Citation Nr: 20021987 Decision Date: 03/30/20 Archive Date: 03/30/20 DOCKET NO. 09-49 706 DATE: March 30, 2020 REMANDED Entitlement to an initial compensable disability rating for allergic rhinitis is remanded. Entitlement to service connection for a right quadriceps disability is remanded. Entitlement to service connection for a bilateral knee disability is remanded. REASONS FOR REMAND The Veteran had active military service from August 1984 to June 1995 and from January 1998 to August 2008. These issues are on appeal from a March 2009 rating decision. In September 2015, the Board of Veterans’ Appeals (Board) remanded these issues to the Agency of Original Jurisdiction (AOJ) for further development. In a September 2018 decision, the Board denied these claims. The Veteran appealed the Board’s denial to the U.S. Court of Appeals for Veterans Claims (Court). In August 2019, the Court granted a Joint Motion for Partial Remand (JMR) and vacated the Board’s September 2018 decision regarding the above claims. The other issues denied in the Board’s September 2018 decision were dismissed in the August 2019 JMR. The issues were remanded to the Board for further development. 1. Entitlement to an initial compensable disability rating for allergic rhinitis is remanded. The record establishes that the Veteran’s allergic rhinitis is active during spring and summer. See July 2008 Report of Medical History (“Constant congestion Mar – Oct since 2006”); December 2017 VA examination (“It is generally a spring and summer thing”). However, neither of the Veteran’s VA examinations took place in spring or summer. The Veteran should be provided an opportunity to report for a VA examination in the spring or summer to ascertain the current severity and manifestations of his allergic rhinitis. See Ardison v. Brown, 6 Vet. App. 405, 408 (1994) (indicating that, to the extent possible, VA should schedule an examination for a condition that has cyclical manifestations during an active stage of the disease to best determine its severity); Bowers v. Derwinski, 2 Vet. App. 675, 676 (1992) (VA examination ordered during active stage of the veteran's skin disorder). 2. Entitlement to service connection for a right quadriceps disability is remanded. The Board cannot make a fully-informed decision on the right quadriceps issue because the December 2017 VA examiner provided a negative nexus medical opinion based on the rationale that the Veteran “was not seen or treated for a quadriceps condition in service.” This rationale is factually incorrect, as the Veteran’s July 2008 Report of Medical History documents “Right quadriceps 2008.” The examiner also did not address the Veteran’s statements that his symptoms in 2017 were similar to his symptoms in 2008 and had flared up “whenever he runs” since service. Upon remand, an addendum medical opinion must be obtained. 3. Entitlement to service connection for a bilateral knee disability is remanded. The Board cannot make a fully-informed decision on the bilateral knee issue because the December 2017 VA examiner provided a negative nexus opinion based on the rationale that the Veteran does not have a current bilateral knee disability. However, at the December 2017 VA examination, the Veteran reported flare-ups of his knees – specifically, that it was painful for him to walk. Accordingly, the Board finds that an addendum medical opinion must be obtained upon remand. The matters are REMANDED for the following actions: 1. Schedule the Veteran for an examination by an appropriate clinician to determine the current severity of his service-connected allergic rhinitis during the spring or summer months. The examiner should provide a full description of the disability and report all signs and symptoms necessary for evaluating the Veteran’s disability under the rating criteria. 2. Obtain an addendum opinion from an appropriate clinician regarding whether the Veteran’s right quadriceps disability is at least as likely as not related to his active military service, to include the July 2008 Report of Medical History documenting “Right quadriceps 2008.” The examiner must also address the Veteran’s statements that his symptoms in 2017 were similar to his symptoms in 2008 and had flared up “whenever he runs” since service. In forming the opinion, the examiner must address the October 2019 private medical opinion and the medical literature submitted by the Veteran in December 2019. 3. Obtain an addendum opinion from an appropriate clinician regarding whether the Veteran has a current bilateral knee disability is at least as likely as not related to his active military service, to include the knee complaints and treatment in January 1999, March 2000, June 2001, August 2001, June 2007, and March 2008. In the event that the criteria for a bilateral knee diagnosis are not met, the examiner should specifically state whether there is any functional impairment associated with the Veteran’s complaints of bilateral knee pain. Please complete the “Functional Impact” section of the report of examination. If there is functional impairment, please offer an opinion as to whether it is at least as likely as not that such impairment is associated with the Veteran’s active military service, to include the knee complaints and treatment during service. In forming the opinions, the examiner must address the October 2019 private medical opinion and the medical literature submitted by the Veteran in December 2019. J.N. MOATS Acting Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Shauna M. Watkins, 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.