Citation Nr: 21067051 Decision Date: 11/03/21 Archive Date: 11/03/21 DOCKET NO. 14-24 913A DATE: November 3, 2021 REMANDED Entitlement to service connection for a right ankle disability is remanded. Entitlement to service connection for a right knee disability is remanded. REASONS FOR REMAND The Veteran served on active duty from August 1969 to August 1971. The record also indicates that the Veteran served in the National Guard via a July 1984 enlistment examination. The Board denied the Veteran's above-mentioned claims in a June 2018 decision. The Veteran appealed the denial to the United States Court of Appeals for Veterans Claims (Court). By way of an August 2020 Order, the Clerk of Court issued a Joint Motion for Partial Remand (JMPR). In December 2020, the Board remanded the above issues for actions consistent with the August 2020 JMPR, including obtaining VA opinions for the Veteran's claims right ankle and right knee disabilities. The case has since returned to the Board for appellate review. 1. Entitlement to service connection for a right ankle disability is remanded; entitlement to service connection for a right knee disability is remanded. The Veteran contends that he has right ankle and right knee disabilities that are related to his military service. Specifically, the Veteran links his right ankle and right knee disabilities to a single incident in service: while he was serving as a gunner on an M-42 A-1 tank, he fell from the tank and injured his right ankle and right knee. In May 2021, the VA examiner opined that the Veteran's right ankle and right knee disabilities were less likely than not (less than 50 percent probability) incurred in or caused by the claimed in-service injury, event, or illness. With respect to both claimed conditions, including the right knee disability and right ankle disability, the examiner noted the Veteran's reports of falling from a tank during active duty in Vietnam, thereby causing his right ankle and right knee disabilities. The examiner opined, however, that there are numerous other factors related to the Veteran's right knee disability that are as likely or more likely to be the proximate cause of his current issues. Among these are his body habitus, age, and natural changes associated with aging. Additionally, with respect to his right ankle, it did not have its onset until decades after service. Additionally, the VA examiner noted that the Veteran had many documented years of a physical occupation since service that could clearly play a role in both his right ankle and right knee conditions. The Board finds the May 2021 VA opinion inadequate, as the examiner did not address the Veteran's documented reports of right knee pain and right ankle injury during service. Specifically, a May 1971 service treatment record (STR) reflects that the Veteran complained of right knee pain, and the impression was reactive arthritis. Additionally, a June 1971 STR noted that the Veteran was found to have chondromalacia of the right knee after complaining of right knee pain secondary to a right ankle strain. Moreover, while the RO included additional military records in the Veteran's file, the RO did not issue a memorandum detailing all of the Veteran's periods of active military service, whether on active duty, ACDUTRA, or INACDUTRA, which was requested in the Board's December 2020 remand instructions. While the Board regrets the additional delay, a remand is necessary to obtain another opinion regarding the etiology of the Veteran's right ankle and right knee disabilities. A remand is also necessary for the RO to issue a memorandum detailing all of the Veteran's periods of active military service, whether on active duty, ACDUTRA, or INACDUTRA. The matters are REMANDED for the following action: 1. The AOJ should determine the specific dates of when the Veteran served on active duty service, ACDUTRA, and/or INACDUTRA. Records providing retirement points will NOT represent compliance with this instruction. 2. Then, the RO should issue a memorandum for inclusion in the claims file detailing each period of verified active military service, whether on active duty, ACDUTRA, or INACDUTRA. All medical treatment records associated with the Veteran's National Guard service should also be obtained. 3. RIGHT ANKLE: Then, obtain an addendum opinion from an appropriate clinician regarding the Veteran's right ankle disability. The entire claims file, including a copy of this remand, must be made available to the clinician, who must note its review. For each diagnosis of a right ankle condition, to include right ankle enthesopathy, the examiner should opine whether it is at least as likely as not (50 percent or greater probability) that the Veteran's right ankle condition manifested during, or is the result of, his active duty service, ACDUTRA, and/or INACDUTRA. In the opinion, the examiner is requested to address the following evidence: a. The Veteran's reports that he injured his right ankle in a fall from a tank while on active duty in Vietnam; b. A May 1971 Report of Medical History wherein the Veteran reports swollen or painful joints and cramps in his legs; c. A June 1971 Consultation Sheet wherein the Veteran reports ankle pain "secondary to sprain" and diagnosing the Veteran with chondromalacia of the right patella; d. A July 1984 Report of Medical Examination noting no issues with the Veteran's ankle; and e. A July 1984 Report of Medical History in which the Veteran does not report ankle conditions. The clinician should provide a comprehensive report that includes a complete rationale for all opinions and conclusions reached 4. RIGHT KNEE: Then, obtain an addendum opinion from an appropriate clinician regarding the Veteran's right knee disability. The entire claims file, including a copy of this remand, must be made available to the clinician, who must note its review. For each diagnosis of a right knee condition to include right knee joint osteoarthritis, right knee chondromalacia, and total right knee joint replacement the examiner should opine whether it is at least as likely as not (50 percent or greater probability) that the Veteran's right ankle condition manifested during, or is the result of, his active duty service, ACDUTRA, and/or INACDUTRA. In the opinion, the examiner is requested to address the following evidence: a. The Veteran's reports that he fell from the tank and injured his right knee while he was serving as a gunner on an M-42 A-1 tank; b. A May 1974 Report of Medical History wherein the Veteran reports swollen or painful joints and cramps in his legs; c. A May 1974 service medical record diagnosing the Veteran with reactive arthritis; and d. A June 1971 Consultation Sheet diagnosing the Veteran with chondromalacia of the right patella; The clinician should provide a comprehensive report that includes a complete rationale for all opinions and conclusions reached. 5. The AOJ should ensure that there is compliance with the remand instructions and take necessary corrective action if there is not. 6. Then, readjudicate the claim. GAYLE STROMMEN Veterans Law Judge Board of Veterans' Appeals Attorney for the Board C. E. Grossman, 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.