Citation Nr: 21063946 Decision Date: 10/18/21 Archive Date: 10/18/21 DOCKET NO. 19-06 113A DATE: October 18, 2021 ORDER A rating in excess of 40 percent for common peroneal nerve palsy, incomplete, right, with loss of motion in ankle and toes (hereinafter "common peroneal nerve palsy of the right lower extremity") is denied. Service connection for a right leg disorder (other than common peroneal nerve palsy of the right lower extremity, right knee disability status post total knee replacement, and retained foreign bodies of the right leg Muscle Groups XI and XII) is denied. Service connection for a left leg disorder (other than left knee disorder) is denied. As new and material evidence has been received, the claim of entitlement to service connection for left knee disorder, to include as secondary to service-connected right knee disability and retained foreign bodies of the right leg Muscle Groups XI and XII, is reopened. An effective date earlier than June 6, 2016 for the grant of service connection for adjustment disorder with depressed mood is denied. REMANDED Entitlement to service connection for left knee disorder status post torn meniscus, as secondary to service-connected right knee disability status post total knee replacement, common peroneal nerve palsy of the right lower extremity, and retained foreign bodies of the right leg Muscle Groups XI and XII, is remanded. Entitlement to an initial rating in excess of 30 percent for adjustment disorder with depressed mood is remanded. Entitlement to a rating in excess of 30 percent for total knee replacement and degenerative joint disease of the right knee ("hereinafter right knee disability status post total knee replacement") is remanded. Entitlement to a rating in excess of 10 percent for retained foreign bodies of the right leg Muscle Group XI is remanded. Entitlement to an initial rating in excess of 10 percent for retained foreign bodies of the right leg Muscle Group XII is remanded. FINDINGS OF FACT 1. The Veteran's service-connected common peroneal nerve palsy of the right lower extremity has been assigned at 40 percent, the maximum rating authorized, under Diagnostic Code 8521. 2. The Veteran has not been shown to have a current disorder or functional impairment attributable to pain of the right leg (other than common peroneal nerve palsy of the right lower extremity, right knee disability status post total knee replacement, and retained foreign bodies of the right leg Muscle Groups XI and XII) at any time since separation from service in May 1969. 3. The Veteran has not been shown to have a current disorder or functional impairment attributable to pain of the left leg (other than left knee disorder) at any time since separation from service in May 1969. 4. In a June 2008 VA rating decision, the claim to reopen service connection for left knee condition status post torn lateral meniscus was denied; the Veteran was notified of this action and of his appellate rights but did not file a timely NOD or submit new and material evidence within a year thereafter. 5. The evidence received since the June 2008 VA rating decision, regarding service connection for left knee disorder, is not cumulative or redundant and raises the possibility of substantiating the claim. 6. The Veteran's initial claim of service connection for depression was received on June 6, 2016; and the issue of service connection for adjustment disorder with depressed mood was granted on a secondary basis in a September 2017 VA rating decision. 7. The Veteran was notified of the September 2017 VA rating decision and of his appellate rights in a September 2017 letter and submitted a timely NOD with regards to the effective date assigned. 8. The earliest date entitlement arose for service connection for adjustment disorder with depressed mood was in September 2017 based on a VA medical opinion. CONCLUSIONS OF LAW 1. There is no legal basis for the assignment of a schedular rating in excess of 40 percent for common peroneal nerve palsy of the right lower extremity. 38 C.F.R. § 4.124a, Diagnostic Code 8521 (2020). 2. The criteria for entitlement to service connection for a right leg disorder (other than common peroneal nerve palsy of the right lower extremity, right knee disability status post total knee replacement, and retained foreign bodies of the right leg Muscle Groups XI and XII) have not been met. 38 U.S.C. § 1110; 38 C.F.R. §§ 3.102, 3.303. 3. The criteria for entitlement to service connection for a left leg disorder (other than left knee disorder) have not been met. 38 U.S.C. § 1110; 38 C.F.R. §§ 3.102, 3.303. 4. The June 2008 VA rating decision, denying to reopen service connection for left knee condition status post torn lateral meniscus, is final. 