Citation Nr: 21000145 Decision Date: 01/04/21 Archive Date: 01/04/21 DOCKET NO. 17-50 409 DATE: January 4, 2021 REMANDED Service connection for a left knee disability is remanded. Service connection for a left ankle disability is remanded. REASONS FOR REMAND The Veteran served on active duty from February 2002 to April 2006 and June 2008 to June 2009 in the United States Army. He was awarded the Combat Infantryman Badge for each period of service. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a December 2013 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO). In May 2019, the Veteran and his spouse testified before the undersigned during a videoconference hearing. A transcript of the hearing is included in the electronic claims file. 1. Service connection for a left knee disability is remanded. 2. Service connection for a left ankle disability is remanded. In September 2019, the Board remanded the above claims in order to obtain any outstanding treatment records, and afford the Veteran VA examinations for his claims. While VA examinations were conducted in November 2019, the Board finds that a further opinion must be obtained. When VA undertakes to provide a VA examination or obtain a VA opinion, it must ensure that the examination or opinion is adequate. Barr v. Nicholson, 21 Vet. App. 303, 312 (2007). The examiner provided a negative nexus opinion for both claims, finding that the Veteran experienced only an acute injury in service. In doing so, however, it does not appear that she considered the entirety of the pertinent service treatment records, or the fact that the Veteran is a combat veteran and reports left knee and ankle injuries related to the general rigors of combat. Service treatment records show that on a service examination in February 2006, the Veteran had bilateral knee and ankle crepitus and popping. In October 2008, he sprained his left ankle stepping out of a Humvee. An accompanying Statement of Medical Examination and Duty Status indicates the injury was incurred in the line of duty and was likely to result in a claim against the government for future medical care. In May 2009, his “problem list” included an ankle and knee sprain. Further, the examiner provided conflicting statements regarding the etiology of the left ankle. Within the same sentence, she stated that the left ankle condition was “at least likely as not incurred in or caused by ankle injury during service,” and also that a nexus had not been established. For all of these reasons, the Board finds that a further opinion must be obtained. Additionally, in a November 2020 Post-Remand Brief, the Veteran’s representative, citing Stegall v. West, 11 Vet. App. 268 (1998), requested a remand due to the fact that the Veteran had not been provided with a letter inviting him to identify any outstanding treatment records pertinent to his claims, pursuant to the underlying remand directive. While the Board notes that a January 2020 letter requests such information, it is unclear whether the letter was sent in response to the present appeal, or other pending claims. On remand, the requested letter must be sent. The matters are REMANDED for the following action: 1. Contact the Veteran and invite him to identify any outstanding evidence, either VA or private, pertaining to the claims on appeal. The RO/AMC must thereafter request and obtain any outstanding VA treatment records, as well as any private records upon his completion of a VA Form 21-4142. 2. Schedule the Veteran for an examination to obtain an opinion addressing the nature and etiology of his left knee and ankle disabilities. A complete explanation must be provided for all opinions rendered. The examiner must respond to the following inquiries: Is it at least as likely as not (50 percent probability or greater) that the Veteran's (a.) left knee and/or (b.) left ankle disability is the result of a disease, injury, or event in service, to include his combat service? In rendering this opinion, the examiner must consider the following: • The Veteran has been awarded the Combat Infantryman Badge for both periods of active duty and reports that his left knee and ankle symptoms are related to the rigors of combat. As such, the examiner is directed to accept the in-service incurrence of the Veteran’s combat-related left knee and ankle injuries and thus, must accept as fact that these “injuries” occurred in service. • February 2006 service examination documented bilateral knee and ankle crepitus and popping. • October 2008 service treatment record documented a sprained left ankle. An accompanying Statement of Medical Examination and Duty Status indicates the injury was incurred in the line of duty and was likely to result in a claim against the government for future medical care. • May 2009 “problem list” includes an ankle and knee sprain M. Tenner Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board J. Smith, 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.