Citation Nr: 21000548 Decision Date: 01/05/21 Archive Date: 01/05/21 DOCKET NO. 17-13 798 DATE: January 5, 2021 REMANDED Entitlement to service connection for a right knee disability as proximately due to or aggravated by service-connected disabilities is remanded. REASONS FOR REMAND The Veteran served on active duty from September 1966 to November 1971. The matter comes before the Board of Veterans’ Appeals (Board) on appeal from a November 2012 rating decision by a Department of Veterans Affairs (VA) Regional Office (RO). The Veteran testified at a videoconference hearing before the undersigned Veterans Law Judge (VLJ) in March 2020. The hearing transcript is of record. The Board remanded the claim in May 2020 for further development by the RO. The case has been returned to the Board for further appellate action. While the Board regrets the delay, another remand is necessary in this case. The RO obtained a September 2020 medical opinion. The examiner opined that the Veteran’s right knee disability is less likely than not proximately due to, the result of, or aggravated beyond its natural progression by Veteran’s service-connected condition. The examiner reasoned that the Veteran’s right knee disability and the other service-connected conditions are not medically related. Joint conditions are not transferable, although injury to one extremity or side of the body can lead to overuse of the opposite, healthier side. The examiner goes on to explain that a condition in one joint does not spread to another and determined that no nexus was established. However, the examiner’s statement regarding the effects of possible overuse is general and speculative. The examiner does address whether, for the Veteran in particular, overuse and compensation of the right knee due to the other service-connected conditions was present or etiologically related to his right knee disability. The case must be returned for an addendum opinion. Barr v. Nicholson, 21 Vet. App. 303 (2007) (holding that once VA undertakes an examination, it must provide an adequate one). The matter is REMANDED for the following action: 1. Obtain updated VA treatment records. 2. Thereafter, obtain an addendum opinion from an appropriate medical professional. The claims file, as updated, must be made available to and reviewed by the examiner. The examiner should opine on the following: (a) Is the Veteran’s right knee disability etiologically related (caused or aggravated), in whole or in part, to the Veteran’s active service? (b) Is the Veteran’s right knee disability at least as likely as not (50 percent or greater probability) proximately due to or aggravated by service-connected lumbar spine, left hip, left knee, and/or left ankle? If, and only if, the examiner determines that another VA examination is necessary to provide an informed opinion, such an examination should be scheduled. A complete rationale should be given for all opinions and conclusions expressed. If the examiner cannot provide an opinion without resort to speculation, the examiner should provide an explanation as to why this is so and must state whether there is additional evidence that would permit the necessary opinion to be made. Nathaniel J. Doan Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board M. Minaya, 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.