Citation Nr: 21068716 Decision Date: 11/12/21 Archive Date: 11/12/21 DOCKET NO. 16-50 999 DATE: November 12, 2021 REMANDED Entitlement to service connection for a recurrent right knee disability is remanded. REASONS FOR REMAND The Veteran had active service from March 1987 to September 1992. Entitlement to service connection for a recurrent right knee disability is remanded. In its June 2021 Remand instructions, the Board of Veterans' Appeals (Board) requested that the Veteran be afforded a Department of Veterans Affairs (VA) knee examination. The examiner was directed to "opine as to whether it is at least as likely as not that the Veteran's right knee disorder is related to his military service, to include any injury or symptomatology therein;" to "clarify whether the Veteran has osteoarthritis of the right knee in addition to the diagnosed sprain;" and to "opine as to whether it is at least as likely as not that the Veteran's right knee disorder was caused or aggravated beyond its normal progression by his service-connected right ankle disability." The report of an August 2021 examination conducted for VA states that the Veteran complained of recurrent right knee pain since 1989. On examination of the right knee, the Veteran exhibited a range of motion of 0 to 95 degrees with pain. The Veteran was diagnosed with right knee strain. The examiner concluded that "the claimed condition was less likely than not (less than 50 percent probability) incurred in or caused by the claimed in-service injury, event, or illness." The examining physician assistant commented that: "Veteran's C-file shows one episode of right knee, as this incident occurred over 10 years after active duty in June 2007;" "file shows no chronic complaints of right knee issue at all, almost all notations are of the left knee which he offers no complaints about on exam today;" "an objective nexus cannot be created for his right knee;" and "as records show no ongoing complaints of right knee pain, there is no way for me to create a connection between this and his right ankle condition when I have no evidence of chronic knee issue at all." Given the concurrent and conflicting findings that the Veteran was diagnosed with right knee strain; there was "no evidence of chronic knee issue at all;" the Veteran had presented a history of recurrent right knee pain since 1989; and the "records show no ongoing complaints of right knee pain," the Board finds that the August 2021 examination report is of limited probative value. VA's duty to assist includes, in appropriate cases, the duty to conduct a thorough and contemporaneous medical examination which is accurate and fully descriptive. McLendon v. Nicholson, 20 Vet. App. 79 (2006); Green v. Derwinski, 1 Vet. App. 121, 124 (1991). When VA undertakes to obtain an evaluation, it must ensure that the evaluation is adequate. Barr v. Nicholson, 21 Vet. App. 303, 312 (2007). Further VA knee evaluation is needed. Clinical documentation dated after September 2020 is not of record. VA should obtain all relevant VA and private treatment records which could potentially be helpful in resolving the Veteran's claim. Murphy v. Derwinski, 1 Vet. App. 78 (1990); Bell v. Derwinski, 2 Vet. App. 611 (1992). The matters are REMANDED for the following action: 1. Ask the Veteran to complete a VA Form 21-4142 for each private healthcare provider who has treated any right knee disabilities. Make two requests for the authorized records from all identified healthcare providers unless it is clear after the first request that a second request would be futile. 2. Obtain any VA treatment records not of record, to include those pertaining to treatment after September 2020. 3. Schedule the Veteran for a VA knee examination conducted by a medical doctor to assist in determining the current nature of any identified recurrent right knee disabilities and any relationship to active service or a service-connected disability. The examiner must review the record and should note that review in the report. A rationale for all opinions should be provided. The examiner should: (a) Identify all recurrent right knee disabilities found. If a specific right knee disability is not diagnosed, the examiner must specifically state whether any reported right knee pain and functional impairment is recurrent in nature and thus constitutes a disability. (b) Opine whether it is at least as likely as not (50 percent probability or greater) that any identified recurrent right knee disability had its onset during active service or is related to any incident of service. (c) Opine whether it is at least as likely as not (50 percent probability or greater) that any identified right knee disability is due to or caused by the service-connected right ankle and left ankle disabilities. (d) Opine whether it at least as likely as not (50 percent probability or greater) that any identified right knee disability has been aggravated (increased in severity beyond the natural progress of the disorder) by the service-connected right ankle and left ankle disabilities. J. T. HUTCHESON Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Macek, M. A. 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.