Citation Nr: 21068100 Decision Date: 11/09/21 Archive Date: 11/09/21 DOCKET NO. 18-50 011A DATE: November 9, 2021 REMANDED Entitlement to service connection for a left knee disorder is remanded. Entitlement to service connection for a left ankle disorder is remanded. Entitlement to service connection for a right shoulder disorder is remanded. Entitlement to service connection for a skin disorder, claimed as pseudofolliculitis barbae, is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Air Force from September 1993 to January 2001, and then served with the United States Air Force National Guard (ANGUS) from January 2001 until September 2001. This claim comes before the Board of Veterans' Appeals (Board) on appeal of an August 2017 rating decision issued by a Department of Veterans Affairs (VA) Regional Office (RO). A hearing was conducted before the undersigned Veterans Law Judge (VLJ) on June 23, 2020, with the Veteran and his representative present. A transcript of the hearing has been produced and associated with the claims file for Board review. See Hearing Tr. (June 23, 2020). 1. Entitlement to service connection for a left knee disorder is remanded. 2. Entitlement to service connection for a left ankle disorder is remanded. 3. Entitlement to service connection for a right shoulder disorder is remanded. 4. Entitlement to service connection for a skin disorder, claimed as pseudofolliculitis barbae, is remanded. The Board notes that the Veteran's service treatment records were never associated with the claims file. Even though the Veteran did not have his own copy of his service treatment records, the Veteran offered competent and credible testimony as to where he suffered his in-service injuries and where he received immediate treatment for them. Meanwhile, despite some evidence that certain databases were searched without finding the Veteran's service treatment records, see Memo from VA Records Management Center ( Mar. 24, 2017 ), other evidence suggests that records are available but have yet to be scanned into image format for Board review, see cf. DPRIS Response (rec'd Feb. 20, 2017); VA Form 21-3101 Request for Information (Mar. 23, 2017). The Federal Circuit has held that VA's duty to assist includes the duty to obtain VA medical records, regardless of the relevancy of those records. See Sullivan v. McDonald, 815 F.3d 786 (Fed. Cir. 2016). Without them, the Board cannot escape the conclusion that a remand is required. The Board sincerely regrets additional delay that may be incurred as a result. The Veteran has alleged that his skin disorder began during service and that he had a shaving profile during service. In addition, the Veteran has alleged stumbling or falling in a hole while carrying a casket during service, and that his left knee disorder, left ankle disorder and right shoulder disorder were the result of this incident. A February 2021 opinion from S.M. indicates that the Veteran's current left knee disorder is consistent with the reported lateral meniscus tear that was diagnosed in the summer of 1997 and that his current lateral meniscus tear is consistent with that history; this opinion did not address the other claimed disabilities. As the Board is remanding the claims for additional development to obtain potentially relevant service treatment records and post-service treatment records, a decision on the claimed left knee disorder will be deferred at this time. However, examinations have not been conducted with regards to the claimed left ankle disorder, right shoulder disorder and skin disorder. Such examinations and etiology opinions should be obtained on remand. McLendon v. Nicholson, 20 Vet. App. 79, 83 (2006). The matters are REMANDED for the following action: 1. The AOJ is directed to associate all service treatment records with the Veteran's claims file. During the Board hearing, the Veteran's testified that the injuries for which he presently seeks service connection were incurred in 1997 while performing duties with the Air Force Honor Guard at Arlington National Cemetery. Previous attempts dated February 20, 2017 and March 23, 2017 indicate that records are available, but they have not yet been scanned as images for Board review. If no records are available, then a negative search result that reconciles the above positive results must be associated with the claims file. The AOJ is specifically advised that the Veteran's first name appears to be misspelled on his DD Form 214, compared to other legal documents associated with the claims file. Both variations of the Veteran's name should be used with the Veteran's Social Security Number in pursuit of his service treatment records. 2. The Veteran should be given the opportunity to identify any outstanding private or VA treatment records relevant to the claims on appeal. After obtaining any necessary authorization from the Veteran, all outstanding records should be obtained, to include updated VA treatment records and records from the VA Medical Center in Buffalo, New York, on Bailey Avenue. The AOJ should note that the Veteran has specifically testified that VA treatment records for his left knee, left ankle, right shoulder, and dermatological disorders should have started approximately eight months after his 2001 discharge at the emergency room of the VA Medical Center in Buffalo, New York, located on Bailey Avenue. For private treatment records, make at least two (2) attempts to obtain records from any identified sources. If any such records are unavailable, inform the Veteran and his representative and afford him an opportunity to submit any copies in their possession. For federal records, all reasonable attempts should be made to obtain such records. If any records cannot be obtained after reasonable efforts have been made, issue a formal determination that such records do not exist or that further efforts to obtain such records would be futile, which should be documented in the claims file. The Veteran must be notified of the attempts made and why further attempts would be futile, and allowed the opportunity to provide such records, as provided in 38 U.S.C. § 5103A(b)(2) and 38 C.F.R. § 3.159(e). 3. Following the receipt of outstanding records, schedule the Veteran for an examination by an appropriate clinician to determine the nature and etiology of his claimed left ankle disorder, right shoulder disorder and skin disorder. Any and all indicated evaluations, studies and tests deemed necessary by the examiner should be accomplished. The need for further in-person examination is left to the discretion of the examiner. The examiner should respond to the following questions: (A) Is it at least as likely as not (50 percent or higher probability) that the Veteran's left ankle disorder is related to an in-service injury, event, or disease? The examiner should specifically address the Veteran's contention that his stumbled in a hole while carrying a casket during service. (B) Is it at least as likely as not (50 percent or higher probability) that the Veteran's right shoulder disorder is related to an in-service injury, event, or disease? The examiner should specifically address the Veteran's contention that his stumbled in a hole while carrying a casket during service. (C) Is it at least as likely as not (50 percent or higher probability) that the Veteran's a skin disorder is related to an in-service injury, event, or disease? The examiner should specifically address the Veteran's contention that he had a shaving profile during service. The examiner must reconcile any conflicting medical evidence of record. A clear rationale for all opinions must be provided, and a discussion of the facts and medical principles involved would be of considerable assistance. If the examiner opines that any of the above questions cannot be resolved without resorting to speculation, then a detailed medical explanation as to why this is so must be provided. A rationale should be provided for any opinion offered. If it is not possible to provide a specific opinion regarding the above questions, the examiner must 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), a deficiency in the record (additional facts are required), or the examiner (does not have the knowledge or training). The medical opinion must support the conclusions reached with an analysis that is adequate to consider and weigh against other evidence of record; medical opinions must contain not only clear conclusions with supporting data, but also a reasoned medical explanation connecting the two. If an opinion cannot be expressed without resort to speculation, ensure that the clinician so indicates and discusses why an opinion is not possible, to include whether there is additional evidence that could enable an opinion to be provided, or whether the inability to provide the opinion is based on the limits of medical knowledge. KRISTY L. ZADORA Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Michael B. Engle, Associate 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.