Citation Nr: 21069435 Decision Date: 11/18/21 Archive Date: 11/18/21 DOCKET NO. 17-14 095 DATE: November 18, 2021 REMANDED Entitlement to service connection for cervical spine disability is remanded. Entitlement to service connection for lower back disability is remanded. Entitlement to service connection for right knee disability is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Marine Corps from September 1971 to August 1973. This matter comes to the Board of Veterans' Appeals (Board) from a February 2016 rating decision by a Department of Veterans Affairs (VA) Regional Office (RO) in Nashville, Tennessee, which is the Agency of Original Jurisdiction (AOJ). In April 2021, the Veteran presented testimony in support of his appeal at a Board hearing conducted by the undersigned Veterans Law Judge via videoconferencing equipment. A transcript of the hearing is associated with the file. 1. Entitlement to service connection for cervical spine disability is remanded. 2. Entitlement to service connection for lower back disability is remanded. 3. Entitlement to service connection for right knee disability is remanded. To promote efficiency, the issues of entitlement to service connection for cervical spine disability, lower back disability, and right knee disability will be addressed together. In this case, the Veteran contends his cervical spine, lower back, and right knee disabilities were all incurred in or caused by his active-duty service. Specifically, he contends that these disabilities were caused by documented in-service injuries. Initially, the Board notes the Veteran has a current diagnosed disability of degenerative disc disease of the lumbar spine and has received treatment in the form of injections. Medical records from Memphis VA Medical Center (VAMC) contains extensive treatment records for low back pain with pain radiating into his legs. Furthermore, the Veteran's medical records indicates he experiences knee pain. During his Board hearing, he first testified that he injured his back when he jumped out of a deuce-and-a-half truck. Second, he states he injured his cervical spine during an incident where, following practice at the rifle range, he went to sit down, missed the bench, and hit his neck off the concrete bench. He also testified that he injured his knee while stationed in Japan while he was riding a bike, and a bus cut him off, and he fell and injured his knee. The Veteran's service treatment records (STRs) contain a history of complaints and treatment for back and knee pain. The Veteran was seen during basic training at Paris Island in October 1971 with complaints of back pain. A clinical record from November 1972 notes that the Veteran "missed a step while descending stairs on the night of admission and fell, striking his lumbosacral strain." The clinical note states there were normal x-rays but the Veteran had severe local pain and was prescribed bedrest. He was diagnosed with acute back strain. In June 1972, the Veteran was seen at Camp Lejeune with complaints of lower back pain. In addition, a September 1972 STR notation indicates the Veteran was seen in a Japanese hospital for a back injury and a June 1973 STR notation notes the Veteran was seen in the hospital in Japan for a right knee injury. In addition, the Veteran's STRs note in April 1973 he experienced an injury to his right knee. Based on evidence of a current disability, the extensive history and testimony regarding in-service back, neck, and knee pain, and the lack of a contemporary VA examination, the Board concludes that the low threshold to provide the Veteran with VA examinations and etiological opinions has been met. 38 C.F.R. § 3.159(c)(4); McLendon v. Nicholson, 20 Vet. App. 79, 81 (2006). In McLendon, the United States Court of Appeals for Veterans Claims (Court) held that an examination is required when (1) there is evidence of a current disability, (2) evidence establishing an "in-service event, injury or disease," or a disease manifested in accordance with presumptive service connection regulations occurred which would support incurrence or aggravation, (3) an indication that the current disability may be related to the in-service event, and (4) insufficient evidence to decide the case. Therefore, as the McLendon factors have been met, a remand is necessary to provide the Veteran with VA examinations to determine the etiology of his cervical, lumbar, and right knee disabilities. The matters are REMANDED for the following action: 1. The AOJ must obtain all updated records of VA and private treatment, with the Veteran's assistance regarding the latter. 2. Thereafter, the AOJ must request that the Veteran be scheduled for appropriate VA examinations to determine the nature and etiology of his cervical spine, lumbar spine, and right knee disabilities. The complete electronic record must be made available to, and reviewed by, the VA examiner prior to conducting the examination. All necessary studies and tests should be conducted. Thereafter, the examiners are requested to address the following: (a) Opine as to whether it is at least as likely as not (50 percent or greater probability) that the Veteran's cervical spine disability had its onset during, or is otherwise related to, the Veteran's active-duty service. (b) Opine as to whether it is at least as likely as not (50 percent or greater probability) that the Veteran's lumbar spine disability had its onset during, or is otherwise related to, the Veteran's active-duty service. (c) Opine as to whether it is at least as likely as not (50 percent or greater probability) that the Veteran's right knee disability had its onset during, or is otherwise related to, the Veteran's active-duty service. Any opinion expressed by the examiner should be accompanied by a complete rationale. If medical literature is relied upon in rendering a determination, the examiner should identify and specifically cite each reference material utilized. If the examiner is unable to offer an opinion without resort to speculation, a thorough explanation as to why an opinion cannot be rendered should be provided. Michael J. Skaltsounis Veterans Law Judge Board of Veterans' Appeals Attorney for the Board C. DeBoer, Associate 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.