Citation Nr: 21001782 Decision Date: 01/11/21 Archive Date: 01/11/21 DOCKET NO. 02-17 656 DATE: January 11, 2021 REMANDED Entitlement to service connection for a right knee condition, to include a secondary to a service-connected left ankle condition, is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Army from July 1980 to July 1984. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a February 2002 rating decision of the Department of Veterans’ Affairs (VA) Regional Office (RO) in San Juan, Puerto Rico. This appeal was most recently before the Board in January 2020. At that time, the appeal included the issue of entitlement to service connection for a low back condition. Upon consideration of the record, the Board remanded the appeal in its entirety for further evidentiary development. Upon remand, the AOJ granted service connection for the low back disability. As this grant represents a full grant of benefits sought, this issue is no longer in appellate status and the Board does not have jurisdiction over it. In regard to the issue of service connection for a right knee disability, the January 2020 Board remand sought an additional VA opinion regarding whether the Veteran’s right knee condition was caused by or otherwise etiologically related to his period of service. At the July 2020 VA examination, the examiner opined that the Veteran’s right knee disability was less likely than not related to his period of service. In so finding, the examiner found that there was no evidence of a right knee condition during service or within one year of after separation from service. The Board finds this opinion to be inadequate, as it did not appear to consider the Veteran’s reports of right knee pain during service and continuously thereafter. Buchanan v. Nicholson, 451 F.3d 1331, 1336, n. 1 (Fed. Cir. 2006) (noting that VA’s examiner’s opinion, which relied on the absence of contemporaneous medical evidence, “failed to consider whether the lay statements presented sufficient evidence of the etiology of [the veteran’s] disability such that his claim for service connection could be proven without contemporaneous medical evidence”). Therefore, the Board finds that remand is required for an addendum opinion addressing whether the Veteran has a right knee condition directly related to his active service. The examiner is instructed to refer to the Veteran’s lay statements recounting the chronology of his symptoms of right knee pain since service in rendering the opinion. The matters are REMANDED for the following action: 1. Obtain an addendum opinion from an appropriate clinician regarding whether the Veteran’s right knee disability is at least as likely as not related to service. The examiner is asked to specifically discuss the Veteran’s contention that he had right knee pain continually since active service, and discuss whether there is any medical reason to accept or reject the Veteran’s belief that chronic right knee pain since service represented the onset of his current right knee disability. The need for further physical examination is left to the discretion of the examiner. The term “at least as likely as not” does not mean “within the realm of medical possibility.” Rather, it means that the weight of medical evidence both for and against a conclusion is so evenly divided that it is as medically sound to find in favor of the conclusion (e.g., etiology) as it is to find against the conclusion. The examiner is advised that the Veteran is competent to report his symptoms and history, and such reports must be acknowledged and considered in formulating any opinion. Furthermore, if medical literature is related upon in rendering this determination, the VA examiner should identify and specifically cite each reference material utilized. T. MAINELLI Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board C. Orie, 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.