Citation Nr: 21063773 Decision Date: 10/15/21 Archive Date: 10/15/21 DOCKET NO. 16-63 301 DATE: October 15, 2021 REMANDED Entitlement to a compensable rating for service-connected dermatitis (claimed as shaving condition) is remanded. Entitlement to service connection for a low back disability (claimed as back pain) is remanded. Entitlement to service connection for a right knee disability (claimed as right knee pain) is remanded. Entitlement to service connection for a left knee disability (claimed as left knee pain) is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Army from February 1987 to November 1991. The Board must discuss all theories of entitlement raised by the Veteran or by the evidence of record. Robinson v. Mansfield, 21 Vet. App. 545 (2008). Accordingly, the Board has recharacterized the claims as indicated above to afford the Veteran the broadest possible scope of review. See Clemons v. Shinseki, 23 Vet. App. 1, 5-6 (2009). In July 2021 the Veteran testified before the undersigned Veterans Law Judge at a Board hearing. A transcript of the hearing is of record. Although the Board regrets the delay, a remand is necessary to ensure that there is a complete record upon which to decide the Veteran's claims. 38 U.S.C. § 5103A; 38 C.F.R. § 3.159. Entitlement to a compensable rating for service-connected dermatitis (claimed as shaving condition) is remanded. Relevant to the Veteran's claim for a compensable rating for his dermatitis, the Court has held that, where the record does not adequately reveal the current state of a claimant's disability, fulfillment of the statutory duty to assist requires a contemporaneous medical examination, particularly if there is no additional medical evidence that adequately addresses the level of impairment of the disability since the last examination. Allday v. Brown, 7 Vet. App. 517, 526 (1995). The Board finds that the Veteran's claim for a compensable rating for his dermatitis must be remanded in order to afford him a contemporaneous VA examination in order to assess the current nature and severity of his service-connected disability. In this regard, the record reflects that the Veteran was most recently afforded a VA Skin Conditions examination in January 2014. Since the January 2014 examination, the Veteran has noted an increase in the severity of his symptoms and alleges that a compensable rating is warranted. In light of the allegations of worsening symptoms, the degenerative nature of the Veteran's condition, and the amount of time which has passed since the Veteran's prior examination, the Board finds that a remand is required in order to afford the Veteran a contemporaneous VA examination so as to determine his current level of impairment with regard to his service-connected dermatitis. See Snuffer v. Gober, 10 Vet. App. 400 (1997); Caffrey v. Brown, 6 Vet. App. 377 (1994); VAOPGCPREC 11-95 (1995). Entitlement to service connection for a low back disability (claimed as back pain) and for bilateral knee disabilities (claimed as right and left knee pain) are remanded. The Veteran alleges that he suffers from a low back disability, to include low back pain, as well as bilateral knee disabilities, to include bilateral knee pain, which began during or were caused by his active-duty service. In the alternative, he has alleged that his low back disability caused or aggravated his bilateral knee disabilities. Specifically, the Veteran contends that his job in the military as a plumber required bending and kneeling and that such caused great strain on his back and knees. Furthermore, he contends that the repeated jumping on and off of trucks caused additional stress and strain on his back and knees. See July 2021 hearing testimony. VA's duty to assist includes a duty to provide a medical examination or obtain a medical opinion where it is deemed necessary to make a decision on the claim. 38 U.S.C. § 5103A (d); 38 C.F.R. § 3.159 (c)(4); Duenas v. Principi, 18 Vet. App. 512 (2004); Robinette v. Brown, 8 Vet. App. 69 (1995); McLendon v. Nicholson, 20 Vet. App. 79 (2006). In addition, once VA undertakes the effort to provide an examination when developing a service connection claim, even if not statutorily obligated to do so, it must provide an adequate one or, at a minimum, notify the claimant why one will not or cannot be provided. Barr v. Nicholson, 21 Vet. App. 303, 311 (2007). For below noted reasons, the Board finds that an additional VA Back Conditions examination as well as an original VA Knee and Lower Leg Conditions examination are needed to determine the nature and etiology of the Veteran's claimed low back and bilateral knee disabilities. The Veteran's service treatment records reflect the Veteran's reports of back pain and his diagnosis of lumbar strain; they are silent for any complaints, treatment, or diagnosis of bilateral knee disabilities. However, the Veteran's DD-214 does note that his military occupational specialty (MOS) was plumber. In January 2014 the Veteran underwent a VA Back Conditions examination. The examiner diagnosed the Veteran with lumbar strain. The examiner opined that the Veteran's back disability was less likely than not incurred in or caused by his active-duty service. The examiner provided the rationale that the Veteran experienced back pain in service and was diagnosed with acute lumbar strain but that such resolved. The Board, however, finds this to be an incomplete rationale. The examiner failed to take into account the Veteran's claims that his back pain began in service and never resolved and in fact increased over the years. Furthermore, the Veteran at his July 2021 hearing, stated that