Citation Nr: 21072563 Decision Date: 12/03/21 Archive Date: 12/03/21 DOCKET NO. 09-32 055A DATE: December 3, 2021 REMANDED Entitlement to service connection for arthritis of the knees, ankles, and hands is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Army from September 1999 to January 2003. This matter comes before the Board of Veterans' Appeals (Board) from an April 2006 rating decision by a Department of Veterans Affairs (VA) Regional Office (RO). In March 2014, the Veteran testified at a videoconference hearing before the undersigned Veterans Law Judge. A transcript of the proceeding has been associated with the claims file. The Board, in a September 2018 decision, denied the Veteran's claim. The Veteran appealed to the Court of Appeals for Veterans Claims (Court). In a June 2020 Memorandum Decision, the Court found that the April 2016 VA examination report contained contradictions and factual discrepancies, rendering it inadequate. Specifically, the Court noted that the April 2016 VA examiner had contradicted herself, stating there was no evidence of "inflammatory or degenerative arthritis" but earlier in the exam noting the Veteran had documented arthritis in both ankles. The examiner did not explain this factual discrepancy. Further, the examiner attributed the Veteran's current ankle problems to a post-service fall but ignored the Veteran's complaints of in-service symptoms. Similarly, the examiner attributed the Veteran's right knee issues to the same fall but disregarded the documented right knee complaints in service. As to the Veteran's left knee complaints, the examiner found the Veteran had no currently diagnosed left knee condition, but again did not discuss the in-service complaints or explain why the Veteran was not diagnosed with a current left knee condition. As such, the Court vacated the Board's decision and remanded the matter to the Board for further proceedings consistent with the Memorandum Decision. The Board remanded the matter in July 2021. The July 2021 remand requested that the Veteran be provided with a VA examination that considered the Veteran's in-service knee complaints, as well as explained why the Veteran's ankle and knee disabilities were due to post-service injury, rather than the Veteran's in-service complaints. The Veteran was provided with VA examinations in September 2021. The VA examiner noted that the Veteran had arthritis in his right ankle and right knee. His left knee, left ankle, and hands did not have arthritis. The examiner opined that the Veteran's right knee and right ankle conditions were acute only during service and concluded that a nexus was not established. However, the examiner did not opine as to the etiology of the Veteran's knee and ankle disabilities and did not explain why the Veteran's right knee and right ankle arthritis are not related to the in-service injuries. Stegall v. West, 11 Vet. App. 268, 271 (1998) (Board remand confers a right on a claimant to compliance with the remand order). Given that the Court specifically noted that the April 2016 examination failed to explain why the Veteran's current ankle condition was related to post-service rather than in-service complaints, the Board is again left without an explanation that fully addresses whether the Veteran's current conditions are related to an in-service injury, or were present during service. Further, the examiner noted that chronicity of care was not established but failed to acknowledge the Veteran's lay statements concerning the duration of his knee and ankle pain, other than noting that these conditions were "acute only." As the examiner's rationale did not consider the in-service complaints and provide a clear explanation as to the etiology and cause of the Veteran's conditions, another examination is required. The matters are REMANDED for the following action: 1. Provide the Veteran's claims file to an appropriate examiner. If the requested opinion cannot be provided without examination of the Veteran, that should be arranged. The examiner should opine as to the nature and cause of the Veteran's claimed knee, ankle, and hand disabilities. In doing so, the examiner should address whether arthritis, or any disability found to be present in these joints, had its onset during service, or is due to any in-service injury, including the ankle, knee, and wrist complaints noted in the Veteran's service treatment records. The examiner must note the Veteran's in-service complaints and indicate whether those complaints are related to his current condition(s). If the examiner finds that these conditions are not related to service, the examiner must provide a clear explanation as to why the in-service complaints are not related to any currently diagnosed condition. The examiner should provide a complete rationale for any opinion rendered. If he or she cannot provide the requested opinions without resorting to speculation, he or she should expressly indicate this and provide a supporting rationale as to why that is so. 2. After completing the above actions, to include any other development as may be indicated by any response received as a consequence of the actions taken in the preceding paragraphs, the Veteran's claim should be readjudicated based on the entirety of the evidence. MICHAEL E. KILCOYNE Veterans Law Judge Board of Veterans' Appeals Attorney for the Board V. Geer, 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.