Citation Nr: 21071154 Decision Date: 11/29/21 Archive Date: 11/29/21 DOCKET NO. 17-14 633 DATE: November 29, 2021 REMANDED Entitlement to service connection for a left lower extremity disability is remanded. REASONS FOR REMAND The Veteran had active military service from July 1987 to December 1987 and from November 1990 to June 1991. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a September 2016 rating decision by a Department of Veterans Affairs (VA) Regional Office (RO). The Veteran testified before the undersigned Veterans Law Judge during a December 2020 Board hearing. A copy of the transcript has been associated with the file. The Veteran's initial claim was for service connection for left knee/leg arthritis. As indicated above, the Board has expanded this claim to include entitlement to service connection for a left lower extremity disability, to include the ankle. Clemons v. Shinseki, 23 Vet. App. 1 (2009). Entitlement to service connection for a left lower extremity disability is remanded. The Veteran seeks service connection for a left lower extremity disability. She asserts that her left lower extremity disability is related to her active service. The Veteran provided testimony during her December 2020 Board hearing to the effect that she injured her left knee during service and has had pain ever since. She has not been provided a VA examination. VA must provide a medical examination when there is evidence of (1) a current disability, (2) an in-service event, injury, or disease, (3) some indication that the claimed disability may be associated with the established event, injury, or disease, and (4) insufficient competent evidence of record for VA to make a decision. McClendon v. Nicholson, 20 Vet. App. 79 (2006); see also 38 U.S.C. § 5103A(d)(2); 38 C.F.R. § 3.159. The third prong, which requires evidence that the claimed disability or symptoms "may be" associated with the established event, is a low threshold. McClendon, 20 Vet. App. at 83. As the Veteran has related her current disability to falls during service, the low threshold for obtaining a VA examination regarding the Veteran's service connection claim have been met and a remand is necessary for such additional development. The matter is REMANDED for the following action: 1. Associate with the file any outstanding VA treatment records. The Veteran testified that she receives treatment for her left knee at the Washington D.C. VA Medical Center on Irvin Street. 2. Schedule the Veteran for a VA examination with an appropriate examiner to determine the nature and etiology of her left lower extremity disability. Following a review of the claims file, including a copy of this Remand, and a thorough examination of the Veteran, the reviewing examiner is requested to furnish an opinion with respect to the following: (a.) Identify all lower left extremity disabilities, existing at any point during the pendency of the appeal (i.e., since July 2015), even if they are currently asymptomatic or have resolved during the pendency of the appeal. (b.) For each identified disability, is it at least as likely as not (50 percent or greater probability) that the disability had its onset during service, manifested within one year following service, or is otherwise related to service? In addition to the other relevant evidence of record, the examiner is asked to consider the following information with a caution that this list is not a substitute for a review of the record: (1) An August 2016 knee MRI that showed tricompartmental osteoarthritis, a small popliteal cyst, and a radial tear at junction of posterior horn and body segment of medial meniscus. (2) An August 2016 treatment record noting the Veteran reported her knee buckles at times. (3) The Veteran's contentions of injuring both her left ankle and left knee during service after sustaining (3) falls. (4) The Veteran's report of continuity of symptomatology during and since service. The Veteran is competent to attest to factual matters of which she has first-hand knowledge, including observable symptomatology. If there is a medical basis to support or doubt the history provided by the Veteran, the examiner should provide a fully reasoned explanation. A complete rationale for all opinions reached should be supplied. H.M. WALKER Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Krista Johnson, 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.