Citation Nr: 21004109 Decision Date: 01/26/21 Archive Date: 01/26/21 DOCKET NO. 14-15 994 DATE: January 26, 2021 REMANDED Entitlement to service connection for a left knee disorder, to include as secondary to bilateral pes planus, is remanded. REASONS FOR REMAND The Veteran served on active duty from September 1963 to September 1967. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a June 2011 rating decision by a Department of Veterans Affairs (VA) Regional Office. In April 2017, the Veteran testified at a Board hearing before the undersigned Veterans Law Judge. A transcript of the hearing is of record. In April 2018, January 2019, and September 2020, the Board remanded the case for additional development and it now returns for further appellate review. Entitlement to service connection for a left knee disorder, to include as secondary to bilateral pes planus. By way of background, in the April 2018 Remand, the Board noted that a May 2011 VA examiner indicated that no significant left knee disorder was found on examination. However, in light of the Veteran’s complaints and alleged functional impairment, the Board remanded the case in April 2018 in order to obtain an addendum opinion addressing whether his reported left knee symptomatology, to include pain, resulted in functional impairment of earning capacity, and, thus, a disability for VA purposes. However, in a May 2018 addendum opinion, a VA examiner diagnosed degenerative arthritis of the left knee, but, as indicated in the January 2019 Remand, it was unclear upon what evidence such diagnosis was based. Thus, the Board again remanded the claim in order to obtain a clarifying opinion as to whether the Veteran currently had a left knee disorder, to include degenerative arthritis and, if so, the examiner was directed to identify the medical evidence supporting such a diagnosis. Thereafter, in a September 2019 addendum opinion, the May 2018 VA examiner noted a diagnosis of degenerative joint disease of the left knee, but again did not identify the medical evidence supporting such diagnosis. Consequently, in September 2020, the Board again remanded the case in order to obtain yet another addendum opinion addressing such inquiry. See Stegall v. West, 11 Vet. App. 268, 271 (1998). Thereafter, an addendum opinion was obtained from another VA examiner in December 2020. In this regard, after a review of the record, he indicated that mild bilateral degenerative joint disease was diagnosed in 2011; however, he did not identify the medical evidence supporting such a diagnosis as requested in the September 2020 Remand. Id. In this regard, the Board again notes that the May 2011 VA examiner, after reviewing the record, conducting a physical examination, and obtaining X-rays of the bilateral knees, found no significant left knee disorder. In particular, the Board notes that contemporaneous X-rays of the left knee revealed no acute fracture, dislocation, or joint effusion; unremarkable soft tissues; and tiny patellar osteophytes with no significant degenerative changes. Thus, the Board finds that another remand is necessary in order to obtain an addendum opinion addressing whether the Veteran has a current left knee disorder, to include degenerative arthritis and/or degenerative joint disease, and, if so, the examiner should identify the medical evidence supporting such a diagnosis. Furthermore, while the aforementioned VA examiners have addressed whether the Veteran’s claimed left knee disorder is related to his military service, or caused or aggravated by his bilateral pes planus, the examiner should be provided an opportunity to revisit such opinions in light of his or her response to the aforementioned inquiry regarding the presence of a current left knee disorder. The matter is REMANDED for the following action: Return the record, to include a copy of this Remand, to the December 2020 examiner, or an appropriate substitute if he is unavailable, for an addendum opinion addressing the nature of the Veteran’s claimed left knee disorder. The need for another examination is left to the discretion of the medical professional offering the addendum opinion. Following a review of the record, the examiner should address the below inquiries: (A) Does the Veteran currently have a left knee disorder, to include degenerative arthritis and/or degenerative joint disease? If so, please list each disorder and identify the medical evidence supporting such a diagnosis. In offering such opinion, the examiner should consider the findings from the May 2011 VA examination, to include X-rays findings pertinent to the left knee that revealed no acute fracture, dislocation, or joint effusion; unremarkable soft tissues; and tiny patellar osteophytes with no significant degenerative changes. If examiner finds that the Veteran does not have a current left knee disorder, is it at least as likely as not (i.e., a 50 percent or greater probability) that his reported left knee pain results in functional impairment of earning capacity, i.e., a disability for VA purposes? (B) After addressing the foregoing inquiries, the examiner is invited to revisit the opinions offered in May 2018, September 2019, and December 2020 addressing whether the Veteran’s claimed left knee disorder is at least as likely as not (i.e., a 50 percent or greater probability) is related to his military service, or caused or aggravated by his bilateral pes planus. A rationale for any opinion offered should be provided. A. JAEGER Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board J. M. Kelly, 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.