Citation Nr: 21061420 Decision Date: 10/04/21 Archive Date: 10/04/21 DOCKET NO. 16-55 721 DATE: October 4, 2021 REMANDED Entitlement to service connection for left knee meniscal tear is remanded. REASONS FOR REMAND The Veteran served on active duty from March 1989 to October 1994, with additional service from March 1988 to June 1988. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a February 2016 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO). In September 2019, the Veteran testified at a Board video conference hearing before the undersigned Veterans Law Judge. A transcript of this hearing is of record. This matter was last before the Board in March 2021, when it was remanded for further development. 1. Entitlement to service connection for left knee meniscal tear is remanded. The Veteran testified that his left knee disability was caused by an in-service injury. Alternatively, he contends the left knee disability is secondary to his service-connected right knee, right ankle or back. In October 2019, the Veteran's private physician, Dr. P. R. noted in a letter that the Veteran has continued to have a left knee pain following an initial injury in Saudi Arabia and that he compensates for the right knee and back with his left knee. In August 2021, Dr. M. S. indicated that the Veteran's symptoms can likely be coming from overcompensation using the left leg because of pain from subtalar arthropathy on the right from an injury he sustained in the military. However, these opinions did not contain adequate rationale. The March 2021 remand requested an opinion to address the question of whether the Veteran's left knee disability was aggravated by the service-connected right knee, right ankle, and/or back disabilities. However, the opinion obtained in April 2021 did not fully address this question. Specifically, the examiner's rationale saying there was no aggravation addressed causes of arthritis, and did not explain why the right knee disability, to include favoring of the right knee and ankle, did not worsen the left knee disability. While further delay is regrettable, in light of the above, the Board finds that an additional remand is warranted. The matters are REMANDED for the following action: 1. Ask the Veteran to provide the names and addresses of all medical care providers who have recently treated him for his left knee disability. After securing any necessary releases, request any relevant records identified. In addition, obtain updated VA treatment records. If any requested records are unavailable, the Veteran and his representative should be notified of such. 2. After the above has been completed to the extent possible, obtain an addendum opinion with respect to the Veteran's left knee disability. The claims file must be reviewed by the examiner. If a new examination is deemed necessary to respond to the request, one should be scheduled. After review of the claims file, the examiner should respond to the following: (a.) Is it at least as likely as not that the Veteran's left knee disability has been worsened beyond the normal progression (aggravated) by the service-connected right knee, right ankle or back disability, to include the contention that he placed more stress on the left knee due to favoring the right leg and back? Please explain why or why not to include addressing Dr. P. R's October 2019 statement and Dr. M. S.' August 2021 statement that the Veteran's symptoms can likely be coming from overcompensation using the left leg because of pain from subtalar arthropathy on the right. A rationale for the opinion expressed should be provided (b.) If the examiner finds the left knee disability has been aggravated by any service-connected disability, the examiner should provide an opinion as to the baseline level of disability prior to aggravation. quantify the degree of aggravation beyond the baseline level of left knee disability. A rationale for the opinion expressed should be provided. K. A. BANFIELD Veterans Law Judge Board of Veterans' Appeals Attorney for the Board A. Asare, 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.