38 U.S.C. § 7105(b), (d); 38 C.F.R. §§ 19.52, 19.55, 20.1103. 5. New and material evidence has been received since the June 2008 VA rating decision to reopen service connection for left knee disorder status post torn lateral meniscus. 38 U.S.C. § 5108 (2012); 38 C.F.R. §§ 3.156, 3.310 (2020). 6. The criteria for entitlement to an effective date earlier than June 6, 2016, for the grant of service connection for adjustment disorder with depressed mood, have not been met. 38 U.S.C. § 5110 (2012); 38 C.F.R. § 3.400 (2020). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty in the United States Army from August 1967 to May 1969. In the March 2019 and November 2019 substantive appeal, VA Form 9, the Veteran indicated he did not want an option Board hearing. Nevertheless, the Veteran was notified by a June 2021 notice letter that he was scheduled for a video conference hearing before the Board in August 2021. The June 2021 notice was sent to the most recent address of record. The Veteran did not appear for the August 2021 hearing and, as of this date, no response has been received by the Veteran. Before reaching the merits of the claim for left knee disorder status post torn lateral meniscus, the Board must first determine whether new and material evidence has been received to reopen the previously denied claim. Jackson v. Principi, 265 F.3d 1366, 1369 (Fed. Cir. 2001). Additionally, while service personnel records were associated with the record in February 2015 and November 2017 and service entry and separation examination reports were associated with the record in October 2009, these official service department records are not relevant to the merits of why service connection for left knee disorder status post torn lateral meniscus was last denied in this case. See 38 C.F.R. § 3.156(c) (2020). Therefore, the Board has recharacterized this issue accordingly. Neither the Veteran nor his attorney have raised any issues with the duty to notify or duty to assist with regards to the issues discussed below on the merits. See Scott v. McDonald, 789 F.3d 1375, 1381 (Fed. Cir. 2015) (holding that "the Board's obligation to read filings in a liberal manner does not require the Board... to search the record and address procedural arguments when the veteran fails to raise them before the Board."); Dickens v. McDonald, 814 F.3d 1359, 1361 (Fed. Cir. 2016) (applying Scott to a duty to assist argument). 1. Entitlement to a rating in excess of 40 percent for common peroneal nerve palsy of the right lower extremity Disability ratings are determined by applying the criteria set forth in VA's Schedule for Rating Disabilities, which is based on the average impairment of earning capacity. Individual disabilities are assigned separate diagnostic codes. 38 U.S.C. § 1155; 38 C.F.R. § 4.1. If two evaluations are potentially applicable, the higher evaluation will be assigned if the disability picture more nearly approximates the criteria required for that rating; otherwise, the lower rating will be assigned. 38 C.F.R. § 4.7. When reasonable doubt arises as to the degree of disability, such doubt will be resolved in the veteran's favor. 38 C.F.R. § 4.3. Where entitlement to compensation has already been established and an increase in the disability rating is at issue, such as for the service-connected disability in this case, the present level of disability is of primary concern. Although a rating specialist is directed to review the recorded history of a disability to make a more accurate evaluation, the regulations do not give past medical reports precedence over current findings. 38 C.F.R. § 4.2; Francisco v. Brown, 7 Vet. App. 55, 58 (1994). Pertinent regulations do not require that all cases show all findings specified by the Rating Schedule, but that findings sufficiently characteristic to identify the disease and the resulting disability and above all, coordination of rating with impairment of function will be expected in all cases. 38 C.F.R. § 4.21. On February 23, 2015, the Veteran's request for a higher rating for the issue on appeal was obtained and associated with the record. The Board considers whether a rating in excess of 40 percent for common peroneal nerve palsy of the right lower extremity is warranted at any time since or within one year prior to the date of claim on February 23, 2015. See 38 C.F.R. § 4.124a, Diagnostic Code 8521. Since the Veteran's service-connected common peroneal nerve palsy of the right lower extremity has been assigned the maximum schedular rating available for complete paralysis of the external popliteal nerve (common peroneal) under Diagnostic Code 8521 throughout the entire appeal period, the Board finds there is no legal basis upon which to award a higher schedular evaluation for common peroneal nerve palsy of the right lower extremity during the appeal period. As such, entitlement to a rating in excess of 40 percent for common peroneal nerve palsy of the right lower extremity is not warranted on a schedular basis. See Sabonis v. Brown, 6 Vet. App. 426 (1994). 