Citation Nr: 21062810
Decision Date: 10/12/21	Archive Date: 10/12/21

DOCKET NO. 16-26 599
DATE: October 12, 2021

REMANDED

Entitlement to service connection for a left knee disability is remanded. 

Entitlement to service connection for a right knee disability is remanded. 

INTRODUCTION

The Veteran served on active duty from May 1966 to May 1969. 

When this case was previously before the Board in April 2021, the above-noted claims were remanded for additional development.  The case has since been returned for further appellate review. 

REASONS FOR REMAND

The Board is of the opinion that additional development is required before the claims on appeal are decided. 

When VA undertakes to provide a VA examination or obtain a VA opinion, it must ensure that the examination or opinion is adequate.  Barr v. Nicholson, 21 Vet. App. 303, 312 (2007).  To be considered adequate, a medical examination report must contain not only clear conclusions with supporting data, but also a reasoned medical explanation connecting the two.  See Nieves-Rodriguez v. Peake, 22 Vet. App. 295 (2008). 

In the course of the above-noted April 2021 remand, the Board found a previous May 2016 VA medical opinion to be inadequate, because the examiner failed to explain how or why the Veteran's duties as a parachutist in service could not have caused or contributed to his current bilateral knee disabilities.  The Veteran recently underwent a second VA examination in August 2021.  Following that examination, the Veteran was diagnosed with bilateral degenerative joint disease, with left knee meniscal tear.  However, the examiner again found the Veteran's disabilities were less likely than not incurred in service.  In support of this conclusion, the examiner noted several facts relative to the Veteran's bilateral knee medical history but failed to explain how or why these facts led to her conclusion.  Further, the examiner again failed to explain how or why the Veteran's bilateral knee disabilities could not have been caused by the traumatic stress placed on his musculoskeletal system from parachute jumps as requested.  A remand by the Board confers upon the claimant, 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). 

Accordingly, these matters are REMANDED for the following actions: 

Afford the Veteran a VA examination by an Orthopedist with sufficient expertise, who has not previously examined the Veteran, to address the etiology of the Veteran's claimed bilateral knee disabilities.  All pertinent evidence of record must be made available to and reviewed by the examiner.  Any indicated studies should be performed. 

Following a review of the relevant records and lay statements, the examiner should state an opinion with respect to whether any diagnosed left or right knee disability at least as likely as not (a 50 percent probability or greater) originated during his period of active service or is otherwise etiologically related to his active service, to specifically include as a result of repeated traumatic stress placed on his knees from parachute jumps.  

The examiner must provide a complete rationale for all proffered opinions.  In this regard, the examiner must discuss and consider the Veteran's competent lay statements.  If the examiner is unable to provide any required opinion, he or she should explain why.  If the examiner cannot provide an opinion without resorting to mere speculation, he or she shall provide a complete explanation as to why this is so.  If the inability to provide a more definitive opinion is the result of a need for additional information, the examiner should identify the additional information that is needed.

 

 

T. REYNOLDS

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	G. Fraser, 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.