Citation Nr: 21065103 Decision Date: 10/25/21 Archive Date: 10/25/21 DOCKET NO. 18-31 413 DATE: October 25, 2021 REMANDED Service connection for bilateral wrist disorder is remanded. Service connection for right knee disorder is remanded. Service connection for left knee disorder is remanded. REASONS FOR REMAND The Veteran has active duty in the United States Army from September 1986 to September 1989. These matters come before the Board of Veterans' Appeals (Board) on appeal from an April 2014 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO). In April 2020, the Veteran testified before the undersigned Veterans Law Judge at a Board hearing. The Veteran's claims file contains a copy of the hearing transcript. In June 2020, the part remanded these matters for additional evidentiary development. The Board finds that there has been substantial compliance with its remand directives. See Stegall v. West, 11 Vet. App. 268, 271 (1998). Regrettably, a remand is necessary in this case to ensure that due process is followed and that there is a complete record upon which to decide the Veteran's claim so that he is afforded every possible consideration. 38 U.S.C. § 5103A; 38 C.F.R. § 3.159. Discussion The Veteran asserts that bilateral wrist, right knee disorder, and left knee disorder were incurred in, aggravated by, or otherwise attributable to, active-duty service. At the April 2020 Board hearing, the Veteran testified that he served on the "Nijmegen team" as a marcher and cadence caller. The Nijmegen team, according to the Veteran, is an event in which a group of United States Army soldiers and soldiers from "throughout the world," participate in celebratory historical World War II accomplishments once a year. When the Veteran served on the team, events took place in Switzerland and involved marching 50 miles in two days. See April 29, 2020 Hearing Transcript, pp. 5-6. In his year of participation, the Veteran participated in multiple "Volksmarches" of 5 kilometers, 3 kilometers, and 10 kilometers. See id. at p. 7. Moreover, the Nijmegen team sometimes trained by marching up to 18 miles in single days over the different grades of terrain in Switzerland, including rocky terrain and mountains. The Veteran described training for this event required daily gym workouts and long distance ruck marches over rough terrain. The Veteran testified that if any medical issues were addressed by an assigned medic. See id. at p. 13. Service personnel records show that the Veteran was assigned duties in material storage and handling in Germany. There are no certificates or medals for participation in the competition or other notation in the records of these duties. However, publicly available information confirms that this competition sponsored in the Netherlands has been held annually for many years and includes military teams. Service treatment records are silent for any symptoms, diagnoses, or treatment for wrist or knee abnormalities or injuries. The Board recognizes that the RO followed all directives pursuant to 38 U.S.C. § 5103A(b)(2)(B). And, despite these efforts, the RO was unable records or specific information as to when the Veteran served as a participant on the Nijmegen team or other pertinent details (names of team members; dates; and/or roster of events). Nevertheless, the Veteran's military personnel records disclose that the Veteran had peacetime active-duty service in the Republic of Germany. Consequently, these records support the Veteran's account that he served in continental Europe where the contended Nijmegen events occurred. Thus, the Board finds that the Veteran has presented facially plausible evidence as to in-service rigorous training for long distance marches. Caluza v. Brown, 7 Vet. App. 498, 511 (1995). A medical examination or medical opinion is necessary if the information and evidence of record does not contain sufficient competent medical evidence to decide the claim, but: (1) contains competent evidence of a current diagnosed disability or persistent or recurrent symptoms of a disability; (2) establishes that an event, injury, or disease occurred in service or certain diseases manifested during an applicable presumptive period for which the claimant qualifies; and (3) indicates that the disability or symptoms may be associated with the established event, injury or disease in service or with another service-connected disability. McLendon v. Nicholson, 20 Vet. App. 79 (2006). The third prong, which requires that the evidence of record "indicate" that the claimed disability or symptoms "may be" associated with the established event, is a low threshold. Id. Here, the evidence of record does indicate a current bilateral wrist disorder, right knee disorder, and left knee disorder and the Veteran's testimony suggests that they may be associated with events or injuries in service (specifically during service in Germany). Therefore, the low threshold for a VA examination is met. The matters are REMANDED for the following actions: 1. Contact the Veteran and his representative and request that they provide or identify and authorize the recovery of any additional private records of treatment for the claimed disabilities. The RO must follow the procedures laid out in 38 U.S.C. § 5103A(b)(2)(B). 2. Obtain any outstanding VA treatment records and associate them with the claims file. 3. Arrange for a VA wrist conditions and VA knee condition examination with an appropriate clinician. The clinician must review the entirety of the claims file and indicate such review in the body of each respective opinion or examination report. The clinician should perform all necessary evaluation protocols. Upon completion of the above, the clinician should respond to the following inquiries: a. What, if any, current diagnoses are apposite to, or best approximate: 1) bilateral wrist disorder; 2) right knee disorder; and 3) left knee disorder? Upon each respective current diagnostic determination, the clinician should opine: b. Whether it is at least as likely as not (50 percent probability or more) that the respective diagnosed disability had its onset in service or is otherwise etiologically related to the Veteran's active service, including any incidence of service including his testimony regarding the rigorous training for the competitive marching events as described in his Board hearing transcript? For all opinions, complete rationales should be provided. The clinician should reconcile any opinion with all other clinical evidence of record and the Veteran's and other lay evidence. The Board notes that the Veteran is competent to report his symptoms and history. Such reports, including those of continuity of symptomatology, must be acknowledged and considered in formulating any opinion. The examiner may consider whether the reports are consistent with the medical evidence. J.W. FRANCIS Veterans Law Judge Board of Veterans' Appeals Attorney for the Board B. J. Komins, 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.