Citation Nr: 21070933 Decision Date: 11/27/21 Archive Date: 11/27/21 DOCKET NO. 19-04 148 DATE: November 27, 2021 REMANDED Service connection for a left knee disability is remanded. Service connection for a right knee disability is remanded. REASONS FOR REMAND The Veteran served on active duty from August 1960 to August 1961. This case is before the Board of Veterans' Appeals (Board) on appeal from a September 2018 rating decision issued by a Department of Veterans Affairs (VA) regional office. In August 2021, the Veteran testified before the undersigned Veterans Law Judge at a virtual hearing. A copy of the hearing transcript is in the claims file. Service Connection for Left and Right Knee Disabilities The Veteran attributes his bilateral knee disability to "wear and tear" from parachute jumps and training during service. See e.g. November 2018 Notice of Disagreement. After careful review, the Board finds that remand to the agency of original jurisdiction (AOJ) is warranted. At hearing, the Veteran testified that he currently receives non-VA therapy for his knees. Similarly, at a December 2018 VA examination for lower extremity radiculopathy, he reported that he has seen a private orthopedic doctor ("Dr. G.") since 1990. The claims file contains private cardiology and audiology records, as well as a September 2018 private medical opinion from "Dr. J.B." However, there are no private orthopedic or physical therapy records on file. The Veteran's testimony and statements to the December 2018 examiner suggest there may be outstanding records relevant to this appeal. On remand, the AOJ should make reasonable efforts to obtain them. Additionally, the medical opinions on file are not adequate to decide the claims. The private medical opinion indicates that the Veteran's knee problems "are a direct result of years of multiple jumps and physical activity he experienced as a Paratrooper." However, Dr. J.B. did not provide a clear medical rationale in support of this conclusion. On the other hand, a May 2018 VA medical opinion indicates that the Veteran's degenerative arthritis of the knees was less likely than not incurred in or caused by service. The May 2018 examiner summarized his medical history, but did not directly address whether the disability could be related to wear and tear from parachute jumps and/or training. Thus, neither opinion includes a reasoned medical explanation as to why the current disability is or is not due to service. See Nieves-Rodriquez v. Peake, 22 Vet. App. 295, 301 (2008) ("a medical examination report must contain not only clear conclusions with supporting data, but also a reasoned medical explanation connecting the two"); Stefl v. Nicholson, 21 Vet. App. 120, 124 (2007) (a medical opinion "must support its conclusion with an analysis that the Board can consider and weigh against contrary opinions"). On remand, the AOJ should obtain an addendum opinion. In particular, the examiner must address the Veteran's August 2021 testimony that he "started feeling [knee pain] during [his] jumps" and that he sought medical help for his knees while he was on active duty. See Miller v. Wilkie, 32 Vet. App. 249, 259-60 (2020) (a VA examiner must address the Veteran's lay statements to provide the Board with an adequate medical opinion). The Board by this remand makes no determination, expressed or implied, concerning the credibility of any statements on file. The matters are REMANDED for the following action: 1. Ask the Veteran to complete a VA Form 21-4142 for all relevant private treatment records, including records from "Dr. G." Make two requests for the authorized records, unless it is clear after the first request that a second request would be futile. Associate any records received with the claims file. 2. Obtain an addendum medical opinion on the nature and etiology of the Veteran's bilateral knee disability. Schedule another in-person examination only if the examiner deems it necessary to render the opinion. After reviewing the claims file, the examiner must address the following questions: (a.) Is it at least as likely as not (50 percent or greater probability) that the bilateral knee disability was incurred in service or is otherwise related to service, including parachute jumps and physical training? (b.) Is it at least as likely as not (50 percent or greater probability) that the bilateral knee disability became manifest within one year of separation? If so, what were the manifestations? In particular, the examiner must clearly consider and discuss the Veteran's August 2021 testimony that he "started feeling [knee pain] during [his] jumps" and that he sought medical help for his knees while he was on active duty. 3. Review the medical opinion above to ensure substantial compliance with the Board's directives. Take any necessary corrective action. 4. Readjudicate the Veteran's claims. If either claim remains denied, issue a supplemental statement of the case, and allow the Veteran and his representative the opportunity to respond. Then return to the Board for further appellate review. KELLI A. KORDICH Veterans Law Judge Board of Veterans' Appeals Attorney for the Board D.Z. Wall, 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.