Citation Nr: 20003549 Decision Date: 01/16/20 Archive Date: 01/15/20 DOCKET NO. 16-55 365 DATE: January 16, 2020 REMANDED Entitlement to service connection for a bilateral knee disorder is remanded. Entitlement to service connection for a right elbow disorder is remanded. REASONS FOR REMAND The Veteran served on active duty from September 1971 to June 1977.This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a November 2015 rating decision by a Department of Veterans Affairs (VA) Regional Office. In July 2019, the Veteran and his daughter testified at a Board hearing before the undersigned Veterans Law Judge. A transcript of the hearing is of record. 1. Entitlement to service connection for a bilateral knee disorder. 2. Entitlement to service connection for a right elbow disorder. The Veteran contends that he has a current bilateral knee disorder as a result from injuries incurred while playing softball during his military service, to include being hit in the knees with the ball, and as due to the physical stress from frequently walking and standing on the concrete flight line. He further claims that he chipped a bone in his right elbow when he slid into home base while playing softball. The Veteran also alleges that he has experienced a continuity of bilateral knee and right elbow pain since his military service. Thus, he contends that service connection for such disorders is warranted. The Veteran’s service treatment records reflect that, upon his April 1977 separation examination, he had scars on his knees that were noted to be related to a 1974 football injury. However, such are otherwise negative for any complaints, treatment, or diagnosis referable to his knees or right elbow. In this regard, the Veteran explained that he did not seek medical treatment for any of the aforementioned injuries because it was strongly discouraged by the coach. See January 2016 Notice of Disagreement; July 2019 Hearing Transcript. Nonetheless, in a January 2017 statement, a fellow service member reported noticing that the Veteran modified his physical activity after being hit in the knees and the right elbow by balls when playing for the Military Airlift Command Baseball Team during service. Additionally, the record reflects that the Veteran has current diagnoses of right knee patellofemoral dysfunction, left knee patellar tendinopathy, bilateral knee osteoarthritis, and calcific tendinopathy of the right elbow. See December 2015 Private Medical Treatment Records. Further, in December 2015, a private treatment provider, Dr. B.A., opined that the Veteran’s right elbow disorder likely started in the Air Force and progressed gradually with repeated use; however, as such statement is conclusory, it is inadequate for determining service connection. See Nieves-Rodriguez v. Peake, 22 Vet. App. 295 (2008); Stefl v. Nicholson, 21 Vet. App. 120, 124 (2007) (“[A]medical opinion... must support its conclusion with an analysis that the Board can consider and weigh against contrary opinions”). Further, there is no medical opinion addressing the etiology of the Veteran’s bilateral knee disorder. Consequently, in light of the aforementioned reported in-service injuries, the Veteran’s statements regarding a continuity of relevant symptomatology, current diagnoses of bilateral knee and right elbow disorders, and Dr. B.A.’s suggestion that the Veteran’s right elbow disorder may be related to service, the Board finds that a remand is necessary in order to afford the Veteran a VA examination so as to determine the nature and etiology of his claimed disorders. The matters are REMANDED for the following action: 1. Afford the Veteran an appropriate VA examination to determine the current nature and etiology of his bilateral knee disorder. The record, to include a complete copy of this Remand, must be made available to the examiner, and all indicated tests should be conducted. Thereafter, the examiner should address the following inquiries: (A) The examiner should identify all current left and/or right knee disorders, to include right knee patellofemoral dysfunction, left knee patellar tendinopathy, bilateral knee osteoarthritis. (B) For each currently diagnosed knee disorder, the examiner should provide an opinion as to whether it is at least as likely as not (i.e., a 50 percent or greater probability) that such disorder had its onset in, or is otherwise related to, the Veteran’s military service, to include his reported injuries incurred while playing softball, to include being hit in the knees with the ball, as due to the physical stress from frequently walking and standing on the concrete flight line, and/or the 1974 football injury that resulted in scars on the knees as detailed at his April 1977 separation examination. (C) With respect to the diagnosis of arthritis of the knees, the examiner should offer an opinion as to whether such disorder manifested within one year of the Veteran’s separation from service in June 1977 (i.e., by June 1978), and, if so, describe the manifestations. In rendering his or her opinion, the examiner should consider the Veteran’s report of in-service bilateral knee pain that has continued since such time and the January 2017 statement from a fellow service member who reported that the Veteran modified his physical activity after being hit in the bilateral knees by balls when playing for the Military Airlift Command Baseball Team during service. He or she is further advised that the sole basis of a negative opinion cannot be the fact that the Veteran’s service treatment records are silent for any complaints, treatment, or diagnosis referable to a knee disorder. A rationale for any opinion offered should be provided. 2. Afford the Veteran an appropriate VA examination to determine the current nature and etiology of his right elbow disorder. The record, to include a complete copy of this Remand, must be made available to the examiner, and all indicated tests should be conducted. Thereafter, the examiner should address the following inquiries: (A) The examiner should identify all current right elbow disorders, to include calcific tendinopathy of the right elbow. (B) For each currently diagnosed right elbow disorder, the examiner should provide an opinion as to whether it is at least as likely as not (i.e., a 50 percent or greater probability) that such disorder had its onset in, or is otherwise related to, the Veteran’s military service, to include his reported injury when he chipped a bone in his right elbow when he slid into home base while playing softball. In rendering his or her opinion, the examiner should consider the Veteran’s report of in-service right elbow pain that has continued since such time, the January 2017 statement from a fellow service member who reported that the Veteran modified his physical activity after being hit in the right elbow by balls when playing for the Military Airlift Command Baseball Team during service, and Dr. B.A.’s December 2015 opinion that the Veteran’s right elbow disorder likely started in the Air Force and progressed gradually with repeated use. He or she is further advised that the sole basis of a negative opinion cannot be the fact that the Veteran’s service treatment records are silent for any complaints, treatment, or diagnosis referable to a right elbow disorder. A rationale for any opinion offered should be provided. A. JAEGER Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board M.B. English, 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.