Citation Nr: 21064424 Decision Date: 10/20/21 Archive Date: 10/20/21 DOCKET NO. 15-13 683 DATE: October 20, 2021 REMANDED Entitlement to service connection for a left knee condition is remanded. REASONS FOR REMAND The Veteran served on active duty with the United States Army from November 1990 to June 1991 and January 1992 to June 1992. He also served on active duty for training (ACDUTRA) from May 1979 to September 1979 and July 11, 1992 to July 25, 1992 and had periods of reserve service prior to and after his periods of active duty. This matter is before the Board of Veterans' Appeals (Board) on appeal from a January 2013 decision of a Department of Veterans Affairs (VA) Regional Office (RO). The Veteran testified before the Board at a hearing in July 2018. A transcript of the hearing is of record. Subsequently, the Board remanded the case in May 2019 and December 2020 for further development. Entitlement to service connection for a left knee condition is remanded. The Board finds that the claim must be remanded for additional development as there has not been substantial compliance with the mandates of the December 2020 remand order. See Stegall v. West, 11 Vet. App. 268, 271 (1998) (holding that where the remand orders of the Board are not substantially complied with, the Board errs as a matter of law when it fails to ensure substantial compliance). In the December 2020 Board remand, the Board specifically directed the VA clinician to opine as to whether the Veteran's left knee condition, that clearly and unmistakably preexisted his service, was clearly and unmistakably not aggravated by his service. In February 2021, a reviewing clinician opined that the Veteran's left knee condition was less likely than not incurred in or caused by the claimed in-service injuries. In the rationale provided, the reviewing clinician stated he concurred with the rationale provided in the November 2019 VA opinion. Furthermore, the reviewing clinician stated "[w]hile [the] [V]eteran was seen numerous times for his left knee, there is nothing beyond the natural progression of his left knee osteoarthritis, therefore it is less likely than not his current progression of the left knee is related to his time in service." However, the February 2021 opinion does not address whether the Veteran's preexisting left knee condition was clearly and unmistakably not aggravated by his service. Therefore, an additional VA opinion is necessary. See Stegall, 11 Vet. App. at 271. The matter is REMANDED for the following actions: 1. Obtain and associate with the Veteran's electronic record any outstanding VA treatment records. 2. After completing the development requested above, obtain a medical opinion from a qualified clinician for the Veteran's left knee condition claim. The electronic claims file must be made available to the clinician for review in connection with the request for an opinion. If the reviewing clinician determines that an in-person examination (including via telehealth interview) is needed in order to answer the questions posed, then such should be scheduled. After reviewing the claims file, the reviewing clinician should address the following: (a.) Was the Veteran's left knee condition that clearly and unmistakably existed prior to his periods of active duty (beginning in November 1990 and January 1992) and ACDUTRA in July 1992 clearly and unmistakably not aggravated by service? In providing an opinion on this question, the reviewing clinician must address the indication in the April 1991 service examination that the Veteran had a left knee sprain in February 1991. Furthermore, the reviewing clinician must address the Veteran's July 1992 left knee injury that occurred during a period of ACDUTRA. In addition, the reviewing clinician should address the August 2002 left knee surgery, which the Veteran has contended his 1991 and 1992 left knee injuries contributed to the need for the surgery. (b.) If the reviewing clinician finds that a left knee condition was not clearly and unmistakably aggravated by a period of active service (including ACDUTRA in July 1992), the reviewing clinician must opine whether it is at least as likely as not that a left knee condition is related to an in-service injury, event, or disease, including a left knee sprain in February 1991, or an injury during a period of ACDUTRA or INACDUTRA (including the July 1992 basketball injury that occurred during a period of ACDUTRA). The reviewing clinician must fully explain the rationale for any opinion, with citation to supporting clinical data/lay statements, as deemed appropriate. If the reviewing clinician cannot provide the requested opinion without resorting to speculation, he or she should expressly indicate this and provide supporting rationale as to why an opinion cannot be made without resorting to speculation. M. SORISIO Veterans Law Judge Board of Veterans' Appeals Attorney for the Board N. Breitbach, 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.