Citation Nr: 21068401 Decision Date: 11/10/21 Archive Date: 11/10/21 DOCKET NO. 15-38 985A DATE: November 10, 2021 REMANDED Entitlement to service connection for a right knee disorder is remanded. Entitlement to service connection for a left knee disorder is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Army from October 1969 to August 1972. In July 2019, the Board granted the issue of entitlement to service connection for shin splints, determined that new and material evidence had been received to reopen the previously denied issue of entitlement to service connection for a back disorder, and remanded the issue of entitlement to service connection for a back disorder for additional evidentiary development. That issue was grated in a March 2020 VA rating decision, which represents a full grant of the benefits sought so it is no longer on appeal before the Board. In July 2019, the Board also remanded the remaining issues of service connection for right and left leg disorders (other than shin splints), right and left ankle disorders, and right and left knee disorders for additional evidentiary development. In October 2020, the Board denied the issues of service connection for right and left leg disorders (other than shin splints) and remanded the issues of service connection for right and left ankle disorders and right and left knee disorders for additional evidentiary development. In the September 2021 VA rating decision, the issues of service connection for right and left ankle disorders were granted, which represents a full grant of the benefits sought so they are no longer on appeal before the Board. The remaining issues on appeal for service connection for right and left knee disorders have been returned to the Board for further appellate review. 1. Entitlement to service connection for a right knee disorder 2. Entitlement to service connection for a left knee disorder Pursuant to the October 2020 Board remand directives, these issues on appeal were remanded for the agency of original jurisdiction (AOJ) to obtain a VA medical opinion to address the etiology of the Veteran's bilateral knee disorder on a direct basis. VA medical opinions for right and left knee disorders were provided on a direct basis in August 2021; however, the Board finds the rationales provided were based solely on the absence of documented chronicity and continuity of care for many years after separation from service, thus is inadequate. When VA undertakes to provide a VA medical opinion, it must ensure that the opinion is adequate. Barr v. Nicholson, 21 Vet. App. 303, 312 (2007). As such, the Board finds that an additional VA medical opinion on a direct basis is needed to clarify the etiology of the Veteran's bilateral knee disorder. The matters are REMANDED for the following actions: 1. Return the Veteran's claims file to the examiner who provided the August 2021 VA medical opinions regarding the Veteran's bilateral knee disorder so a supplemental opinion may be provided. If that examiner is no longer available, provide the Veteran's claims file to a qualified clinician. The entire claims file and a copy of this remand must be made available to the examiner for review. A new examination (physical or telehealth) is only required if deemed necessary by the examiner. The examiner must opine as to whether it is at least as likely as not (50 percent or greater probability) that the Veteran's bilateral knee disability (diagnosed as patellofemoral pain syndrome, even if since resolved) began during active service or is related to an incident of service, to include consideration of job duties as a lineman and physical training during service. Note - It is not sufficient to provide an opinion that the Veteran's bilateral knee disability is not directly related to an incident of service solely based on the absence of documented treatment, chronicity, or diagnosis for many years after separation from service. The examiner must provide all findings, along with a complete rationale for his or her opinion(s) in the examination report. If any of the above requested opinions cannot be made without resort to speculation, the examiner must state this and provide a rationale for such conclusion. 2. Then, review the medical opinions to ensure that the requested information was provided. If any report or opinion is deficient in any manner, the AOJ must implement corrective procedures. (Continued on the next page) 3. Then, readjudicate the claims. If any decision is adverse to the Veteran, issue a Supplemental Statement of the Case and allow the applicable time for response. Then, return the case to the Board. D. Martz Ames Veterans Law Judge Board of Veterans' Appeals Attorney for the Board T. Carter, 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.