Citation Nr: 20019796 Decision Date: 03/17/20 Archive Date: 03/17/20 DOCKET NO. 16-46 302 DATE: March 17, 2020 REMANDED Entitlement to service connection for a right knee disability is remanded. REASONS FOR REMAND The Veteran served on active duty from July 1972 to December 1975. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a March 2013 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO). In February 2020, the Veteran and his spouse testified at a hearing before the undersigned Veterans Law Judge. A transcript of this hearing is of record. The Board finds that more development is necessary prior to final adjudication of the claims remaining on appeal. The Board notes that VA is obligated to provide an examination when the record contains competent evidence that the claimant has a current disability or signs and symptoms of a current disability, the record indicates that the disability or signs and symptoms of disability may be associated with active service; and the record does not contain sufficient information to make a decision on the claim. 38 U.S.C. § 5103A (d) (2012). The threshold for finding a link between current disability and disease or injury in service is low. McLendon v. Nicholson, 20 Vet. App. 79 (2006). The Veteran contends that he broke his right femur in 1968 prior to his service and that his service, to include work as an infantryman, aggravated this condition which resulted in his current right knee disability. The Veteran’s June 1972 entrance examination noted that the Veteran on his Report of Medical History reported that he had a broken leg at age 15. In a February 2020 correspondence, a private physician opined that the Veteran’s service aggravated the existing condition resulting in him undergoing knee replacement surgery earlier then he would have been having if not for his military service. Notably, a pre-existing injury or disease will be considered to have been aggravated by active military, naval or air service, where there is an increase in disability during such service, unless there is a specific finding that the increase in disability is due to the natural progress of the disease. 38 U.S.C. § 1153; 38 C.F.R. § 3.306(a). The record demonstrates that the Veteran might have a right knee or right leg disability that might have preexisted his service. As a result, the Board finds that further development is warranted so an examiner can provide an opinion as to whether any right knee or right leg disability that preexisted his service was not aggravated beyond their natural progression during service. See 38 U.S.C. § 1153 (2012) (providing that a pre-existing disease or injury will be considered to have been aggravated by active service where there is an increase in disability during service absent a finding that the increase was due to the natural progress of the disease). The matters are REMANDED for the following action: 1. The Veteran should be requested to provide the names, addresses and approximate dates of treatment of all medical care providers, VA and non-VA, who have treated him for the disability on appeal. After the Veteran has signed the appropriate releases, those records should be obtained and associated with the claims folder. 2. Schedule the Veteran for a VA examination to determine the etiology of the claimed right knee disability. The evidentiary record, including a copy of this remand, must be made available to and reviewed by the examiner. After the record review and examination of the Veteran, the VA examiner should determine: (i) is it at least as likely as not (50 percent or greater probability) that the Veteran currently has a right knee or right leg disability that is etiologically related to his active service? (ii) Is it clear and unmistakable (undebatable) that a right knee or right leg disability preexisted the Veteran’s enlistment into service? (iii) If so, is it clear and unmistakable (undebatable) that any preexisting right knee or right leg disability was not permanently aggravated beyond its natural progress during the Veteran’s active service? Adequate reasons and bases for any opinion must be provided. All studies deemed appropriate in the medical opinion of the examiner should be performed, and all the findings should be set forth in detail. The claims file should be made available to the examiner, who should review the entire claims folder in conjunction with this examination. 3. Thereafter, readjudicate the issue on appeal. If any benefit sought on appeal remains denied, the Veteran and his representative should be provided with a Supplemental Statement of the Case and be afforded a reasonable opportunity to respond. The case should then be returned to the Board for further appellate review, if otherwise in order. MICHAEL LANE Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board James A. DeFrank, 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.