Citation Nr: 21062282 Decision Date: 10/06/21 Archive Date: 10/06/21 DOCKET NO. 17-01 992 DATE: October 6, 2021 REMANDED Entitlement to service connection for left knee patellofemoral pain syndrome, to include as secondary to service-connected right hip disability, is remanded. Entitlement to service connection for right knee patellofemoral pain syndrome, to include as secondary to service-connected right hip disability, is remanded. REASONS FOR REMAND The Veteran served on active duty from January 2003 to December 2003 and May 2005 to May 2006. In November 2019, the Veteran testified before the undersigned Veterans Law Judge (VLJ). A transcript of the hearing is of record. In February 2020 and March 2021, the Board remanded the claim for further development. In March 2021, the Board remanded the claims for entitlement to service connection for lumbar spine disability, left hip femoro acetabular impingement, and bilateral knee disability. In its June 2021 rating decision, the agency of original jurisdiction (AOJ) granted service connection for the Veteran's lumbar spine and left hip disabilities. This represents a full grant of benefits. Accordingly, these issues are no longer before the Board. See AB v. Brown, 6 Vet. App. 35 (1993). The Veteran contends that his bilateral knee disability is due to military service, or in the alternative, secondary to his service-connected right hip disability. In its June 2021 decision, the AOJ granted service connection for lumbosacral strain, to include as secondary to service-connected right hip disability. The grant was based on the VA examiner's opinion, i.e., the Veteran's back condition was at least as likely as not proximately due to or the result of his service-connected right hip disability. The examiner's rationale was that the lumbar strain was a potential effect of femoroacetabular impingement (FAI). In his July 2021 correspondence, the Veteran stated, in the March 31, 2021 VA opinion and as a basis for service-connection for lumbosacral strain, secondary to FAI, the VA medical examiner cited medical literature that described back pain as a common symptom of FAI. The Veteran further stated that same literature also identifies knee pain as a common symptom of FAI. The literature cited the relationship of both knees and back pain as common symptoms of FAI within the same sentence. The Board notes that the article in question, The Warwick Agreement on Femoroacetabular Impingement Syndrome (FAI syndrome): An International Consensus Statement, notes that most patients report pain in the groin or hip, but pain is also reported in the lateral hip, anterior thigh, buttock, knee, lower back, lateral, and posterior thigh. As noted above, based on this article, the examiner opined that the Veteran's lumbosacral strain is at least as likely as not proximately due to or the result of the service-connected right hip disability. However, the examiner opined that it is less likely than not that the Veteran's bilateral knee disability is due to or the result of the service-connected right hip disability. Based on the article and the VA examiner's positive opinion regarding the relationship between FAI and lumbosacral strain, the Board finds that an addendum opinion should be obtained to address the information found in the article regarding the relationship between FAI and knee pain. The matters are REMANDED for the following action: 1. Obtain and associate all outstanding relevant VA and private treatment records with the claims file. 2. Obtain an addendum opinion from the May 2021 examiner. The evidentiary record, including a copy of this remand, must be made available to and reviewed by the examiner. The addendum opinion must include a notation that this record review took place. It is up to the discretion of the examiner as to whether a new examination is necessary to provide an adequate opinion. If the examiner is no longer available, obtain an opinion from another appropriate examiner. The examiner should opine as to whether it is at least as likely as not (at least a 50 percent probability) that the Veteran's bilateral knee disability is caused or aggravated by, proximately due to, or the result of the Veteran's service-connected right hip disability. If aggravation is found, the examiner should also state, to the extent possible, the baseline level of disability prior to aggravation. The examiner must address the information found in the Warwick Agreement on Femoroacetabular Impingement Syndrome (FAI syndrome): An International Consensus Statement regarding FAI and knee pain. The supporting rationale for all opinions expressed must be provided. The examiner should consider the Veteran's lay statements. 3. Then, readjudicate the issues on appeal. If the benefits sought on appeal remain denied, furnish the Veteran and his representative a Supplemental Statement of the Case and allow them an opportunity to respond. MICHAEL LANE Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Moore, Tara-Deen 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.