Citation Nr: 21001969 Decision Date: 01/12/21 Archive Date: 01/12/21 DOCKET NO. 11-30 769 DATE: January 12, 2021 REMANDED Entitlement to service connection for a bilateral knee disability, to include as secondary to service-connected disabilities, is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Air Force from November 1961 to November 1965. This matter comes to the Board of Veterans’ Appeals (Board) on appeal from February and July 2010 rating decisions issued by the Department of Veterans Affairs (VA) Regional Office in Cleveland, Ohio. The issue presently on appeal was previously before the Board in May 2012, April 2015, December 2017, and December 2018, when it was remanded to the agency of original jurisdiction (AOJ) for additional development. On each occasion, after taking further action, the AOJ confirmed and continued the prior denials and returned the case to the Board. Although the Board regrets the additional delay, a remand is necessary to ensure that there is a complete record upon which to decide the Veteran’s claim and to afford him every possible consideration. Entitlement to service connection for a bilateral knee disability, to include as secondary to service-connected disabilities, is remanded. The Veteran seeks to establish service connection for a bilateral knee disability. He maintains that he injured his knees in service. He claims to have reported an in-service injury after he jumped off of a fire truck. He also reports injuring his knees playing football in service. Alternatively, his representative contended in an October 2017 brief that the Veteran’s bilateral knee disability was caused, or had been aggravated, by his service-connected disabilities. At the time that contention was raised, the Veteran was and continues to be service connected for a low back disability and left lower extremity radiculopathy. No competent medical examination/opinion is of record which explicitly addresses the contention that his bilateral knee disability could be secondary to his service-connected disabilities. Secondary service connection may be granted for a disability that is proximately due to, or aggravated by, a service-connected disease or injury. 38 C.F.R. § 3.310; Allen v. Brown, 7 Vet. App. 439, 448 (1995). Once VA has provided an examination, it is required to provide an adequate one. Barr v. Nicholson, 21 Vet. App. 303 (2007). As none of the VA examinations pertaining to the Veteran’s knees have addressed secondary service connection, further development is warranted. This matter is REMANDED for the following action: 1. Obtain copies of records pertaining to any VA treatment the Veteran has received since the time that such records were last procured, following the procedures set forth in 38 C.F.R. § 3.159. The evidence obtained, if any, should be associated with the record. 2. After the foregoing development has been completed, arrange to provide the record on appeal to an appropriate VA clinician for purposes of obtaining an opinion with respect to the etiology of the Veteran’s knee disabilities. Following review of the claims file, the examiner should provide opinions as to each of the following questions: a. Is it at least as likely as not (i.e., is it 50 percent or more probable) that the Veteran has a disability of either knee that was caused by a service-connected disability, to include his service-connected low back disability and/or left lower extremity radiculopathy? b. If not, is it at least as likely as not that the Veteran has a disability of either knee that was aggravated by (i.e., worsened beyond natural progression by) a service-connected disability, to include his service-connected low back disability and/or left lower extremity radiculopathy? The need for another examination and/or telephonic or video interview of the Veteran is left to the discretion of the examiner selected to offer the requested opinions. A complete medical rationale for all opinions expressed must be provided. 3. After completing the above, and any other development as may be indicated by any response received as a consequence of the actions taken in the preceding paragraphs, the issue on appeal should be readjudicated based on the entirety of the evidence. If any benefit sought remains denied, the Veteran should be issued a supplemental statement of the case. An   appropriate period of time should be allowed for response. DAVID A. BRENNINGMEYER Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Joseph T. Leonard, Law Clerk 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.