Citation Nr: 21004754 Decision Date: 01/28/21 Archive Date: 01/28/21 DOCKET NO. 14-41 687 DATE: January 28, 2021 REMANDED Entitlement to service connection, to include on a secondary basis, for a right knee disability is remanded. REASONS FOR REMAND The Veteran served on active duty from February 1989 to September 1990 and from June 1993 to September 1993. This case comes before the Board of Veterans’ Appeals (Board) on appeal from an October 2013 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO). The Veteran initially requested a hearing on her November 2014 VA Form 9. A hearing was scheduled for February 2019; however, the Veteran did not appear for her requested hearing nor did she request that it be rescheduled. The appeal was last remanded by the Board in May 2020 for additional development. Regrettably, more development is still necessary. Entitlement to service connection, to include on a secondary basis, for a right knee disability is remanded. The appeal was last remanded in May 2020 for an opinion addressing the Veteran’s reports that her right foot pain caused or aggravated her right knee disability. The Veteran was afforded another VA examination in October 2020. The October 2020 VA examiner provided an opinion that the Veteran’s right knee disability was less likely than not (less than 50 percent probability) proximately due to or the result of the Veteran’s service-connected condition. The October 2020 VA examiner explained that the Veteran’s right knee disability was not medically related to and was a separate entity entirely from the Veteran’s service-connected right foot disability. However, the VA examiner did not address whether the Veteran’s service-connected right foot disability aggravated her right knee disability. The United States Court of Appeals for Veterans Claims (Court) held that the phrases “caused by” and “related to” do not address the aggravation aspect of secondary service connection. Allen v. Brown, 7 Vet. App. 439, 449 (1995). The Court has held that when an examiner determines whether service connection is warranted on a secondary basis, he or she must address both direct causation as well as aggravation. Id. Accordingly, remand is required to for a VA medical opinion addressing whether the Veteran’s right foot disability, including right foot pain, aggravated her right knee disability. The Board in this remand makes no determination, expressed or implied, concerning the credibility of any statements on file. The matters are REMANDED for the following action: 1. Obtain an addendum opinion, or schedule a VA examination, if necessary, to determine whether the Veteran’s service-connected right foot disability aggravated her right knee disability. The Veteran’s claims file, including a copy of this remand, must be made accessible to the examiner in conjunction with the examination. The opinion should include a discussion of the Veteran’s documented medical history. The examiner must opine as to the following: (a.) Is it at least as likely as not (50 percent probability or grater) that the Veteran’s right knee disability was aggravated (any incremental increase in the right knee disability beyond its normal progression) by her service-connected right foot disability? If it is determined that the right knee disability is aggravated by a service-connected disability, to the extent possible, the examiner should indicate the approximate degree of disability or baseline before the onset of aggravation. 2. Then, readjudicate the claim. If the determination of the claim remains unfavorable to the Veteran, then issue a Supplemental Statement of the Case and afford her a reasonable period of time to respond before returning the case to the Board. KELLI A. KORDICH Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board J. Palombi, 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.