Citation Nr: 20021144 Decision Date: 03/24/20 Archive Date: 03/24/20 DOCKET NO. 18-50 681 DATE: March 24, 2020 REMANDED Entitlement to service connection for left knee disability is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Navy from August 1991 through February 2001. Entitlement to service connection for left knee disability is remanded. In August 2019, the Board remanded this issue for a VA examiner to opine as to whether it is at least as likely as not that any currently diagnosed left knee disorder is caused or aggravated by service or a service-connected disability, to include the right knee. The Veteran was afforded a VA examination in January 2020. The examiner stated that the Veteran’s left knee arthritis was not caused or aggravated by service and was not caused or aggravated by the right knee condition; rather it is the result of aging. To support this statement, the examiner noted that radiographs from 2013 did not show arthritis. Although the Board sincerely regrets the additional delay, a remand is necessary to obtain an addendum opinion. First, the Board notes that the January 2020 opinion did not use the standard of at least as likely as not. Moreover, the opinion is not supported by detailed rationale. While the examiner concluded that the left knee disability was due to aging because 2013 radiographs were clear, she did not explain why the left knee disability could not have been caused or aggravated by the right knee disability. Remand is necessary. See Stefl v. Nicholson, 21 Vet. App. 120 (2007). Additionally, in October 2013, bilateral knee x-rays were ordered, however it is not apparent if the results were added to the current record. Because the examiner noted the 2013 radiographs did not show arthritis, but the results of which are not apparent in the record, a remand is necessary to clarify if there was imaging of the left knee performed in 2013 and if so, to include such results in the current record. The matters are REMANDED for the following action: 1. Obtain copies of records pertaining to any relevant VA treatment the Veteran has received since the time that such records were last procured, following the procedures set forth in 38 C.F.R. § 3.159. In particular the AOJ should determine if 2013 imaging of the left knee was performed, and if the results are available. The evidence obtained, if any, should be associated with the record. 2. After the foregoing development has been completed, to the extent possible, make arrangements to obtain an opinion from the VA examiner who previously offered opinions on the etiology of the Veteran’s left knee disability in January 2020. The claims file should be made available to the examiner. The examiner must identify all currently diagnosed left knee conditions; the examiner is reminded pain that causes functional impairment is considered a disability even in the absence of pathology. For any current left knee disability, the examiner must opine as to whether the disability is at least as likely as not related to service and whether any current left knee disability was at least as likely as not caused or aggravated (worsened) by a service-connected disability, to include the right knee. A full and complete rationale for all opinions expressed is required, including why one etiology is believed to be more likely over another. If aggravation is found, the examiner should provide a baseline level of disability prior to aggravation. A. P. Armstrong Acting Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board A. Smith 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.