Citation Nr: 21062546 Decision Date: 10/07/21 Archive Date: 10/07/21 DOCKET NO. 18-47 339 DATE: October 7, 2021 REMANDED Entitlement to service connection for an acquired psychiatric disorder, other than unspecified anxiety disorder, to include alcohol use disorder and cannabis use disorder is remanded. Entitlement to an initial rating in excess of 10 percent for left knee patellofemoral syndrome (PFS) based on limitation of flexion is remanded. Entitlement to an initial rating in excess of 10 percent for left knee patellofemoral syndrome (PFS) based on instability is remanded. Entitlement to a rating in excess of 10 percent disabling for a chronic left ankle strain prior to June 13, 2015 is remanded. Entitlement to a rating in excess of 20 percent disabling for a chronic left ankle strain from June 13, 2015 is remanded. REASONS FOR REMAND The Veteran served active duty in the U.S. Army from January 2006 to October 2014. This case comes before the Board on appeal of a June 2015 rating decision. This case was previously before the Board in February 2020, where the issues on appeal were decided. However, the Veteran appealed the Board's decision to the Court of Veterans Claims. In March 2021, the CAVC granted a joint motion for partial remand (JMPR), which remanded the claims back to the Board consistent with the JMPR. Although the Board regrets the additional delay, a remand is necessary to ensure that due process is followed and that there is a complete record upon which to decide the Veteran's claim so that he is afforded every possible consideration. 38 U.S.C. § 5103A (2012); 38 C.F.R. § 3.159 (2019). 1. Entitlement to service connection for a psychiatric condition, other than unspecified anxiety disorder, to include alcohol use disorder and cannabis use disorder is remanded. Here, as discussed in the March 2021 JMPR, the Veteran was diagnosed with alcohol use and cannabis use disorder which may be secondary to his service-connected unspecified anxiety disorder. Specifically, in March 2016 VA examination, the Veteran was diagnosed with cannabis use disorder and alcohol use disorder. Importantly, during the examination, the Veteran reported increased drinking and marijuana use after his second deployment to Iraq. He explained that he used substances when his anxiety significantly increased, in order to manage his anxiety. Given the Veteran's competent and credible report of increased substance use during periods of heightened anxiety, it must be determined whether his alcohol use disorder and cannabis use disorder is secondary to his service-connected unspecified anxiety disorder. As such, remand is necessary to determine whether his alcohol use and cannabis use disorder was caused or aggravated by his unspecified anxiety disorder. 2. Entitlement to an initial rating in excess of 10 percent for left knee patellofemoral syndrome (PFS) based on limitation of flexion is remanded. 3. Entitlement to an initial rating in excess of 10 percent for left knee patellofemoral syndrome (PFS) based on instability is remanded. 4. Entitlement to a rating in excess of 10 percent disabling for a chronic left ankle strain prior to June 13, 2015 is remanded. 5. Entitlement to a rating in excess of 20 percent disabling for a chronic left ankle strain from June 13, 2015 is remanded. Here, as discussed in the JMPR, the Board failed to ensure the duty to assist was satisfied because the prior examinations of the Veteran's left knee and ankle were inadequate. Specifically, the examinations from June 2014 and 2015, and September 2015, did not provide testing of pain on both active and passive motion, in weight-bearing and non-weight bearing with the range of the opposite undamaged joint, per Correia. The examiners included only one set of range of motion results for the Veteran's left knee and ankle, which did not adequately address the requirements set out in Correia. Moreover, the Veteran reported that his orthopedic conditions had deteriorated and increased in severity since his last examination, thus new examinations are required. Weggenmann v. Brown, 5 Vet. App. 281, 284 (1993). Based on the foregoing, remand for new examinations of the Veteran's left knee ankle is warranted. The matters are REMANDED for the following action: 1. Obtain all relevant outstanding VA treatment records, and any private treatment records identified by the Veteran. All records and/or responses received should be associated with the claims file. 2. Then, schedule the Veteran for a VA examination to determine the current severity of his left knee and ankle. The VA examiner must review the complete claims file and must note that review in the report. A copy of this REMAND must also be provided to the VA examiner. All necessary tests and studies should be accomplished, and all clinical findings reported in detail. Likewise, all tests should be compliant with Sharp and Correia. 3. Additionally, schedule the Veteran for a VA examination to determine the etiology of his alcohol use disorder and cannabis use disorder. A copy of this REMAND must also be provided to the VA examiner. All necessary tests and studies should be accomplished, and all clinical findings reported in detail. The VA examiner should address the following: 4. Whether it is at least as likely as not (i.e., a 50 percent or greater probability) that the Veteran's alcohol use disorder and cannabis use disorder had its onset during service or is otherwise causally related to any event or circumstance of the Veteran's service. 5. Whether it is at least as likely as not (i.e., a 50 percent or greater probability) that the Veteran's alcohol use disorder and cannabis use disorder is caused by his service-connected unspecified anxiety disorder. 6. Whether it is at least as likely as not (i.e., a 50 percent or greater probability) that the Veteran's alcohol use disorder and cannabis use disorder is aggravated (i.e., worsened beyond normal progression) by his service-connected unspecified anxiety disorder. The examiner is reminded that the term "as likely as not" does not mean "within the realm of medical possibility," but rather that the evidence of record is so evenly divided that, in the examiner's expert opinion, it is as medically sound to find in favor of the proposition as against it. For the purposes of secondary service connection, the examiner is advised that aggravation is defined as "any increase in disability." See Allen v. Brown, 7 Vet. App. 439, 448 (1995). 7. The examiner should cite to the pertinent medical and competent lay evidence of record and explain the rationale for all opinions given. If after consideration of all pertinent factors it remains that the opinion sought cannot be given without resort to speculation, it should be so stated, and the provider must (to comply with governing legal guidelines) explain why the opinion sought cannot be offered without resort to speculation. 8. Thereafter, readjudicate the claims on appeal. KRISTI L. GUNN Veterans Law Judge Board of Veterans' Appeals Attorney for the Board I. Umo, 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.