Citation Nr: 21004722 Decision Date: 01/28/21 Archive Date: 01/28/21 DOCKET NO. 17-18 334 DATE: January 28, 2021 REMANDED Entitlement to service connection for a right knee condition is remanded. Entitlement to service connection for a left knee condition is remanded. REASONS FOR REMAND The Veteran served on active duty from May 1950 to September 1954, from February 1955 to August 1960, and from November 1963 to August 1974, with additional periods of active duty for training. This matter is on appeal from an August 2014 decision of a Department of Veterans Affairs (VA) Regional Office (RO). The Veteran passed away during the pendency of the appeal, and in August 2020, the agency of original jurisdiction (AOJ) granted the appellant’s request for substitution. In December 2017, the Board denied the Veteran’s claim for entitlement to service connection for left and right knee osteoarthritis. The Veteran appealed the December 2017 decision to the United States Court of Appeals for Veterans Claims (Court). In July 2018, the Court vacated the Board’s decision and remanded the claims. In February 2019, the Board remanded the matter for further development. In December 2019, the Board denied the claim. In September 2020, the Court granted a Joint Motion for Remand (JMR) that vacated the Board’s December 2019 decision and remanded it for further action. 1. Entitlement to service connection for a right knee condition is remanded. 2. Entitlement to service connection for a left knee condition is remanded. The appellant contends that entitlement to service connection for a right and left knee condition is warranted. However, the Board finds that remand is necessary to ensure substantial compliance with prior remand directives and the terms of the September 2020 JMR. As explained in the September 2020 JMR, the February 2019 remand directives requested for the examiner to address Dr. T.B.’s July 2013 opinion that the compressive force of walking on the steel decks, stairways, and ladders of ships in the Navy over 27 years of service “positively contributed” to the onset of osteoarthritis. In September 2019, VA obtained an opinion from nurse practitioner V.S., who opined that the Veteran’s condition is less likely than not related to service. She noted that the Veteran “spent some time aboard ships with steel decks and stairs” but found no nexus to service because “the medical record reflects a 27-year duration of absence of a knee injury or complaint while in military service.” Upon review of the record, the Board finds that the September 2019 rationale does not adequately address the history of the Veteran’s disability. In a March 2015 Notice of Disagreement (NOD), the Veteran stated that he experienced pain in his legs during service but did not see a doctor because he was told that they were growing pains. While this report of pain was not documented in service, the absence of contemporaneous medical records does not, in and of itself, necessarily weigh against the claim. Buchanan v. Nicholson, 451 F.3d 1331, 1336-37 (Fed. Cir. 2006). Further, an opinion is considered adequate when it is based on consideration of a Veteran’s prior medical history and examinations and describes the disability in sufficient detail so that the Board’s evaluation of the claimed disability is a fully informed one. Stefl v. Nicholson, 21 Vet. App. 120, 124 (2007). As the September 2019 opinion does not reflect consideration of these reports of leg pains in service, an addendum opinion must be obtained to adequately address the claim on appeal and comply with the prior remand directives. See Stegall v. West, 11 Vet. App. 268, 271 (1998) (stating that a Board remand confers a right on a claimant to compliance with the remand order). These matters are REMANDED for the following action: Obtain an addendum opinion from an appropriate clinician. The reviewing clinician is to provide opinions (based on a review of the record) to answer the following: Is it at least as likely as not (a 50 percent or greater probability) that the Veteran’s osteoarthritis of the left and right knees had their: (a) onset during service, (b) onset within the first year after separation from service, or (c) is related to an in-service injury, disease, or event? The examiner is asked to address Dr. T.B.’s July 2013 opinion that the compressive force of walking on the steel decks, stairways, and ladders of ships in the Navy over 27 years of service “positively contributed” to the onset of osteoarthritis. See 09/28/2018 Medical Treatment Record – Non-Gov’t Facility. In doing so, the examiner should address the significance, if any, of the Veteran’s March 2015 reports of leg pain in service. A complete rationale for all opinions must be provided. If the clinician cannot provide a requested opinion without resorting to speculation, it must be so stated, and the clinician must provide the reasons why an opinion would require speculation. The clinician must indicate whether there was any further need for information or testing necessary to make a determination. Additionally, the clinician must indicate whether any opinion could not be rendered due to limitations of knowledge in the medical community at large and not those of the particular examiner. Paul Sorisio Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board M. H. White, 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.