Citation Nr: 21062875 Decision Date: 10/12/21 Archive Date: 10/12/21 DOCKET NO. 16-17 412 DATE: October 12, 2021 REMANDED Entitlement to service connection for a left knee disability, to include osteoarthritis, is remanded. REASONS FOR REMAND The Veteran had active service from June 1970 to January 1972. The Veteran served in the Republic of Vietnam and was awarded the Combat Infantryman Badge and the Air Medal. Entitlement to service connection for a left knee disability, to include osteoarthritis, is remanded. Service connection may be established on a secondary basis for a disability which is proximately due to or the result of service-connected disease or injury. 38 C.F.R. § 3.310(a). Any increase in severity of a nonservice-connected disease or injury that is proximately due to or the result of a service-connected disease or injury, and not due to the natural progress of the nonservice-connected disease, will be service connected. 38 C.F.R. § 3.310(b). When aggravation of a nonservice-connected condition is proximately due to or a result of a service-connected disability, a veteran may be compensated for the degree of disability over and above the degree of disability existing prior to the aggravation. Allen v. Brown, 7 Vet. App. 439, 448 (1995). Service connection had been established for right total knee replacement residuals, a post-operative right knee scar, PTSD, coronary artery disease with an implanted pacemaker, a post operative scar, bilateral hearing loss, and tinnitus. In his September 2012 informal claim for service connection, the Veteran indicated that he had been diagnosed with left knee osteoarthritis in 2003. The report of an October 2019 Department of Veterans Affairs (VA) knee examination states that the Veteran reported progressive left knee pain since active service. The report of an August 2021 knee evaluation conducted for VA conveys that the Veteran was diagnosed with left knee osteoarthritis and underwent an October 2013 left knee total knee replacement. The examiner concluded that "the claimed condition is less likely than not (less than 50 percent probability) proximately due to or the result of Veteran's service connected condition." The nurse practitioner commented that "since both knees were replaced the same year due to osteoarthritis, there is no evidence that osteoarthritis was caused or aggravated by the right knee leading to total knee replacement surgery" and "there is no evidence that the right knee caused or aggravated left knee condition." She did not note or otherwise address the Veteran's competent statements that he experienced left knee pain during active service. The nurse practitioner did not provide a rationale why the date of the left knee replacement surgery precluded that the aggravation of the left knee disability by the service connected right knee disability. In light of the cited deficiencies, the Board of Veterans' Appeals (Board) finds that the evaluation is of essentially no probative value. VA's duty to assist includes, in appropriate cases, the duty to conduct a thorough and contemporaneous medical examination which is accurate and fully descriptive. McLendon v. Nicholson, 20 Vet. App. 79 (2006); Green v. Derwinski, 1 Vet. App. 121, 124 (1991). When VA undertakes to obtain an evaluation, it must ensure that the evaluation is adequate. Barr v. Nicholson, 21 Vet. App. 303, 312 (2007). The Board finds further VA knee evaluation is needed. The matters are REMANDED for the following action: Schedule the Veteran for a VA examination conducted by a medical doctor to assist in determining the nature of the left knee disability and any relationship to active service or any service-connected disability. The examiner must review the record and should note that review in the report. A rationale for all opinions should be provided. The examiner should: (a) Diagnose all left knee disabilities found. (b) Opine whether it is at least as likely as not (50 percent probability or greater) that any left knee disability had its onset during active service or is related to any incident of service. (Continued on the next page) (c) Opine whether it is at least as likely as not (50 percent probability or greater) that any identified left knee disability is due to or the result of the right knee disability and the other service-connected disabilities. (d) Opine whether it is at least as likely as not (50 percent probability or greater) that any left knee spine disability has been aggravated (increased in severity beyond the natural progress of the disorder) by the right knee disability and the other service-connected disabilities. J. T. HUTCHESON Veterans Law Judge Board of Veterans' Appeals Attorney for the Board T. Douglas 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.