2. Entitlement to service connection for a right leg disorder (other than common peroneal nerve palsy of the right lower extremity, right knee disability status post total knee replacement, and retained foreign bodies of the right leg for Muscle Groups XI and XII) 3. Entitlement to service connection for a left leg disorder (other than left knee disorder) Service connection may be established for disability resulting from personal injury suffered or disease contracted in line of duty in the active military, naval, or air service. 38 U.S.C. § 1110. Service connection may be granted for any injury or disease diagnosed after discharge, when all the evidence, including that pertinent to service, establishes that the disease or injury was incurred in service. 38 C.F.R. § 3.303(d). In a March 2008 VA Form 21-4138, the Veteran reported right knee and leg pain over the last two years and pain in the left knee and leg most likely related to unusual gait and foot drop from gunshot injury (service-connected common peroneal nerve palsy of the right lower extremity). In a June 2016 VA Form 21-526b, the Veteran requested service connection for (unspecified) leg condition. In an August 2016 VA Form 27-0820, VA contacted the Veteran to request clarification of the requested claim for "leg condition." It was documented that the Veteran requested to be given additional time to speak with his attorney to determine if he will continue with the appeal or the claim for compensation. In response, the Veteran requested service connection for bilateral leg condition in a May 2018 VA Form 21-526b and it was explained in the August 2018 VA Form 21-0958 (NOD) that the link between the claimed medical conditions for right and left leg conditions and military service is that the Veteran was shot in the knee and limped for 30 years. The Board has recharacterized the Veteran's claims for leg condition and bilateral leg condition as service connection for a right leg disorder (other than common peroneal nerve palsy of the right lower extremity, right knee disability status post total knee replacement, and retained foreign bodies of the right leg for Muscle Groups XI and XII) and for a left leg disorder (other than left knee disorder) in order to clarify the nature of the benefits sought and ensure complete consideration of the claims. In the July 2018 VA rating decision, the Agency of Original Jurisdiction (AOJ) did not find that there was a current diagnosed right or left leg disorder. Based on the evidence of record, there is no probative and competent evidence that demonstrates a current right leg disorder (other than common peroneal nerve palsy of the right lower extremity, right knee disability status post total knee replacement, and retained foreign bodies of the right leg for Muscle Groups XI and XII) and for a left leg disorder (other than left knee disorder) or a current left leg disorder (other than left knee disorder) or functional impairment attributable to pain in the legs during the appeal period. See 38 U.S.C. § 1110; 38 C.F.R. § 3.303(d). Review of the May 2015 VA examination for peripheral nerves conditions reveals only a diagnosis of common peroneal nerve palsy of the right lower extremity. Clinical findings did not show impairment of the left lower extremity. The VA examiner also noted the Veteran's unlimited ability to, in part, work, kneel/squat, stand, sit, climb, drive, walk, repetitive motion, and high and low impact vibration. Review of the March 2019 VA examination for peripheral nerves conditions reveals only diagnoses of common peroneal nerve palsy of the right lower extremity and foot drop with status post-surgery to correct secondary to gunshot wound. Clinical findings did not show impairment of the left lower extremity. The VA examiner also noted the Veteran's decreased capacity to walk for prolonged periods attributable to the service-connected common peroneal nerve palsy of the right lower extremity. Review of the May 2015 and March 2019 VA examinations for knee and lower leg conditions reveals diagnosis of gunshot wound retained foreign bodies in the right knee, right total knee replacement, left knee meniscal tear, and left knee osteoporosis with joint manifestations. Additionally, review of VA treatment