Citation Nr: 21062317 Decision Date: 10/07/21 Archive Date: 10/07/21 DOCKET NO. 17-51 936 DATE: October 7, 2021 REMANDED Entitlement to service connection for a right knee disability is remanded. Entitlement to service connection for a left knee disability, to include as due to a right knee disability, is remanded. REASONS FOR REMAND The Veteran served on active duty for training in the U.S. Army from October 2008 to March 2009 with additional periods of inactive duty for training from 2009 to 2013 in the Army Reserve. This appeal comes before the Board of Veterans' Appeals (Board) from an April 2014 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO). The Veteran testified before the undersigned Veterans' Law Judge at a December 2019 Travel Board hearing. A transcript of the hearing has been associated with the claims file. Previously, the claims were before the Board in March 2021, and were remanded for additional development. As discussed in greater detail below, the directives of the prior remand have not been complied with and additional development is warranted. 1. Entitlement to service connection for a right knee disability 2. Entitlement to service connection for a left knee disability, to include as due to a right knee disability The Veteran contends that service connection is warranted for a right knee disability, and that service connection is warranted for a left knee disability, to include as due to her right knee disability. The Veteran contends that she injured her right knee during inactive duty for training while completing physical training and such has resulted in her current right and left knee disabilities. Regrettably, another remand is warranted to comply with the March 2021 remand directives. A remand by the Board confers upon the Veteran, as a matter of law, the right to compliance with the remand instructions, and imposes upon VA a concomitant duty to ensure compliance with the terms of the remand. See Stegall v. West, 11 Vet. App. 268, 271 (1998). Where the remand orders of the Board are not complied with, the Board errs as a matter of law when it fails to ensure compliance. As a result of the prior Board remand, service treatment records and personnel records form the Veteran's Reserve service have been associated with the claims file. In addition, leave and earning statements (LES) have been associated with the claims file. An LES notes the Veteran had inactive duty for training in June 2011, July 2011, August 2011, September 2011 and October 2011. The Veteran served on inactive duty for training from August 6, 2011 to August 8, 2011. Treatment records note the Veteran was then seen in the emergency room on August 9, 2011 with reports of an injury to the right knee and pain and swelling. X-ray imaging of the right knee were negative, and the Veteran later underwent a right knee MRI on September 10, 2011 where she reported a right knee injury 2 to 3 weeks ago with immediate buckling, swelling and persistent pain down the medial joint line. The Veteran reports that she was still unable to weight bear. The MRI noted a high grade tear of the anterior cruciate ligament and likely tear of the medial aspect of the posterior horn of the lateral meniscus. A VA opinion from June 2021 has been associated with the claims file. The examiner noted no in-service injury, event or disease that occurred during active duty for training or inactive duty training has been found and it is less likely than not that the Veteran's current right knee disability was incurred in or caused by the claimed in-service, injury, event or illness. The examiner also noted that the Veteran's left knee disability was less likely than not proximately due to or the result of a claimed service connected condition. However, a supplemental VA opinion is warranted because the examiner failed to fully address the Veteran's consistent statements of ongoing right knee pain and symptomology in-service and during physical training during periods of inactive duty for training. Further, an LES confirms that the Veteran served on inactive duty for training from August 6, 2011 to August 8, 2011. Then, the Veteran was seen in the emergency room on the next day August 9, 2011. An MRI several weeks later confirmed a right knee ACL tear. The Veteran underwent her first right knee surgery and repair in November 2011, relating to this August 2011 injury. The examiner should address whether the Veteran's current right knee injury is related to wear and tear and aggravation from physical training during inactive duty for training in August 2011. A remand is warranted for a supplemental opinion to fully address direct and secondary service connection. The matters are REMANDED for the following action: 1. Schedule the Veteran for a supplemental VA opinion for her right and left knee disabilities. The examiner must review the claims file, and is asked to provide a response to the following: (a.) Is it at least as not (a 50 percent probability or greater) that the Veteran's current right knee disability is caused by an in-service injury, event or disease that occurred during active duty for training or inactive duty training? Including the Veteran's inactive duty for training from August 6, 2011 to August 8, 2011. Then only if the Veteran's right knee is found to be caused by an in-service injury, event or disease then: (b.) Is it at least as likely as not (a 50 percent probability or greater) that the Veteran's left knee disability was caused by her right knee disability? (c.) Is it at least as likely as not (a 50 percent probability or greater) that the Veteran's left knee disability was aggravated by her right knee disability? Review of the entire claims file is required. The examiner must provide a complete rationale for all findings and opinions, and a discussion of the facts and medical principles involved would be of considerable assistance to the Board. A private opinion from November 2019 notes that the Veteran clearly injured her bilateral knees while still in service. In addition, attention is invited to the June 2021 VA opinion. The examiner noted no in-service injury, event or disease that occurred during active duty for training or inactive duty training has been found and it is less likely than not that the Veteran's current right knee disability was incurred in or caused by the claimed in-service, injury, event or illness. The examiner also noted that the Veteran's left knee disability was less likely than not proximately due to or the result of a claimed service connected condition. An LES confirms that the Veteran served on inactive duty for training from August 6, 2011 to August 8, 2011. Then, the Veteran was seen in the emergency room on the next day August 9, 2011. An MRI several weeks later confirmed a right knee ACL tear. J.W. FRANCIS Veterans Law Judge Board of Veterans' Appeals Attorney for the Board K.R. Kardian, 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.