Citation Nr: 20043036 Decision Date: 06/25/20 Archive Date: 06/25/20 DOCKET NO. 13-11 784 DATE: June 25, 2020 REMANDED Service connection for a left knee disorder, to include as due to an undiagnosed illness or other qualifying chronic disability, is remanded. Service connection for a left ankle disorder, to include as due to an undiagnosed illness or other qualifying chronic disability, is remanded. Service connection for a right ankle disorder, to include as due to an undiagnosed illness or other qualifying chronic disability, is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Marine Corps from May 2004 to October 2009 and is a recipient of the Iraq Campaign Medal. In a decision issued in March 2017, the Board denied entitlement to service connection for a left knee disorder, a left ankle disorder and a right ankle disorder. The Board determined that the Veteran did not have diagnoses, and no disabilities were shown of the left knee, left ankle or right ankle since separation. The Veteran appealed this decision to the United States Court of Appeals for Veterans Claims (Court). In a December 2017 Joint Motion for Partial Remand, the Court and the Veteran agreed that VA did not provide an adequate statement of reasons or bases for denying the claims of service connection for the Veteran’s left knee, left ankle and right ankle disorders. Particularly, the parties agreed that the Board failed to address whether the Veteran was entitled to service connection for an undiagnosed illness manifested by left knee, left ankle and right ankle pain, swelling and other symptoms under 38 U.S.C. § 1117 and 38 C.F.R. § 3.317. Thus, in a July 2018 remand, the Board instructed the agency of original jurisdiction to arrange for the Veteran to undergo a Gulf War General Medical Examination. The examiner was instructed to detail all reported knee and ankle issues and to address specific evidence in the file before rendering an opinion concerning the Veteran’s claimed disabilities. However, the resulting January 2020 Gulf War General Medical Examination only addressed sleep apnea, in relation to a separate claim, and was not responsive in any way to the Board’s July 2018 remand instructions. When VA endeavors to provide an examination or obtain a VA opinion, it must ensure that the examination or opinion is, at the very least, adequate. Barr v. Nicholson, 21 Vet. App. 303, 312 (2007). In addition, a remand by the Board confers on a veteran, as a matter of law, the right to compliance with the remand orders. Stegall v. West, 11 Vet. App. 268, 271 (1998). Per Stegall, the Board errs when it fails to ensure compliance with its previous remand orders. Here, as there has been no substantive compliance with the Board’s July 2018 directives, further remand is necessary. The matter is REMANDED for the following action: Obtain a VA examination and opinion that conforms to the guidelines for conducting Gulf War examinations. The claims file should be made available for review. a) The examiner should note and detail all assertions as to problems associated with the Veteran’s complaints of left knee, left ankle and right ankle pain and swelling and other symptoms, current and documented. The examiner should conduct a comprehensive examination, and provide details about the onset, frequency, duration, and severity of the asserted symptoms and state what precipitates and what relieves them. b) The examiner should list all diagnosed disabilities associated with the Veteran’s left knee, left ankle and right ankle pain and swelling, if any. If all complaints are associated with a diagnosed condition(s), additional specialist examinations for diagnostic purposes are not needed and the examiner should opine whether it is at least as likely as not that the diagnosed condition was incurred in or is related to the Veteran’s active military service. c) If any symptoms associated with the Veteran’s left knee, left ankle and right ankle pain and swelling are not determined to be associated with a known clinical diagnosis, further specialist examination(s) will be required to address these findings, and should be ordered by the primary examiner. d) If any specialist examination(s) is/are warranted, the primary examiner should provide the specialist with all examination reports and test results, specify the relevant symptoms that have not been attributed to a known clinical diagnosis and request that the specialist determine which of these, if any, can be attributed in this Veteran to a known clinical diagnosis and which, if any, cannot be attributed in this Veteran to a known clinical diagnosis. The examiner should specifically address the March 2010 VA examination report showing no diagnoses and normal X-rays; January 2007 private medical record notations of sciatica with pain radiating to his left knee, and decrease in left ankle reflexes; a left knee positive straight leg raising test in December 2014; and the Veteran’s reports of his knee and ankles swelling, giving out, wearing a knee brace, and his ankle rolling. A detailed and fully-supported rationale is requested for any opinion given. R. FEINBERG Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Jeremy J. Olsen, 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.