Citation Nr: 21061577 Decision Date: 10/04/21 Archive Date: 10/04/21 DOCKET NO. 18-38 826 DATE: October 4, 2021 REMANDED Entitlement to a disability rating in excess of 10 percent for right knee degenerative joint disease (DJD) is remanded. Entitlement to a disability rating in excess of 10 percent for right ankle degenerative joint disease (DJD) is remanded. Entitlement to service connection for a right foot disability other than hallux valgus, to include as secondary to service-connected disabilities is remanded. REASONS FOR REMAND The Veteran served on active duty from December 1979 until January 2000. In June 2021, the Veteran testified at a hearing before the undersigned Veterans Law Judge. A transcript of that hearing is of record. Entitlement to a disability rating in excess of 10 percent for right knee DJD is remanded. Entitlement to a disability rating in excess of 10 percent for right ankle DJD is remanded. The Veteran asserts that her right knee and right ankle disabilities warrant a higher disability rating. The claims are remanded to obtain current examinations. The Veteran was afforded VA examinations in January 2015 and July 2017, but testified that her knee and ankle disabilities have worsened since then. See June 2021 hearing. She testified that she now experiences instability and buckling in her right knee when ascending and descending stairs and that she may also experience instability in her right ankle. The Veteran also testified to a decrease in stamina and ability to walk more than 100 yards without pain, drive long distances, or stand for more than 8 10 minutes due to her right ankle and knee conditions. Additionally, the Veteran reported constant pain in her right ankle and that she wears a right ankle brace. Entitlement to service connection for a right foot disability other than hallux valgus, to include as secondary to service-connected disabilities is remanded. The Veteran asserts that she has right foot disabilities other than the already service-connected hallux valgus that are either related to service or secondary to her service-connected foot, knee and ankle conditions. The Agency of Original Jurisdiction (AOJ) readjudicated the claim in a June 2018 rating decision; however, the Veteran perfected an appeal from an April 2015 decision and the claim is before the Board on the merits. The claim must be remanded for a medical opinion. A November 2019 VA opinion is inadequate as to secondary service connection for causation and did not address aggravation at all. On remand, an addendum medical opinion that adequately addresses all raised theories of entitlement must be obtained. Finally, at the June 2021 Board hearing, the Veteran identified additional treatment records from Peterson Air Force Base since those records were obtained in October 2018. The regional office must make appropriate efforts to obtain the identified records on remand. The matters are REMANDED for the following action: 1. Take all appropriate action to obtain the Veteran's treatment records from Peterson Air Force Base from October 2018 until the present. Document all requests for information as well as all responses in the claims file. 2. After completion of the above, schedule the Veteran for an examination by an appropriate clinician to determine the current severity of her service-connected right knee and right ankle disabilities. Copies of all pertinent records should be provided to the examiner for review. The examiner should provide a full description of the disability and report all signs and symptoms necessary for evaluating the Veteran's disability under the rating criteria. The examiner must complete the corresponding VA disability benefits questionnaire (DBQ), provide a full description of the disability and report all signs and symptoms necessary for evaluating the Veteran's disability under the rating criteria. The examiner must test the Veteran's active motion, passive motion, and pain with weight-bearing and without weight-bearing. If it is not possible to provide a specific measurement without speculation, the examiner must state whether the need to speculate is due to a deficiency in the state of general medical knowledge (no one could respond given medical science and the known facts), a deficiency in the record (additional facts are required), or the examiner (does not have the knowledge or training). Additionally, the examiner must attempt to elicit information regarding the severity, frequency, and duration of any flare-ups, and the degree of functional loss during flare-ups. If it is not possible to provide a specific measurement based on direct observation, the examiner should provide an estimate, if at all possible, of the additional impairment due to flare-ups based on the other evidence of record and the Veteran's statements. If it is not possible to provide a specific measurement without speculation, the examiner must state whether the need to speculate is due to a deficiency in the state of general medical knowledge (no one could respond given medical science and the known facts), a deficiency in the record (additional facts are required), or the examiner (does not have the knowledge or training). 3. Schedule the Veteran for an examination with an appropriate clinician to obtain an opinion as to the nature and likely etiology of any diagnosed right foot disability, other than hallux valgus. Copies of all pertinent records should be made available to the examiner for review. The examiner must answer the following: (a) Identify all currently diagnosed right foot disabilities, other than hallux valgus. (b) Is it at least as likely as not that any diagnosed right foot disability other than hallux valgus was incurred in or otherwise directly related to service? Why or why not? (c) Is it at least as likely as not that any diagnosed right foot disability other than hallux valgus is caused by the service-connected right hallux valgus, knee or ankle disabilities? (d) Is it at least as likely as not that any diagnosed right foot disability other than hallux valgus is aggravated by (defined as any increase in disability) the service-connected right hallux valgus, knee or ankle disabilities? A complete rationale must be provided for all opinions. If the examiner cannot provide an opinion without resort to speculation, the examiner must state whether the need to speculate is due to a deficiency in the state of general medical knowledge; the examiner's own expertise, or; whether additional facts are required and note what, if any, additional evidence would permit such an opinion to be made. 4. After completion of the above development, and any additionally indicated development, verify that the obtained medical opinions comport with this remand. Specifically, verify the correct definition of aggravation (any increase in disability) for this circumstance is used although the incorrect definition may be printed on the examination form. If the incorrect definition of aggravation is used, obtain an addendum opinion prior to readjudicating the claim. M.E. Larkin Veterans Law Judge Board of Veterans' Appeals Attorney for the Board M.D. Collins, 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.