Citation Nr: 21071435 Decision Date: 11/30/21 Archive Date: 11/30/21 DOCKET NO. 17-40 395 DATE: November 30, 2021 REMANDED Entitlement to service connection for a right knee disability is remanded. REASONS FOR REMAND The appellant is a Veteran who served on active duty from September 1977 to September 1981. This matter is before the Board of Veterans' Appeals (Board) on appeal from a January 2015 Department of Veterans Affairs (VA) rating decision. [The January 2015 rating decision assigned a 10 percent evaluation for a chronic lumbosacral strain with lumbago, and denied service connection for left and right leg disabilities, a left shoulder disability, hearing loss, and tinnitus.] An interim, June 2017, rating decision granted service connection for tinnitus, and left lower extremity (femoral and sciatic) radiculopathy. In March 2020, the Board denied service connection for a left shoulder disability and remanded for further development the issue of service connection for a right knee condition. Entitlement to service connection for a right knee disability. The March 2020 Board remand, citing September 1977 service treatment records (STRs), noted that the Veteran sought treatment for knee popping and pain during service. Upon further review of the record, the September 1977 notation of knee popping and pain is in a pre-service report of medical history. The Veteran's STRs, to include his service entrance examination report, are silent for complaints, treatment, or diagnosis of a right lower extremity condition. The March 2020 Board remand ordered development for a medical examination to address whether the Veteran's right knee disability is related to service, or to a service-connected disability. On December 2020 VA examination, the examiner diagnosed a 2019 right knee strain and opined it is an independent injury caused by the twisting of the right knee while working in 2019. The consulting provider noted that the right knee strain was not caused or made worse by his service-connected lumbago. The examiner did not address whether the Veteran's service-connected lumbar degenerative arthritis or right lower extremity radiculopathy caused or aggravated his right knee disability. Accordingly, development for a fully adequate medical opinion in this matter is necessary. See Barr v. Nicholson, 21 Vet. App. 303, 311 (2007); Stegall v. West, 11 Vet. App. 268 (1998). The matters are REMANDED for the following action: Arrange for the Veteran's claims file to be forwarded to an appropriate clinician (in orthopedics) for review and a medical advisory opinion regarding the likely etiology of his right knee disability. [If further examination of the Veteran is deemed necessary for an opinion sought, such should be arranged.] The examiner should provide opinions that respond to the following: (a.) Identify (by diagnosis) each right knee disability entity shown during the pendency of this claim. (b.) Identify the likely etiology for the Veteran's right knee disability entity diagnosed. Specifically, is it at least as likely as not (a 50% or better probability) that it had its onset/was incurred during the Veteran's active service? [The examiner is advised that the Veteran is presumed sound on entrance to service and his STRs are silent for complaints, treatment, or diagnoses of a right knee disability in-service.] (c.) Identify the likely etiology for each right knee disability entity diagnosed. Is it at least as likely as not that the diagnosed disability was caused or aggravated by the Veteran's service-connected (lumbar spine arthritis and right and left lower extremity radiculopathy) disabilities? (d.) If a diagnosed right knee disability is found to not have been caused, but to have been aggravated, by a service-connected disability, identify the baseline severity of such disability prior to the aggravation and the level of severity of the disability following aggravation. GEORGE R. SENYK Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Lederman, Michael 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.