Citation Nr: 21066420 Decision Date: 10/30/21 Archive Date: 10/30/21 DOCKET NO. 17-50 377A DATE: October 30, 2021 ORDER Entitlement to service connection for right knee disability is granted. REMANDED Entitlement to service connection for left knee disability, to include as secondary to right knee disability, is remanded. FINDING OF FACT Resolving reasonable doubt in the Veteran's favor, his right knee disability began during active service. CONCLUSION OF LAW The criteria for service connection for right knee disability have been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from February 1972 to March 1975. These matters come before the Board of Veterans' Appeals (Board) on appeal from a rating decision issued by the Department of Veterans Affairs (VA) Regional Office (RO). In October 2021, the Veteran testified before the Undersigned Veterans Law Judge during a Travel Board hearing. 1. Entitlement to service connection for right knee disability The Board concludes that the Veteran has a current disability that began during active service. 38 U.S.C. §§ 1110, 5107(b); Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009); 38 C.F.R. § 3.303(a). The Veteran's service treatment records (STRs) document right knee complaints during service. Indeed, he was seen and treated for an avulsion fracture of the right lateral tibial plateau/condyle from playing football. He had a cast placed and he underwent physical therapy. During December 1974 separation examination the examiner noted the right knee was slightly swollen and tender. During November 2015 VA examination, the examiner indicated that it is less likely as not that the Veteran's knee disability was caused by military service. He stated that the current knee disability was more likely due to the aging process. In an August 2017 opinion, J.B., DO, stated that the Veteran has been under his care since 2014. The examiner diagnosed rupture of the right ACL, both menisci, and synovial osteochondromatosis. He has reviewed the Veteran's file, examined him, and finds that based on the Veteran's knee presentation, it is more likely that the current knee disability is related to military service. The examiner indicated that the Veteran has no other known risk factors that would have precipitated the current right knee degenerative disease. The Veteran has indicated that he has experienced right knee pain and stiffness since his in-service injury. The Veteran is competent to report right knee symptomatology. Given the Veteran's in-service right knee complaints and treatment for several years, as well as, continued post-service complaints and the findings of the private 2017 medical provider who found that the Veteran's current right knee disability is due to the in-service injury, the Board finds the evidence to at least be in equipoise as to whether the Veteran's current right knee disability arose in service. Accordingly, after resolving all doubt in favor of the Veteran, the Board finds that service connection for a right knee disability is warranted. REASONS FOR REMAND 1. Entitlement to service connection for left knee disability, to include as secondary to right knee disability is remanded. The Board finds that during the November 2015 VA examination, the left knee was not adequately addressed with regards to direct service connection. The evidence of record also suggests the Veteran's left knee disability could be secondary to the now service-connected right knee disability. As such, an opinion and/or new VA examination is necessary. The matters are REMANDED for the following action: 1. Forward the Veteran's claims file to an appropriate examiner for a supplemental opinion on the etiology of the current left knee disability, i.e., whether it was more likely the left knee was due to the in-service injury. The examiner must also address whether or not the left knee disability was caused OR aggravated (worsened beyond its natural progression) by the service-connected right knee disability? The examiner is asked to provide opinions as to both causation and aggravation on the secondary service connection claim. It is left to the examiner's discretion whether to examine the Veteran. The examiner is asked to provide a rationale/reasoning for any opinions rendered. H.M. WALKER Veterans Law Judge Board of Veterans' Appeals Attorney for the Board M. McPhaull, 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.