Citation Nr: 21066748 Decision Date: 11/02/21 Archive Date: 11/02/21 DOCKET NO. 15-10 612A DATE: November 2, 2021 REMANDED Entitlement to service connection for a right knee disability is remanded. Entitlement to service connection for a left knee disability is remanded. Entitlement to service connection for a right foot disability is remanded. Entitlement to service connection for a left foot disability is remanded. Entitlement to service connection for a right arm disability is remanded. Entitlement to an initial rating in excess of 10 percent for a right ankle disability is remanded. REASONS FOR REMAND 1. Entitlement to service connection for a right knee disability is remanded. 2. Entitlement to service connection for a left knee disability is remanded. The Veteran claims to have incurred knee injuries after falling from a tank turret during service. In a March 2020 VA treatment record, a VA examiner opined that the disabilities were less likely related to service, because, in large part, there was no documentation of the claimed injuries in the service medical records. The examiner did not make any reference to the Veteran's lay reports of the injuries or the reports of continuous pain following the claimed injuries. In the same report, the same VA examiner indicated that that the Veteran's service-connected low back and right foot disabilities had not aggravated claimed knee disabilities. Subsequently, in a May 2021 VA treatment record, the Veteran was treated for increased knee disability symptomatology, characterized by pain. Because the knee disabilities have potentially worsened since the March 2020 examination, the possibility of further aggravation of the disabilities cannot be ruled out. Remand is necessary for an examination. 3. Entitlement to service connection for a right foot disability is remanded. 4. Entitlement to service connection for a left foot disability is remanded. 5. Entitlement to service connection for a right arm disability is remanded. The Veteran claims to have incurred foot and arm injuries after falling from a tank turret during service. In a March 2020 VA treatment record, a VA examiner opined that the disabilities were less likely related to service, because, in large part, there was no documentation of the claimed injuries in the service medical records. In so doing, the examiner did not indicate any reference to the Veteran's lay reports of injuries or reports of continuous pain following said injuries. Remand is necessary to schedule an examination. 6. Entitlement to an initial rating in excess of 10 percent for a right ankle disability is remanded. Because the current severity of the service-connected right ankle disability is relevant to the claims of secondary service connection, as part of the examination requested in this remand, an examination of the right ankle should be performed. The matters are REMANDED for the following action: Schedule the Veteran for a VA orthopedic examination with a medical doctor who has not previously examined the Veteran to determine the etiology of the claimed knee, foot, and arm disabilities, and the severity of a right ankle disability. The examiner must review the record and should note that review in the report. In reviewing the record, the examiner should note the service medical records; the post-service treatment records; and the Veteran's lay statements regarding his in-service injuries and subsequent symptomatology. A complete rationale should be provided for all opinions and conclusions expressed. All appropriate tests or studies, to include X rays if considered to be necessary, should be accomplished, and all clinical findings should be reported in detail. Regarding the right ankle, the examiner must report the range of motion of the ankle, expressed in degrees, to include measurements for weight-bearing, nonweight-bearing, passive motion, and active motion of both ankles. The examiner must make specific findings as to whether, during the examination, there is objective evidence of additional loss of function due to painful motion, weakened motion, excess motion, fatigability, incoordination, or on flare up. If pain on motion is observed, the examiner should indicate the point at which pain begins. The examiner should also indicate whether, and to what extent, the Veteran experiences functional loss of the ankle or any other symptoms during flare-ups or with repeated use. To the extent possible, the examiner should express any additional functional loss in terms of additional degrees of limited motion. After an examination, an interview with the Veteran, and a review of the claims file, the examiner is asked to also provide the following: (a.) Diagnose all knee, foot, and right arm disabilities. (b.) Opine whether it is at least as likely as not (50 percent or greater probability) that any diagnosed right or left knee disability is related to service or any incident of service. The examiner should address the Veteran's reports of knee disability symptomatology during and since service. (c.) If an arthritic disability of either knee is diagnosed, opine whether it is at least as likely as not (50 percent or greater probability) that right of left knee arthritis (1) began during active service, (2) manifested within one year after the Veteran's October 1972 separation from service, or (3) was noted during service with continuity of the same symptomatology since service. (d.) Opine whether it is at least as likely as not (50 percent or greater probability) that any diagnosed knee disability is proximately due to or the result of the service-connected disabilities, to include low back and right ankle disability). (e.) Opine whether it at least as likely as not (50 percent or greater probability) that any diagnosed knee disability has been aggravated (increased in severity beyond the natural progress) by the service-connected disabilities, to include low back and right ankle disabilities. (f.) Opine whether it is at least as likely as not (50 percent or greater probability) that any diagnosed right or left foot disability is related to service or any incident of service. The examiner should address the Veteran's reports of foot disability symptomatology during and since service. (g.) If an arthritic disability of either foot is diagnosed, opine whether it is at least as likely as not (50 percent or greater probability) that right or left foot arthritis (1) began during active service, (2) manifested within one year after the Veteran's October 1972 separation from service, or (3) was noted during service with continuity of the same symptomatology since service. (h.) Opine whether it is at least as likely as not (50 percent or greater probability) that any diagnosed right or left foot disability is proximately due to or the result of the service-connected disabilities, to include low back disability and right ankle disabilities. (i.) Opine whether it at least as likely as not (50 percent or greater probability) that any diagnosed right or left foot disability has been aggravated (increased in severity beyond the natural progress) by the service-connected disabilities, to include low back disability and right ankle disabilities. (j.) Opine whether it is at least as likely as not (50 percent or greater probability) that any diagnosed right arm disability is related to service or any incident of service. The examiner should address the Veteran's reports of arm disability symptomatology during and since service. (k.) If an arthritic disability of the right arm is diagnosed, opine as to whether it is at least as likely as not (50 percent or greater probability) that any right arm arthritis (1) began during active service, (2) manifested within one year after the Veteran's October 1972 separation from service, or (3) was noted during service with continuity of the same symptomatology since service. (l.) Opine whether it is at least as likely as not (50 percent or greater probability) that any diagnosed right arm disability is proximately due to or the result of the service-connected disabilities, to include low back and right ankle disabilities. (m.) Opine whether it at least as likely as not (50 percent or greater probability) that any diagnosed right arm disability has been aggravated (increased in severity beyond the natural progress) by the service-connected disabilities, to include low back and right ankle disabilities. Harvey P. Roberts Veterans Law Judge Board of Veterans' Appeals Attorney for the Board T.M. Gillett 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.