records associated with the record during the appeal period are silent for any reported symptomatology and/or functional impairment due to pain in the right leg (other than common peroneal nerve palsy of the right lower extremity, right knee disability status post total knee replacement, and retained foreign bodies of the right leg for Muscle Groups XI and XII) and pain in the left leg (other than left knee disorder). In light of the totality of the evidence of record, and the Veteran's report of symptomatology, the Board finds that the medical evidence of record, including the May 2015 and March 2019 VA examination reports for peripheral nerve conditions and for knee and lower leg conditions are the most probative, and they do not support a finding of any current right leg disorder (other than common peroneal nerve palsy of the right lower extremity, right knee disability status post total knee replacement, and retained foreign bodies of the right leg for Muscle Groups XI and XII) or current left leg disorder (other than left knee disorder). While the Board cannot determine that lay evidence lacks credibility merely because it is unaccompanied by contemporaneous medical evidence, the Board may weigh the absence of contemporaneous medical evidence against the lay evidence in determining credibility. Buchanan v. Nicholson, 451 F.3d 1331 (Fed. Cir. 2006). Here, the Board finds the Veteran's report of pain in the right and left legs is not sufficient evidence to show sufficient functional impairment to be deemed a current right leg disorder (other than common peroneal nerve palsy of the right lower extremity, right knee disability status post total knee replacement, and retained foreign bodies of the right leg for Muscle Groups XI and XII) or a current left leg disorder (other than left knee disorder). Because no functional impairment has been demonstrated, there is no post-service diagnosis of right and left leg disorders (other than common peroneal nerve palsy of the right lower extremity, right knee disability status post total knee replacement, and retained foreign bodies of the right leg for Muscle Groups XI and XII, as well as left knee disorder), and the Veteran has not shown that his subjective symptom of pain causes functional impairment of earning capacity, the Board finds that the Veteran does not have a current disability. See Saunders v. Wilkie, 886 F.3d 1356 (Fed. Cir. 2018) (holding that a "disability" under 38 U.S.C. § 1110 refers to functional impairment of earning capacity). The Board emphasizes that Congress has specifically limited entitlement to service connection for disease or injury to cases where such incidents have resulted in disability. See 38 U.S.C. § 1110; see also 38 C.F.R. §§ 3.303, 3.304. Thus, as no disability is shown, there can be no valid claim for service connection. In the absence of a disability, the other elements of service connection need not be discussed further, and service connection must be denied. For these reasons, service connection for right leg disorder (other than common peroneal nerve palsy of the right lower extremity, right knee disability status post total knee replacement, and retained foreign bodies of the right leg for Muscle Groups XI and XII) and left leg disorder (other than left knee disorder) are denied on a direct basis. In reaching this decision the Board considered the doctrine of reasonable doubt, however, as the preponderance of the evidence is against these claims, the doctrine is not for application. Gilbert v. Derwinski, 1 Vet. App. 49 (1990). 4. Whether new and material evidence has been received to reopen a previously denied claim of entitlement to service connection for left knee condition status post torn meniscus In the January 2004 VA rating decision, service connection for left knee condition status post torn lateral meniscus, to include as secondary to service-connected disabilities of the right lower extremity (right knee disability status post total knee replacement and common peroneal nerve palsy of the right lower extremity), was denied. The AOJ explained that the available evidence of record did not show a left knee injury was incurred during active duty or was a result of his service-connected common peroneal nerve palsy of the right lower extremity. The Veteran was notified of this action and of his appellate rights but did not appeal by filing a NOD or submitting new and material evidence within a year thereafter. Therefore, the January 2004 VA rating decision is final. See 38 U.S.C. § 7105(b), (d); 38 C.F.R. §§ 19.52, 19.55, 20.1103. In March 2008, VA received the Veteran's request to reopen the previously denied claim of service