he was diagnosed with degenerative disc disease (DDD). As the January 2014 examiner failed to provide an adequate rationale for his opinion and did not have the opportunity to discuss the Veteran's DDD diagnosis, an addendum opinion should be obtained on remand. The Board notes that the Veteran has not been provided with an examination in relation to his bilateral knee disabilities. As previously noted, the Veteran has alleged that he suffers from bilateral knee pain and that such began during or was caused by his active-duty service. Specifically, he noted that his duties as a plumber in the service required repetitive kneeling and jumping on and off trucks. Furthermore, the Veteran stated that his private chiropractor indicated that his bilateral knee disabilities could have been caused or aggravated by his back disability. As the Veteran's claims are in keeping with the nature of his service and as the Veteran is competent to report pain, the Board finds that an examination to determine the nature and etiology of his claimed bilateral knee disabilities should be obtained on remand. Finally, during the Veterans July 2021 hearing, the Veteran stated that he received both VA and private treatment for his claimed conditions. However, such treatment records have not been associated with the file. Therefore, on remand all available and relevant treatment records should be obtained. The matters are REMANDED for the following action: 1. The Veteran should be given an opportunity to identify any outstanding private or VA treatment records relevant to the claims on appeal, to include the Veteran's private chiropractic records. After obtaining any necessary authorization from the Veteran, all outstanding records should be obtained. For private treatment records, make at least two (2) attempts to obtain records from any identified sources. If any such records are unavailable, inform the Veteran and afford him an opportunity to submit any copies in his possession. For federal records, all reasonable attempts should be made to obtain such records. If any records cannot be obtained after reasonable efforts have been made, issue a formal determination that such records do not exist or that further efforts to obtain such records would be futile, which should be documented in the claims file. The Veteran must be notified of the attempts made and why further attempts would be futile, and allowed the opportunity to provide such records, as provided in 38 U.S.C. § 5103A (b)(2) and 38 C.F.R. § 3.159 (e). 2. The Veteran should be afforded a VA examination to determine the current nature and severity of his service-connected dermatitis. The claims file, to include a copy of this remand, must be made available and be reviewed by the examiner, and the examination report should note that review. Any indicated evaluations, studies, and tests should be conducted. If any of the requested findings are not possible, please provide an explanation. The examiner should provide a rationale for any opinion expressed and reconcile that opinion with all pertinent evidence of record, including all relevant VA medical records and any lay evidence suggesting that the Veteran's service-connected dermatitis is worse than shown on prior examination. 3. Obtain an addendum opinion from an appropriate clinician regarding whether the Veteran's current back disability is at least as likely as not related to an in-service injury, event, or disease. The claims file, to include a copy of this remand, must be made available and be reviewed by the examiner, and the examination report should note that review. Any indicated evaluations, studies, and tests should be conducted. A) The examiner must identify all current back disabilities and their related manifestations. B) The examiner must also opine whether the Veteran's current back disability at least as likely as not (1) began during active service, (2) manifested within one year after discharge from service, or (3) was noted during service with continuity of the same symptomatology since service. In offering any opinion, the examiner must consider the full record, to include the Veteran's lay statements. The rationale for any opinion offered should be provided. 4. Obtain an opinion from an appropriate clinician regarding the nature and etiology of the Veteran's claimed bilateral knee disabilities. The claims file, to include a copy of this remand, must be made available and be reviewed by the examiner, and the examination report should note that review. Any indicated evaluations, studies, and tests should be conducted. A) The examiner must identify any and all current right and left knee disabilities and their related manifestations. B) The examiner must also opine whether the Veteran's current bilateral knee disabilities at least as likely as not (1) began during active service, (2) manifested within one year after discharge from service, or (3) were noted during service with continuity of the same symptomatology since service. C) The examiner must also opine whether the Veteran's current bilateral knee disabilities are at least as likely as not (1) proximately due to the Veteran's low back disability, or (2) aggravated by the Veteran's low back disability. The examiner must discuss both prongs of secondary service connection, proximately due to AND aggravation. In offering any opinion, the examiner must consider the full record, to include the Veteran's lay statements. The rationale for any opinion offered should be provided. L. M. BARNARD Veterans Law Judge Board of Veterans' Appeals Attorney for the Board J. Unger, 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.