Citation Nr: 20037525 Decision Date: 06/02/20 Archive Date: 06/02/20 DOCKET NO. 17-66 457 DATE: June 2, 2020 REMANDED Entitlement to service connection for right knee degenerative joint disease (DJD), is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Army from December 1968 to March 1972. This matter is before the Board of Veterans’ Appeals (the Board) on appeal from a January 2014 rating decision issued by the Department of Veteran Affairs (VA) Regional Office (RO) in Cleveland Ohio. The rating decision, in pertinent part, denied service connection for right knee DJD. The Statement of the Case (SOC) was issued in October 2017. Although the SOC addressed multiple issues, the Veteran indicated on his December 2017 VA Form 9, appeal to the Board, that he was only appealing the issue of entitlement to service connection for degenerative joint disease of the right knee. Entitlement to service connection for right knee DJD. The Veteran seeks service connection for a right knee disability, contending that he was injured while on active duty, required surgery to repair a meniscal tear, and that his current right knee disability is related to that injury. In his December 2017 VA Form 9, the Veteran stated that his service aggravated his knee disability and that prior to service, he played competitive sports without any knee problems. He reported that his knee neither bothered him prior to service nor prevented him from an active life prior to the military. The injury required meniscal tear surgical repair which the Veteran underwent in 1972 prior to discharge. The Veteran also contended that after the military he lived a sedentary lifestyle and his knee has never been the same. According to the statement on his VA Form 9, the Veteran had been diagnosed with right knee DJD 6 years earlier and underwent a total knee replacement. He continues to have problems with his right knee which impairs his activities due to stiffness and pain. In September 2013, the Veteran underwent a VA examination for his claim. The VA examiner reviewed the Veteran’s file and concluded that the Veteran’s claimed in-service right knee injury involved a meniscal tear and resolved without residuals. The VA examiner also concluded that the Veteran’s current right knee disability is not related to his in-service injury. A review of the Veteran’s file reveals that in March 1972, he filed a claim for service connection for a right knee disability. The Veteran underwent a VA examination for his claim in May 1972; and, pursuant to a June 1972 rating decision, the RO granted service connection for postoperative residuals of right knee medial meniscectomy and assigned an initial noncompensable evaluation effective March 7, 1972. Moreover, in June 1972 the RO sent the Veteran written notification of the decision, informing him that his right knee condition was incurred in service and in the line of duty, and was less than 10 percent disabling, not warranting financial compensation. To the Board’s knowledge, service connection remains in effect. Accordingly, service connection has already been granted for postoperative residuals of a right knee meniscectomy, and significantly, this disability is not reflected in the Veteran’s current rating decision disability code sheet and was not considered in the rating decision on appeal. Although the September 2013 VA examiner opined that the Veteran’s current arthritis is not related to the in-service meniscal tear, it is not clear whether the examiner was aware that the Veteran’s right knee status post meniscal repair has been service-connected since 1972. Thus, it appears that the opinion is based on an inaccurate factual history. Moreover, the September 2013 examination was conducted prior to the Veteran’s 2016 right knee replacement. As such, the September 2013 examiner may not have been aware of the severity of the right knee disability at that time, given that the right knee had deteriorated to the point that knee replacement surgery was ultimately necessary. Finally, the September 2013 examination does not compare findings of the left knee to findings of the right knee. In light of the service-connected postoperative meniscectomy, a comparison of the right knee to the left knee may reveal a level of asymmetry that could potentially alter a medical nexus opinion as to the likely etiology of the right knee DJD and/or other knee disability. When medical evidence is inadequate, VA must supplement the record by seeking an advisory opinion or ordering another medical examination. Colvin v. Derwinski, 1 Vet. App. 171, 175 (1991); Hatlestad v. Derwinski, 3 Vet. App. 213, 216 (1992). Accordingly, this matter is remanded for further adjudication and development. The Veteran’s records should be updated to reflect the June 1972 award of service connection for right knee condition and afforded a new VA examination for his claim. The matter is REMANDED for the following action: 1. The RO must amend the Veteran’s rating decision disability code sheet to reflect that, pursuant to a June 1972 RO rating decision, service connection was granted, with a noncompensable rating assigned, for the Veteran’s postoperative residuals of a right knee medial meniscectomy, effective from March 7, 1972. 2. Schedule the Veteran for an examination by an orthopaedist, if possible, to determine the nature and likely etiology of the Veteran’s current right knee disability, including his DJD prior to the 2016 right knee replacement, and all residuals status post right knee replacement. All necessary tests and studies should be conducted, including, but not limited to a comparison of the Veteran’s right knee to his left knee prior to the right knee replacement. All findings should be reported in detail. The claims folder, to include a copy of this remand, must be made available to the examiner for review prior to the examination. The VA examiner is requested to examine the right and left knees, and opine as to the following: (a.) Whether the Veteran’s right knee DJD prior to the right knee replacement is at least as likely as not related to service, to include whether it is, as likely as not, caused by, or aggravated by the Veteran’s service-connected postoperative right knee meniscectomy. (Aggravation is defined as any increase in severity of the nonservice-connected disability that is proximately due to or the result of a service-connected disability, and not due to the natural progress of the nonservice-connected disability.) In other words, did the Veteran’s right knee DJD, as likely as not, increase in severity as a result of the service-connected right knee disability? If aggravation is found, please indicate, if possible, the baseline severity of the right knee DJD prior to the aggravation. (b) A complete rationale for all opinions must be provided. In this regard, the examiner should comment on a comparison between the findings from the right knee and findings from the left knee. In addition, the examiner should comment on whether it is possible to distinguish symptoms associated with the Veteran’s pre-operative DJD from the service-connected residuals of a postoperative meniscectomy repair. If the examiner is unable to provide an opinion without resort to speculation, he or she should explain why this is so and what if any additional evidence would be necessary before an opinion could be rendered. (c). The VA examiner is requested to comment on the Veteran’s statements as to his statements of continuing symptoms since service. L. B. CRYAN Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board K. Kuksova 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.