connection for left knee condition status post torn lateral meniscus. In the June 2008 VA rating decision, the claim to reopen service connection for left knee condition status post torn lateral meniscus, to include as secondary to service-connected right knee disability and retained foreign bodies of the right leg Muscle Group XI, was denied. The AOJ explained that while VA treatment records showed treatment for osteoarthritis of the left knee, there was no medical opinion supported by rationale relating it to military service or to service-connected disabilities. The Veteran was notified of this action and of his appellate rights but did not appeal by filing a NOD or submitting new and material evidence within a year thereafter. Therefore, the June 2008 VA rating decision is final. Id. In February 2015, the Veteran's request to reopen his claim for left knee disorder was obtained and associated with the record. In November 2017, service personnel and medical records were added to the claims file. At any time after VA issues a decision on a claim, if VA receives or associates with the claims file relevant official service department records that existed and had not been associated with the claims file when VA first decided the claim, VA will reconsider the claim, rather than requiring the submission of new and material evidence. 38 C.F.R. § 3.156(c). "To be relevant, a record must be relevant to the issue that was dispositive against the veteran in the VA adjudication of the claim sought to be reconsidered and, in that way, bear on the outcome of the case." Kisor v. Wilkie, 969 F.3d 1333, 1336 (Fed. Cir. 2020). The service personnel records are not relevant because they do not mention the Veteran's left knee or leg. They describe his accidental gunshot injury but do not mention his left leg or knee. The additional service medical records show a medical examination of his gunshot wound of the right leg, and his physical profile for his right leg. His left leg or knee were not mentioned. The reason his claim was denied was due to lack of a nexus, and the service personnel and medical records are irrelevant because they do not mention his left knee or leg. New and material evidence is required before the merits of the claim may be reached. Evidence received since the June 2008 VA rating decision includes the AOJ's decision to grant service connection for another disability of the right lower extremity, specifically retained foreign bodies of the right leg Muscle Group XII. Although "a new theory of causation for the same disease or injury that was the subject of a previously denied claim cannot be the basis of a new claim under [38 U.S.C. § 7104(b) (2012)]," any evidence supporting a new theory of causation constitutes new and material evidence, and the claim must then be reopened under 38 U.S.C. § 5108. Boggs v. Peake, 520 F.3d 1330, 1336-37 (Fed. Cir. 2008). The Board finds that this evidence is new and material to the element of establishing a nexus on a secondary basis to the service-connected retained foreign bodies of the right leg Muscle Group XII, which was not established at the time of the June 2008 VA rating decision. As a result, this claim is reopened. 38 U.S.C. § 5108; 38 C.F.R. §§ 3.156(a), 3.310. 5. Entitlement to an effective date earlier than June 6, 2016 for the grant of service connection for adjustment disorder with depressed mood At the outset, the Board notes that the Veteran filed a timely NOD with the September 2017 VA rating decision that granted service connection for adjustment disorder with depressed mood, and he perfected this appeal. Thus, the Board has proper jurisdiction over this claim on appeal for an earlier effective date. See Rudd v. Nicholson, 20 Vet. App. 296, 299 (2006) (there is no such thing as a freestanding claim for an earlier effective date). Except as otherwise provided, the effective date of an award based on an initial claim, or a supplemental claim, of compensation shall be fixed in accordance with the facts found but shall not be earlier than the date of receipt of the application. 