Citation Nr: 21069033 Decision Date: 11/17/21 Archive Date: 11/17/21 DOCKET NO. 16-53 259A DATE: November 17, 2021 ISSUES 1. Entitlement to service connection for right knee chondromalacia patella. 2. Entitlement to service connection for left knee chondromalacia patella. REMANDED Entitlement to service connection for right knee chondromalacia patella is remanded. Entitlement to service connection for left knee chondromalacia patella is remanded. REASONS FOR REMAND The Veteran had active duty service from April 1973 to August 1973. This case comes before the Board of Veterans' Appeals (Board) on appeal from a July 2013 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO). The Veteran testified before the undersigned during a September 2020 Board videoconference hearing; a copy of the transcript is of record. The Veteran requested an additional hearing before the Board in October 2021. The Board notes "[t]he purpose of a hearing is to receive argument and testimony relevant and material to the appellate issue." 38 C.F.R. § 20.700 (b). The Board further notes that VA regulation explicitly provides that "only one hearing before the Board will be conducted." 38 C.F.R. § 20.1507 (b)(1). Therefore, the Board finds that there is no need for an additional hearing regarding the issues on appeal, as the Veteran has already been provided a hearing for the issues on appeal, and he has not provided good cause to warrant a second one. When this case was previously before the Board in June 2021, it was remanded for additional evidentiary development. It has since been returned to the Board for further appellate action. The Board finds that additional evidentiary development is required before the issues on appeal are decided. The Veteran asserts that service connection is warranted for right knee and left knee chondromalacia patella as they are related to service. Historically, in a January 2021 remand, the Board found that the Veteran should be afforded a new VA examination, to specifically include X-ray testing. The Board specifically noted in January 2021 that a veteran is presumed in sound condition except for defects noted when examined and accepted for service. Clear and unmistakable evidence that the disability existed prior to service and was not aggravated by service will rebut the presumption of soundness. 38 U.S.C. § 1111; 38 C.F.R. § 3.304; VAOPGCPREC 3-2003. The Board also specifically noted that in his enlistment examination, the Veteran's knees were noted as normal on clinical evaluation. The Veteran was afforded a VA-contracted examination in March 2021 in which the examiner stated in pertinent part that he entered military service as per the entrance examination in 1973 with bowed legs (genu varum) bilateral. The examiner opined that the Veteran was not active duty long enough to have a significant impact on his knees, and there were no active complaints of a chronic condition that began in or was incurred during service. In response to the Board's remand, an addendum opinion was received in July 2021 from the same examiner. The examiner stated that the Veteran suffered knee pain and debility with marked deformity of the knees bilaterally from the age of 6, and this was documented when he entered military service. The examiner stated that there was nothing in the service treatment records or on examination that supported any definite or significant impact of active duty military service on his knees. The examiner stated in pertinent part that the Veteran entered service with marked deformity of his knees and left service with marked deformity of his knees. The examiner stated that at no time during his active duty interval did the Veteran complain by documentation of any exacerbation or of any new condition that could be attributed to/caused by military service alone. In this case, the Board notes again that in his enlistment examination, the Veteran's knees were noted as normal on clinical evaluation. Moreover, bowed legs (genu varum) bilateral was not noted on his enlistment examination. Finally, he was diagnosed with chondromalacia, patella, both knees, in service. As such, the July 2021 opinion was based at least in part on an inaccurate factual basis. See Reonal v. Brown, 5Vet. App.458,461 (1993) (holding that the Board may reject a medical opinion based on an inaccurate factual basis).Therefore, the Board finds that an addendum opinion from a different examiner should be sought on remand. The matters are REMANDED for the following action: 1. Provide the Veteran's claims file to a different examiner than the one who provided the July 2021 opinion to provide an addendum opinion. An examination is only required if deemed necessary by the examiner. The electronic claims files, to include a copy of this remand, must be made available to and be reviewed by the examiner in conjunction with the examination. The examiner should address the following: a) Opine whether any right and left knee disabilities diagnosed during the pendency of this appeal clearly and unmistakably existed prior to the Veteran's service. b) If so, the examiner should provide an opinion as to whether it is clear and unmistakable that any such disorder did not undergo aggravation during service beyond its natural progression. c) If the examiner concludes that any such disorder did not clearly and unmistakable exist prior to service, the examiner should provide an opinion as to whether the disorder is as likely as not etiologically related to service. The examiner is reminded that in his enlistment examination, the Veteran's knees were noted as normal on clinical evaluation. Moreover, bowed legs (genu varum) bilateral was not noted on his enlistment examination. Finally, he was diagnosed with chondromalacia, patella, both knees, in service. A full and complete rationale for all opinions expressed must be provided. 2. After completing the requested actions, and any additional notification and/or development deemed warranted, the RO should readjudicate the claims on appeal. If any benefit sought on appeal remains denied, the RO must furnish the Veteran and his attorney with an appropriate supplemental statement of the case and afford a reasonable opportunity for response. MICHAEL A. PAPPAS Veterans Law Judge Board of Veterans' Appeals Attorney for the Board R.M.K., 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.