Citation Nr: 20028855 Decision Date: 04/24/20 Archive Date: 04/24/20 DOCKET NO. 15-21 845 DATE: April 24, 2020 REMANDED Entitlement to service connection for left knee patellofemoral syndrome is remanded. Entitlement to service connection for right knee patellofemoral syndrome is remanded. Entitlement to service connection for hypertension is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Army from January 1976 to September 1980, and from September 2005 to December 2006. This matter comes to the Board of Veterans' Appeals (Board) from a July 2013 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO) in Louisville, Kentucky. In August 2015, the Veteran testified at a video hearing before the undersigned. A transcript of that hearing is of record. In July 2018, the Board remanded these claims for additional development. 1. Entitlement to service connection for left knee patellofemoral syndrome is remanded. 2. Entitlement to service connection for right knee patellofemoral syndrome is remanded. The Veteran and his representative assert that the Veteran’s bilateral knee disability originated during his active duty service. While the Board sincerely regrets further delay, the Veteran's claims must be remanded for further development before they may be decided on the merits. In July 2018, the Board remanded the appeal for additional development as it determined that a remand was required to secure an addendum opinion that adequately considered the Veteran’s lay assertions from a February 2013 statement and his sworn testimony from the August 2015 Board hearing. As records described the stresses that the Veteran’s military experience put on his knees, a remand was appropriate. Pursuant to the Board remand, the Veteran was afforded a new VA examination and nexus opinions in October 2019. The VA examiner determined that the Veteran did not currently have a bilateral knee disability, and that there therefore can be no nexus to service. The examiner also asserted that the Veteran did not report any knee issues while in service and stated that he did not go to sick call during service in the February 2013 lay statement. The Board notes that, the presence of a chronic disability at any time during or immediately preceding the claims process can justify a grant of service connection, even where the most recent diagnosis is negative. McClain v. Nicholson, 21 Vet. App. 319 (2007); Romanowski v. Shinseki, 26 Vet. App. 289, 294 (2013) (holding the current disability requirement may be satisfied by evidence of the disability shortly before the claim is filed). As the Veteran was found to have a disability in the June 2013 VA examination, during the course of the appeal, merely stating that he does not currently have a disability is an insufficient rationale for a negative medical opinion. The Board further finds that the VA examiner is incorrect regarding the February 2013 lay statement, as it does not assert that the Veteran did not report to sick call during service. The Board also finds that the examiner appears to have disregarded the Board’s request to review the Board hearing testimony regarding his assertions of knee pain during his active duty service. Accordingly, the Board must once again remand the matter to ensure compliance with the July 2018 remand. 3. Entitlement to service connection for hypertension is remanded. The Veteran and his representative assert that the Veteran’s hypertension originated during his active duty service. While the Board sincerely regrets further delay, the Veteran's claim must also be remanded for further development before it may be decided on the merits. In July 2018, the Board remanded the appeal for additional development as it had determined that a remand was required to contact the Veteran and, with his assistance, identify any outstanding records of pertinent medical treatment. The RO was also advised to take appropriate measures to obtain copies of any outstanding records identified by the Veteran, including from Muhlenberg Hospital. The Board also requested that the Veteran be notified if any identified records are unavailable and given an opportunity to respond and submit any additional lay evidence or statements. The Board also requested that the RO obtain VA treatment records from March 31, 2017, to the present. Pursuant to the Board remand, the RO obtained VA treatment records from March 31, 2017. However, the RO did not contact the Veteran to identify any outstanding records of pertinent medical treatment, and did not make any effort to at least obtain records from Muhlenberg Hospital. Accordingly, as the RO did not contact the Veteran in order to obtain the pertinent medical records, the Board must once again remand the matter to ensure compliance with the July 2018 remand. Stegall v. West, 11 Vet. App. 268 (1998). The matters are REMANDED for the following action: 1. Contact the Veteran, and, with his assistance, identify any outstanding records of pertinent medical treatment, to include records from Muhlenberg Hospital. The RO should then take appropriate measures to obtain copies of any outstanding records identified by the Veteran, including Muhlenberg Hospital. The Veteran should be notified if any identified records are unavailable and given an opportunity to respond and submit any additional lay evidence or statements. 2. After obtaining the above records to the extent possible, an examiner should review the entire claims file and provide the following opinions: (a.) Whether it is at least as likely as not (a 50 percent or better probability) that any current or previously-diagnosed patellofemoral syndrome of the right or left knee was incurred in the Veteran’s service; and (b.) Whether the Veteran has any current or previously-diagnosed patellofemoral syndrome of the right or left knee that (i) is proximately due to the Veteran’s service-connected back disorder or (ii) was aggravated by the Veteran’s service-connected back disorder. In reaching these opinions, the examiner should consider the Veteran’s February 2013 statement and August 2015 hearing testimony. These records describe the stresses that the Veteran’s military experience put on his knees. The examiner should provide a complete rationale for any opinions offered. If the examiner is unable to provide any requested opinion without resort to speculation, he or she should explain why this is so. Michael J. Skaltsounis Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board A. R. Montalvo, 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.