Citation Nr: 21070207 Decision Date: 11/23/21 Archive Date: 11/23/21 DOCKET NO. 15-26 294 DATE: November 23, 2021 REMANDED Entitlement to service connection for a left knee condition, to include as secondary to the service-connected left ankle and lumbar spine condition is remanded. Entitlement to service connection for a right knee condition, to include as secondary to the service-connected left ankle and lumbar spine conditions is remanded. Entitlement to a total disability rating based upon individual unemployability (TDIU) is remanded. REASONS FOR REMAND The Veteran had active service in the United States Army from February 1988 to September 1992. These matters are on appeal from February 2013 and April 2014 rating decisions. In October 2019, the Veteran testified at a Board hearing before the undersigned. A transcript of the proceeding is associated with the record. In January 2020 and July 2021, the Board remanded the appeal for additional evidentiary development. 1. Entitlement to service connection for a left knee condition, to include as secondary to the service-connected left ankle and lumbar spine condition is remanded. 2. Entitlement to service connection for a right knee condition, to include as secondary to the service-connected left ankle and lumbar spine conditions is remanded. In January 2020, the Board remanded the claims of entitlement to service connection for a right knee and a left knee condition to afford the Veteran a VA examination. The VA examiner was directed to provide etiological opinions regarding the Veteran's right and left knee conditions. The Board remand found the Veteran's reports of right and left knee pain since service competent and credible. In July 2021, the Board found that the January 2021 VA opinion was inadequate, because its sole rationale was a lack of treatment records. The Board remanded the claims of entitlement to service connection for a right knee and a left knee condition to obtain adequate etiological opinions that addressed the Veteran's lay statements regarding right and left knee pain since service. In August 2021, VA obtained an opinion regarding the etiology of the Veteran's left and right knee disabilities. Again, the sole rationale for the negative etiological opinions is the absence of treatment records. The opinions do not address the Veteran's competent and credible assertion that she has experienced knee pain since active service. The Board finds that there has not been substantial compliance with the prior remand directives. A remand is required to obtain adequate medical opinions. 3. Entitlement to a TDIU is remanded. The Board notes that the Veteran meets the schedular criteria for a TDIU for only a portion of the appeal period. A decision on the remanded issues of entitlement to service connection for a left knee and a right knee condition could significantly impact a decision on the issue of entitlement to a TDIU, the issues are inextricably intertwined. A remand of the claim for a TDIU is required. The matters are REMANDED for the following actions: 1. Obtain an addendum opinion from an appropriate clinician regarding whether the Veteran's left knee and right knee disabilities are at least as likely as not related to active service or had their onset during active service. A rationale must be provided for the opinion. Furthermore, the VA examiner is asked to find the Veteran's statements about her in-service onset of bilateral knee pain credible. In rendering the opinion, the VA examiner is asked to address the Veteran's statements regarding her in-service onset of knee pain. The sole rationale for a negative etiological opinion may not be the absence of treatment records. 2. After the above development, and any additionally indicated development, has been completed, readjudicate the issues on appeal, including the inextricably intertwined issue of entitlement to a TDIU. If the benefits sought are not granted to the Veteran's satisfaction, send the Veteran and her representative a Supplemental Statement of the Case and provide an opportunity to respond. If necessary, return the case to the Board for further appellate review. DAVID L. WIGHT Veterans Law Judge Board of Veterans' Appeals Attorney for the Board R.R. Watkins, 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.