Citation Nr: 21063179 Decision Date: 10/13/21 Archive Date: 10/13/21 DOCKET NO. 16-08 701 DATE: October 13, 2021 REMANDED Entitlement to service connection for a bilateral knee disorder is remanded. Entitlement to a total disability rating based on individual unemployability (TDIU) is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Army from February 1966 to January 1968. In an April 2019 correspondence, the Veteran withdrew his request for a Board hearing. In June 2019, the Board denied service connection for a bilateral knee disorder and a TDIU. The Veteran appealed the Board decision to the United States Court of Appeals for Veterans Claims (Court). In February 2021, the Court vacated and remanded the Board decision. 1. Service connection for a bilateral knee disorder. The Veteran asserts that his bilateral knee disorder is related to active service. Specifically, he contends that his knee disorder is related to parachuting, which required jumps from different heights out of a helicopter. The Board notes that his military occupational specialty was field wireman. The duty to assist includes providing an examination when one is required by law. McLendon v. Nicholson, 20 Vet. App. 79 (2006). A medical examination is required only where there is (1) competent evidence of a current disability or persistent or recurrent symptoms of a disability; (2) evidence establishing that an event, injury, or disease occurred in service; (3) an indication that the disability or persistent or recurrent symptoms of a disability may be associated with the veteran's service; and (4) insufficient competent medical evidence on file for VA to make a decision on the claim. See McLendon, 20 Vet. App. at 83. After careful review, the Board finds that the probative evidence does indicate that the Veteran is entitled to a VA examination under McLendon for his diagnosed bilateral knee disorder. Specifically, VA outpatient treatment records reflect a diagnosis of a bilateral knee osteoarthritis, the Veteran described an in-service event of consistently jumping from varied heights, and out of a helicopter, and running over uneven terrain with a heavy backpack and rifle. Finally, the evidence indicates that the Veteran completed training with paratroopers which required various jumps, including out of a helicopter, and also developed degenerative knee arthritis after service. As such, given the low threshold for a finding in favor of the third element, the Board determines that the Veteran has satisfied this standard. Lastly, the Board finds the Veteran can also satisfy the fourth element as there is insufficient competent medical evidence to decide the claim. The Veteran has reported that he sustained multiple jumps in service, and he has a current bilateral disability. Significantly, the Board notes that the Veteran has yet to be provided with a medical opinion indicating whether his bilateral knee disorder is related to his active service. Therefore, the medical evidence is insufficient, as the record lacks an adequate opinion regarding the likelihood of a medical nexus between the in-service event (basic training duties) and a current disability (degenerative changes in the knees, bilaterally). See Stefl v. Nicholson, 21 Vet. App. 120, 124 (2007) ("Without a medical opinion that clearly addresses the relevant facts and medical science, the Board is left to rely on its own lay opinion, which it is forbidden from doing."). As such, a remand is warranted to assist in determining the etiology of the Veteran's bilateral knee disorder 2. Entitlement to a TDIU. In August 2013, the Veteran filed a claim for a TDIU. The Board notes that when a decision of one claim could have a significant impact on another, they are inextricably intertwined. See Harris v. Derwinski, 1 Vet. App. 180, 183 (1991); Tyrues v. Shinseki, 732 F.3d 1351, 1366 (Fed. Cir. 2013). Here, the Veteran's bilateral knee disorder results in significant impairment of his ability to work and private medical opinions indicate that the Veteran retired from his job as a postal carrier due to his non-service-connected bilateral knee disorder. Thus, the Board finds that the issue of service connection for a bilateral knee disorder and the issue of the Veteran's entitlement to TDIU are inextricably intertwined. See Harris v. Derwinski, 1 Vet. App. 180, 183 (1991). The matters are REMANDED for the following action: 1. Schedule the Veteran for a VA knee examination to determine the current nature and likely etiology of the Veteran's bilateral knee disorder. The entire claims file, including a copy of this REMAND, must be reviewed by the examiner in conjunction with the examination. All indicated studies, tests, and evaluations deemed necessary should be performed. Following a physical examination of the Veteran, the VA examiner should provide the following opinions: Whether the Veteran's diagnosed bilateral knee disorder had its onset in service or is otherwise related to service. The examiner should also specifically describe the overall impact of the Veteran's bilateral knee disorder on his occupational and social functioning. When providing the opinions, the VA examiner MUST discuss and comment on: (a.) The Veteran's lay statements that his knee disorder is related to parachuting, which required jumps from different heights out of a helicopter. A thorough rationale should be provided for all opinions expressed. If any requested medical opinion cannot be given, the examiner should state the reason(s) why. The entire claims file, including a copy of this REMAND, must be reviewed. H. SEESEL Veterans Law Judge Board of Veterans' Appeals Attorney for the Board M. Dourmashkin 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.