38 U.S.C. § 5110(a)(1). The effective date for a grant of disability compensation based on an original claim, as in this case, will be the day following separation from active service or the date entitlement arose if the claim is received within one year after separation from service; otherwise, date of receipt of claim, or date entitlement arose, whichever is later. See 38 U.S.C. § 5110(b)(1); 38 C.F.R. § 3.400(b)(2)(i). In this case, the evidence shows that the Veteran did not file a claim for service connection for a psychiatric disability within one year of his separation from service in May 1969, nor does he so contend. As a result, the Board will assess the date of receipt of claim and the date entitlement arose in this case regarding service connection for adjustment disorder with depressed mood. On June 6, 2016, VA received the Veteran's completed VA Form 21-526b requesting service connection for depression. He does not assert, nor does the record show, that he filed a claim prior to that date. Thus, the Board finds that the Veteran's claim seeking service connection for depression on June 6, 2016 is the date of receipt of claim. In a September 2017 VA rating decision, the issue of service connection for adjustment disorder with depressed mood was granted on a secondary basis. Specifically, a September 2017 VA medical opinion provided probative evidence of record that the Veteran's adjustment disorder with depressed mood was at least as likely as not proximately due to or the result of the Veteran's service-connected right knee disability. Thus, the Board finds that the date entitlement arose for adjustment disorder with depressed mood was in September 2017. Since the AOJ assigned the date of claim as the effective date, which is more favorable to the Veteran, the Board finds that an effective date earlier than June 6, 2016 for the grant of service connection for adjustment disorder with depressed mood is denied. REASONS FOR REMAND 1. Entitlement to service connection for left knee disorder status post torn meniscus, as secondary to service-connected right knee disability status post total knee replacement, common peroneal nerve palsy of the right lower extremity, and retained foreign bodies of the right leg Muscle Groups XI and XII In a July 2003 VA Form 21-4138, the Veteran initially requested service connection for his left knee as secondary to his right leg. In a September 2003 VA memorandum, it was noted the Veteran's request for left knee was due to period of time walking in an irregular gait. Additionally, as previously noted in a March 2008 VA Form 21-4138, the Veteran reported pain in the left knee most likely related to unusual gait and foot drop from gunshot injury (service-connected common peroneal nerve palsy of the right lower extremity). In February 2015, the Veteran's request to reopen his claim for left knee disorder was obtained and associated with the record. During the course of the appeal, the Veteran was provided VA examinations for knee and lower leg conditions in May 2015 and March 2019 at which each examiner rendered current diagnoses of left knee meniscal tear and left knee osteoporosis with joint manifestations. The Veteran was also provided a VA medical opinion in May 2015 that only addressed service connection for a left knee disorder as secondary to service-connected right knee disability on a secondary basis regarding causation only. The Board finds that additional development is needed to properly adjudicate this claim on a secondary basis. 2. Entitlement to an initial rating in excess of 30 percent for adjustment disorder with depressed mood In September 2017, the Veteran was afforded a VA examination for mental disorders in connection with the claim of entitlement to service connection for depression. Since then, review of VA treatment records shows the Veteran's receipt of treatment after an incident from drinking too much alcohol in January 2020 and February 2020 and his attendance at mental health clinical group sessions since February 2020. In light of such evidence, additional development is needed to properly adjudicate the appeal. See 38 U.S.C. § 5103A(a) (2012); 38 C.F.R. § 3.159 (2020); Barr v. Nicholson, 21 Vet. App. 303, 312 (2007). 3. Entitlement to a rating in excess of 30 percent for right knee disability status post total knee replacement 4. Entitlement to a rating in excess of 10 percent for retained foreign bodies of the right leg Muscle Group XI 5. Entitlement to an initial rating in excess of 10 percent for retained foreign bodies of the right leg Muscle Group XII During the course of the appeal, the Veteran was last afforded VA examinations for knee and lower leg conditions and for muscle injuries in March 2019. Since then, review of VA treatment records shows March 2020 x-ray results of the right knee shows a knee cap fracture, in April 2020 the Veteran reported right knee and ankle pain and treating physician recommended future revision of the patellar component and excision of the fracture fragment, and reported right knee and ankle pain in May 2020. In light of such evidence, additional development is needed to properly adjudicate this issue on appeal. See 38 U.S.C. § 5103A(a) (2012); 38 C.F.R. §§ 3.159, 4.73, Diagnostic Code 5311 (Muscle