supporting rationale as to why the opinion cannot be made without resorting to speculation. M.E. Larkin Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board N. Williams 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.