Citation Nr: A21016802 Decision Date: 10/15/21 Archive Date: 10/15/21 DOCKET NO. 191130-50606 DATE: October 15, 2021 REMANDED Entitlement to service connection for a left hip condition, to include pain and instability as secondary to low back intervertebral disc syndrome (IVDS), is remanded. Entitlement to service connection for a left knee condition, to include pain and instability as secondary to low back IVDS, also is remanded. REASONS FOR REMAND This appeal to the Board of Veterans' Appeals (Board) is from a November 7, 2019, rating decision of a Department of Veterans Affairs (VA) Regional Office (RO). On November 30, 2019, the Veteran opted into the Appeals Modernization Act (AMA) review system by submitting a timely VA Form 10182, Decision Review Request: Board Appeal (AMA Notice of Disagreement (NOD)) and elected the hearing docket. She since had her hearing in May 2021 before the undersigned Veterans Law Judge. By choosing the hearing option, the Board may only consider the evidence of record at the time of the rating decision that she has appealed, and any additional evidence submitted during her hearing or within 90 days after it. See 38 C.F.R. § 20.302. However, if, as here, there were pre-decisional, duty-to-assist, errors, it is permissible to correct them before deciding the appeal of these claims. 1. Entitlement to service connection for left hip pain secondary to low back IVDS is remanded. 2. Entitlement to service connection for a left knee condition secondary to low back IVDS also is remanded. The Veteran testified during her May 2021 hearing that she has received additional, relevant treatment from VA including important diagnostic testing linking her left knee and hip conditions to her service-connected low back IVDS. To date, however, these VA treatment records have not been obtained and added to the claims file so that they, too, may be considered in deciding this appeal, and it is not apparent whether they concern evaluation and treatment during or within the permissible review period for allowance of evidence. In addition, the Veteran testified to experiencing instability in her hip and knee joints that affected her ability to walk. She is competent to report experiencing knee and hip instability. These symptoms were not discussed in the reports of her June 2019 VA examinations. Thus, while the examiner indicated the Veteran's reports of knee and hip pain were more likely than not associated with her service-connected radiculopathy of the sciatic nerve, she neither addressed the Veteran's reports of instability nor addressed whether either of these reported conditions were aggravated by service-connected disability (namely, her low back IVDS). Consequently, further development of these claims is needed to correct these pre-decisional, duty-to-assist errors, namely, by obtaining the Veteran's VA treatment records and, in turn, having an examiner opine on whether the Veteran's reported left hip and knee instability is related to her service-connected low back IVDS on a secondary basis either through direct causation or aggravation. Accordingly, these claims are REMANDED for the following action: 1. Obtain the Veteran's VA treatment records, if they concern treatment within the permissible evidentiary window for the hearing option she elected under the AMA. 2. After obtaining any outstanding VA treatment records, forward the claims file to an appropriate VA examiner for supplemental comment (an addendum opinion to the one already provided in June 2019) concerning whether it is at least as likely as not (50 percent or greater probability) the Veteran's reported left hip and left knee instability was caused OR is aggravated by a service-connected disability, namely, by her low back (lumbar) IVDS. NOTE: Whether the Veteran actually needs to be re-examined (meaning undergo another in-person examination) to provide this additional medical comment on this determinative issue of causation or aggravation is left to the discretion of the clinician designated to provide this addendum opinion. To assist in making this important determination, the claims file, including a complete copy of this remand, must be made available to the examiner for review and consideration of the relevant history. When responding, whether favorably or unfavorably, it is essential the examiner provide explanatory rationale preferably citing to evidence in the file supporting conclusions and/or accepted medical authority. KEITH W. ALLEN Veterans Law Judge Board of Veterans' Appeals Attorney for the Board C. B Kucera 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.