Citation Nr: 20002610 Decision Date: 01/14/20 Archive Date: 01/13/20 DOCKET NO. 17-14 807 DATE: January 14, 2020 REMANDED Entitlement to service connection for right knee disability, to include as secondary to service-connected low back strain, is remanded. Entitlement to an initial rating in excess of 30 percent for dysthymic disorder prior to May 21, 2015, and in excess of 50 percent thereafter, is remanded. Entitlement to an initial rating in excess of 10 percent for low back strain is remanded. Entitlement to a total disability rating based upon individual unemployability (TDIU) is remanded. REASONS FOR REMAND The Veteran served on active duty in the U.S. Air Force from September 1998 to July 2014. These matters come before the Board of Veterans’ Appeals (Board) on appeal from January 2015 and February 2016 rating decisions of a Department of Veterans Affairs (VA) Regional Office (RO). In August 2019, the Veteran testified at a video conference hearing before the undersigned Veterans Law Judge. A transcript of the hearing is associated with the record. Entitlement to service connection for right knee disability, to include as secondary to service-connected low back strain, is remanded. In Saunders v. Wilkie, 886 F.3d 1356 (Fed. Cir. 2018), the Federal Circuit held that “pain in the absence of a presently-diagnosed condition can cause functional impairment,” which may qualify as a “disability” for VA compensation purposes. The Veteran has current right knee pain and receives treatment for that pain. A remand is warranted for a medical opinion to address whether the Veteran’s right knee pain is related to service and/or whether it is proximately due to his service-connected low back strain. Entitlement to an initial rating in excess of 30 percent for dysthymic disorder prior to May 21, 2015, and in excess of 50 percent thereafter, is remanded. During his August 2019 hearing, the Veteran reported that his service-connected dysthymic disorder has worsened since his last VA examination in 2015, and described increased symptomatology. A new VA examination is required. Entitlement to an initial rating in excess of 10 percent for low back strain is remanded. The Veteran testified that his service-connected low back strain worsened since his back surgery. Review of the VA treatment records show that the Veteran underwent surgery at the University of New Mexico Sandoval Regional Medical Center in October 2017. VA treatment records also indicate that he received an MRI at the private facility. These private treatment records are not associated with the record and the Board finds that a remand is required to obtain these records. In addition, given that the Veteran testified that he has experienced worsening symptoms, the Board finds that a new VA examination should be provided. Entitlement to TDIU is remanded. The Veteran’s TDIU claim is inextricably intertwined with the remanded claims and its adjudication must be deferred. See Harris v. Derwinski, 1 Vet. App. 180, 183 (1991). The matters are REMANDED for the following action: 1. Take appropriate action to obtain private treatment records for his back surgery from the University of New Mexico Sandoval Regional Medical Center, to include securing any necessary releases. 2. Obtain updated VA medical treatment records. 3. Schedule the Veteran for a VA examination for his right knee pain. The claims file must be reviewed by the examiner and the examiner should indicate if a diagnosis can be provided for the right knee. The examiner must opine whether it is at least as likely as not that any right knee disorder or right knee pain with functional impairment is related to active service. The examiner must also opine whether it is at least as likely as not that any right disorder or right knee pain with functional impairment is proximately due to or aggravated by his service-connected low back strain. 4. Schedule the Veteran for a VA examination to evaluate the current severity of his service-connected dysthymic disorder. The examiner must identify all manifestations and symptoms of the dysthymic disorder. 5. Schedule the Veteran for a VA examination to evaluate the current severity of his service-connected low back strain. The examiner must identify all manifestations and symptoms of the back strain. 6. Then the Veteran’s claims should be readjudicated. If the benefits sought on appeal remain denied, the Veteran and his representative should be furnished a supplemental statement of the case. Then the case should be returned to the Board, if in order. WILLIAM H. DONNELLY Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board J. Seay, 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.