Citation Nr: 21067032 Decision Date: 11/03/21 Archive Date: 11/03/21 DOCKET NO. 16-36 584 DATE: November 3, 2021 REMANDED Entitlement to service connection for a right knee disability is remanded. Entitlement to service connection for a lumbar spine disability is remanded. REASONS FOR REMAND The Veteran had active duty service from August 1985 to May 1994. These matters come before the Board of Veterans' Appeals (Board) on appeal from a May 2014 rating decision issued by a Department of Veterans Affairs (VA) Regional Office (RO). These matters were last before the Board in May 2021, at which time they were remanded for additional evidentiary development. 1. Entitlement to service connection for a right knee disability is remanded; 2. Entitlement to service connection for a lumbar spine disability is remanded. Throughout the rating period on appeal, the Veteran has been assessed with degenerative disc disease of the lumbar spine (lumbar spine disability) and right knee meniscal tear and ostearthritis (right knee disability). The Veteran's service-treatment records reveal that his job included crawling on his knees and that he had complaints of right knee pain commencing in January 1990. In May 1991, the Veteran complained of lumbar back pain with radiculopathy aggravated by a car accident 3 days prior and hurting his back while lifting something at work. He was assessed with sciatica. During the May 1994 separation examination, the Veteran reported swollen or painful joints and the physician listed his knees. The Veteran submitted a statement in July 2014 and noted that his back problems started in 1991 and have continued after discharge in 1994. Moreover, his knees have been a chronic problem since his time in service. A November 2020 statement submitted by his in-laws indicated that they have known him for over 20 years and during this time he has always had problems with his knees and back. Pursuant to the Board's remand instructions, VA examinations were performed in July 2021, at which time the examiner noted that his right knee and lumbar spine disabilities were not related to service given that there was no documentation per the separation examination of any back or right knee disability. After a review of the evidence, the Board finds that the July 2021 VA examinations and medical opinions are insufficient to determine the present claims. In this regard, in the May 2021 remand instructions, the Board instructed the examiner to consider the Veteran's lay statements of record indicating that his right knee and lumbar spine pain have continued since service. However, the examiner did not acknowledge or discuss any lay statements. Moreover, the examiner indicated that there was no documentation of a right knee disability during the separation examination. However, the examiner specifically noted a knee disability on the separation examination. Accordingly, the Board finds that addendum medical opinions are warranted on remand. The matters are REMANDED for the following action: Forward the claims file, including a copy of this remand, to an appropriate clinician, who has not previously provided an opinion in this matter, for a medical opinion to determine the etiology of the Veteran's right knee and lumbar spine disabilities. The claims file, including a copy of this remand, should be reviewed and such review should be noted in the examination report. An examination is only necessary if deemed so by the examiner. The examiner should respond to the following: Is it at least as likely or not (probability of at least 50 percent) that the Veteran's right knee and/or lumbar spine disabilities were incurred in and/or otherwise etiologically related to his period of active service? Attention is called to the Veteran's post-service right knee injury in 2004. The examiner should understand that as long as some level of disability existed prior to the intercurrent incidents, then a positive nexus to service should be made. Solely for the purposes of future rating, if a nexus to service is made, the examiner should then attempt to estimate the percentage of symptoms attributable solely to the in-service injuries. The examiner should provide a comprehensive rationale for each opinion provided. Specifically, the examiner must discuss the Veteran's in-service right knee and back complaints and his July 2014 statement indicating that his back and right knee pain continued post-service. The examiner is advised that the Veteran is competent to report his symptoms and history, and such reports are to be considered in formulating any opinion. If any opinion cannot be given without resorting to speculation, the examiner should explain why and state whether the need to speculate is due to a deficiency in the state of general medical knowledge (no one could respond given medical science and the known facts), the record (additional facts are required), or the examiner does not have the knowledge or training. As appropriate, the AOJ should conduct additional development or supplement the record. Eric S. Leboff Veterans Law Judge Board of Veterans' Appeals Attorney for the Board S. Merrick 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.