Citation Nr: 21069222 Decision Date: 11/17/21 Archive Date: 11/17/21 DOCKET NO. 17-13 952 DATE: November 17, 2021 REMANDED Entitlement to service-connection for a left knee condition is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Navy from September 1986 to September 1990. This matter comes before the Board of Veterans' Appeals (Board) on appeal form an April 2015 Department of Veterans Affairs (VA) rating decision that, in part, denied service connection for a claimed left knee condition. The Veteran appeared before the undersigned Veterans Law Judge at a Board hearing in June 2021. Entitlement to service-connection for a left knee condition is remanded. The Veteran contends that he developed a left knee condition in service, which he believes to have been caused by long marches while carrying heavy loads of equipment required for his service as a naval hospital corpsman. At the Veteran's June 2021 Board hearing, he described that his left knee condition "felt like a dislocation, maybe a severe strain sprain around the joints, a lot of swelling, redness, pain." He further stated that in his military occupational specialty (MOS) as a naval hospital corpsman, supervisors generally directed "buddy care" amongst each other, as opposed to seeking documented treatment, because they were the same servicemembers who would have administered the treatment being sought. He also reported that seeking formal medical treatment was discouraged in service, noting that there were names that they would call servicemembers who reported to sick bay often. The Veteran's claims of repeated knee complaints in-service and the culture of his MOS were corroborated by two April 2014 buddy statements obtained from fellow servicemembers. In March 2015, the Veteran received a VA medical examination where the condition of his left knee was assessed. At this examination, the Veteran was diagnosed with knee strain. The examiner opined that the Veteran's knee strain disability was less likely than not related to service. The Board notes that the examiner's report did not contain an etiology opinion; this conclusion appeared to be based solely on the fact that there were no service treatment records to corroborate the Veteran's claims. The absence of contemporaneous records showing complaints of or treatment for the condition, alone, is insufficient rationale for a nexus opinion. Buchanan v. Nicholson, 451 F.3d 1331, 1337 (Fed. Cir. 2006) (finding lack of contemporaneous medical records does not serve as an "absolute bar" to the service connection claim); Barr v. Nicholson, 21 Vet. App. 303 (2007) ("Board may not reject as not credible any uncorroborated statements merely because the contemporaneous medical evidence is silent as to complaints or treatment for the relevant condition or symptoms"). In addition, the Board notes that there is no indication that the examiner took the Veteran's lay statements or the servicemembers' buddy statements, particularly given their status as trained medical personnel, into consideration in drafting the opinion. Further, the Veteran's condition has since been evaluated as significantly worse than a knee strain; a September 2019 MRI revealed that the Veteran's left knee was found to have a meniscal tear, a meniscal cyst, cartilage erosion, and joint effusion. The Veteran received a partial medial meniscectomy in December 2020. The Board notes that imaging was not conducted at his March 2015 examination. Because the Veteran's claim was denied without adequate rationale and because a significant amount of evidence has yet to be considered, the Board finds that a remand is necessary for this matter. The matters are REMANDED for the following action: Obtain a new VA medical opinion regarding the etiology of the Veteran's claimed left knee condition from a qualified VA clinician, preferably from one who has not examined the Veteran in the past. The examiner must review the claims file. Schedule the Veteran for a new VA examination only if deemed medically necessary by the examiner. The examiner should opine whether the Veteran's current left knee disability is at least as likely as not (50 percent or greater probability) related to his service. The examiner's report should address the August 2014 buddy statements from D.F. and T.K., as well as the Veteran's June 2021 hearing testimony. The examiner is advised that all three parties are trained medical personnel, having served as naval hospital corpsmen. The examiner is advised the Veteran is competent to report his symptoms and history. Such reports must be specifically acknowledged and considered in formulating any opinion. If the examiner rejects the Veteran's reports, he or she must provide a reason for doing so. The examiner is advised that the absence of contemporaneous records showing complaints of or treatment for the condition, alone, is insufficient rationale for a nexus opinion. (Continued on the next page) All findings must be reported in detail and all opinions must be accompanied by a clear rationale. If any of the above issues cannot be resolved without resorting to speculation, then a detailed medical explanation as to why this is so must be provided. M. HYLAND Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Narnor, Harriyah 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.