Citation Nr: 21071536 Decision Date: 11/30/21 Archive Date: 11/30/21 DOCKET NO. 17-66 291 DATE: November 30, 2021 REMANDED Entitlement to service connection for a left hip disability, to include as secondary to service-connected disability, is remanded. Entitlement to service connection for a right hip disability, to include as secondary to service-connected disability, is remanded. Entitlement to service connection for a low back disability, to include as secondary to service-connected disability, is remanded. Entitlement to service connection for a left knee disability, to include as secondary to service-connected disability, is remanded. Entitlement to service connection for a right knee disability, to include as secondary to service-connected disability, is remanded. REASONS FOR REMAND The Veteran had active service from August 1966 to August 1969. These matters come before the Board of Veterans' Appeals (Board) on appeal from an October 2014 rating decision issued by the Department of Veterans Affairs (VA) Regional Office (RO). In August 2021, the Veteran testified at a virtual Board hearing before the undersigned Veterans Law Judge (VLJ). A copy of the transcript has been associated with the Veteran's electronic claims folder. At the hearing, the Veteran requested a 60-day extension in order to permit him to obtain a medical opinion from his treating physician. See Board Hearing Transcript, p. 8. The matter was held in abeyance for 60 days. The Board will proceed with adjudication of the appeal. All matters are remanded. The Veteran contends that he is entitled to service connection for his claimed disabilities because they are secondary to his service-connected pes planus. Specifically, the Veteran testified that since he has been service-connected for his bilateral pes planus, his orthopedic disabilities have formed or worsened. See Board Hearing Transcript, p. 4. The Veteran was afforded a VA examination in September 2014 where the examiner opined that it was less likely than not that the Veteran's claimed disabilities were caused by his service-connected pes planus. The examiner reasoned that the Veteran had a normal gait and normal x-ray of the knees. At the August 2021 Board hearing, the Veteran testified that the September 2014 VA examination was inadequate for adjudication purposes because: (1) the examiner was not qualified to provide the opinion and (2) the examiner did not base the opinion on an accurate factual premise. See Board Hearing Transcript, p. 5. Specifically, the Veteran testified that the examiner erroneously stated that he did not have a problem with his gait. Id. He also testified that his disabilities had worsened since the 2014 examination. Secondary service connection is available for non-service-connected disabilities that are caused or aggravated by a service-connected disability. See 38 C.F.R. § 3.310. The September 2014 examiner did not provide an opinion which addressed the theory of aggravation. Therefore, the Board finds that a remand is necessary to afford the Veteran another VA examination that provides a medical opinion which considers all relevant favorable evidence and theories of entitlement. The matters are REMANDED for the following action: Schedule the Veteran for a VA examination by an orthopedic physician regarding the etiology of the claimed disabilities. The electronic claims folder, including a copy of this remand, must be made available to the examiner for review in connection with the opinion. The examiner is requested to review the electronic claims file (and note such a review) and offer an opinion as to the following: (a) Whether it is at least as likely as not (50 percent probability or greater) that the Veteran's right hip, left hip, low back, right knee or left knee were incurred in or is otherwise related to service. The examiner's attention is directed to the Veteran's Board testimony that during service, he had to walk 20 miles carrying heavy backpack loads. See Board Hearing Transcript, p.4. (b) Whether it is at least as likely as not (50 percent probability or greater) the Veteran's right hip, left hip, low back, right knee or left knee was caused or aggravated by his service-connected pes planus. The examiner's attention is directed to the Veteran's Board testimony that he suffers from abnormal gait. See Board Hearing Transcript, p. 5. If aggravation is found, provide the baseline manifestations and the increased manifestations due to the service-connected pes planus. The Board is returning the matter for an addendum opinion because the September 2014 examination report does not address the theory of aggravation of a non-service-connected disability by a service-connected disability. A complete rationale, including citation to appropriate medical principles, for all opinions must be provided. Michael A. Pappas Veterans Law Judge Board of Veterans' Appeals Attorney for the Board L. Baskerville 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.