Group XI for foot, ankle and calf) and Diagnostic Code 5312 (Muscle Group XII for leg) (2020); Barr v. Nicholson, 21 Vet. App. 303, 312 (2007). The matters are REMANDED for the following actions: 1. Provide the Veteran's claims file to an appropriate clinician to provide an opinion regarding the Veteran's left knee disorder status post torn meniscus. The entire claims file and a copy of this remand must be made available to the examiner for review. A new examination (physical or telehealth) is only required if deemed necessary by the examiner. Although an independent review of the claims file is required, the Board calls the examiner's attention to the following: May 2015 and March 2019 VA examination reports for knee and lower leg conditions shows diagnoses of left knee meniscal tear and left knee osteoporosis with joint manifestations The examiner must opine as to the following regarding causation on a secondary basis: (a.) Whether it is at least as likely as not (50 percent or greater probability) that the left knee disorder status post torn meniscus was proximately due to or the result of his service-connected common peroneal nerve palsy of the right lower extremity. (b.) Whether it is at least as likely as not that the left knee disorder status post torn meniscus was proximately due to or the result of his service-connected retained foreign bodies of the right leg Muscle Group XI. (c.) Whether it is at least as likely as not (50 percent or greater probability) that the left knee disorder status post torn meniscus was proximately due to or the result of his service-connected retained foreign bodies of the right leg Muscle Group XII. The examiner must opine as to the following regarding aggravation on a secondary basis: (d.) Whether it is at least as likely as not (50 percent or greater probability) that the left knee disorder status post torn meniscus was aggravated beyond its natural progression by his service-connected right knee disability status post total knee replacement. (e.) Whether it is at least as likely as not that the left knee disorder status post torn meniscus was aggravated beyond its natural progression by his service-connected common peroneal nerve palsy of the right lower extremity. (f.) Whether it is at least as likely as not that the left knee disorder status post torn meniscus was aggravated beyond its natural progression by his service-connected retained foreign bodies of the right leg Muscle Group XI. (g.) Whether it is at least as likely as not that the left knee disorder status post torn meniscus was aggravated beyond its natural progression by his service-connected retained foreign bodies of the right leg Muscle Group XII. The examiner must provide all findings, along with a complete rationale for his or her opinion(s) in the examination report. If any of the above requested opinions cannot be made without resort to speculation, the examiner must state this and provide a rationale for such conclusion. 2. Schedule the Veteran for an examination with an appropriate clinician to determine the current severity of his service-connected acquired psychiatric disability. The entire claims file and a copy of this remand must be made available to the examiner for review. The examiner must provide all findings, along with a complete rationale for any opinions provided. 3. Schedule the Veteran for an examination with an appropriate clinician to determine the current severity of his service-connected right knee disability status post total knee replacement. The entire claims file and a copy of this remand must be made available to the examiner for review. The examiner must provide all findings, along with a complete rationale for any opinions provided. 4. Schedule the Veteran for an examination with an appropriate clinician to determine the current severity of his service-connected retained foreign bodies of the right leg Muscle Groups XI and XII. The entire claims file and a copy of this remand must be made available to the examiner for review. The examiner must provide all findings, along with a complete rationale for any opinions provided. 5. Then, review all examination reports and medical opinions provided to ensure that the requested information was provided. If any report or opinion is deficient in any manner, the AOJ must implement corrective procedures. 6. Then, readjudicate the claims. If any decision is adverse to the Veteran, issue a Supplemental Statement of the Case and allow the applicable time for response. Then, return the case to the Board. D. Martz Ames Veterans Law Judge Board of Veterans' Appeals Attorney for the Board T. Carter, 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.