Citation Nr: 21068365 Decision Date: 11/10/21 Archive Date: 11/10/21 DOCKET NO. 16-23 306 DATE: November 10, 2021 REMANDED The appeal regarding entitlement to service connection for a right knee disability is remanded. The appeal regarding entitlement to service connection for a left knee disability is remanded. REASONS FOR REMAND The Veteran had active service from February 1979 to September 1980. This matter comes before the Board of Veterans' Appeals (Board) from an August 2012 rating decision by the Agency of Original Jurisdiction (AOJ) that denied service connection for arthritis. The Board remanded the instant claims in January 2019 and April 2021. In the April 2021 remand, the Board recharacterized the issues on appeal to broader consideration, bifurcating the prior claim of entitlement to service connection for arthritis as three separate claims of entitlement to service connection for left and right knee disabilities, as well as for a right ankle disability. See Locklear v. Shinseki, 23 Vet. App. 311 (2011). While the appeal was most recently in remand status, the AOJ issued an August 2021 rating decision that awarded service connection for a right ankle disability. This constitutes a full grant of the benefit sought on appeal. Thus, that issue is no longer in appellate status. In the January 2019 remand, the Board concluded that a December 2011 VA examination was incomplete as the examiner's explanation was unclear and did not provide a complete rationale for the opinion expressed. The Board additionally noted that the examiner failed to consider and address the Veteran's service treatment records, to include a notation of probable arthritis in the right knee. The Veteran was afforded non-degenerative arthritis and knee examinations in October 2019. In April 2021, the Board concluded that the examinations were inadequate. It specified that the examiner's opinion did not appear to consider the Veteran's service treatment records, and that he relied on the lack of documentation of a diagnosis during service. The Board ordered that additional examinations be conducted. On VA examination in July 2021, the diagnoses were degenerative arthritis of the right knee and posttraumatic arthritis of the left knee. The examiner concluded that these disabilities are not related to service. The examiner reasoned as follows: Less likely than not. No record of left knee during service was found. Thus, the veteran's medical records do not support that the currently diagnosed condition of post-traumatic arthritis, related to the veteran's claimed left knee condition, is at least as likely as not caused by the left knee during service. Less likely than not. Only one record of right knee during service was found: STR February 22, year not recorded -Fell and injured right knee. X-rays negative. Thus, the veteran's medical records do not support that the currently diagnosed condition of degenerative arthritis, related to the veteran's claimed right knee condition, is at least as likely as not caused by the right knee during service. The rationale offered by the examiner fails to adequately explain the medical principles underlying his conclusions. Regarding the right knee disability, he acknowledged a documented right knee injury during service, but did not adequately explain why the current right knee disability is not related to this incident of service. Moreover, the examiner did not address the Veteran's contention that his claimed knee disabilities are related to a documented June 1979 motor vehicle accident. The Board notes that service treatment records reflect that the Veteran was hospitalized from June 11, 1979 to June 25, 1979 for trauma following the motor vehicle accident. The Board concludes that an additional examination is necessary to address these questions. The matters are REMANDED for the following action: 1. Schedule the Veteran for an examination to determine the nature and etiology of his claimed right and left knee disabilities. The evidentiary record, including a copy of this remand, must be made available to and reviewed by the examiner. The examination report must include a notation that this record review took place. After the record review and examination of the Veteran, the examiner should identify all relevant conditions referable to the Veteran's knees. The examiner should provide an opinion regarding whether it is at least as likely as not that any such condition was incurred in, or is otherwise related to, active service. In rendering this opinion, the examiner is directed to service treatment records documenting a June 1979 motor vehicle accident and resulting hospitalization. See Service Treatment Records. The examiner is advised that the Veteran is competent to report his symptoms and history. Such reports must be acknowledged and considered in formulating any opinion. Specifically, the examiner is directed to the Veteran's report that the onset of his knee symptoms dates to 1979. See October 2019 VA non-degenerative arthritis examination report. If the examiner rejects the Veteran's reports, he or she must provide an explanation for such rejection. The examiner is not to improperly discount the Veteran's lay statements or mistakenly rely on an absence of medical evidence in the record to support his or her conclusions. The complete rationale for all opinions should be set forth, and a discussion of the facts and medical principles involved would be of considerable assistance to the Board. If an opinion cannot be provided without resorting to mere speculation, the examiner must provide a complete explanation for why an opinion cannot be rendered. In so doing, the examiner must explain whether the inability to provide a more definitive opinion is the result of a need for additional information, or that he or she has exhausted the limits of current medical knowledge in providing an answer to that particular question. (Continued on the next page) 2. Then, readjudicate the Veteran's claims. If the decision remains adverse to the Veteran, he and his representative should be furnished a supplemental statement of the case (SSOC) and afforded an appropriate period within which to respond thereto. DONNIE R. HACHEY Veterans Law Judge Board of Veterans' Appeals Attorney for the Board J. Barone, 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.