Citation Nr: 21072602 Decision Date: 12/03/21 Archive Date: 12/03/21 DOCKET NO. 17-39 924 DATE: December 3, 2021 REMANDED Entitlement to service connection for a left knee disability is remanded. REASONS FOR REMAND The appellant is a Veteran who had active service from June 1982 to September 1986. This case is before the Board of Veterans' Appeals (Board) on appeal from an April 2017 Department of Veterans Affairs (VA) rating decision. In July 2017, the Veteran requested a Board hearing; in September 2021, she withdrew the hearing request. See 38 C.F.R. § 20.704. A September 2019 rating decision granted service connection for gastritis (claimed as a digestive system condition, a stomach condition, and gastroesophageal reflux disease), and a February 2020 rating decision granted service connection for posttraumatic stress disorder (PTSD), resolving the appeals in those matter. See Grantham v. Brown, 114 F.3d 1156 (Fed. Cir. 1997). A March 1987 rating decision granted service connection for a right knee disability. In August 2016, the Veteran filed the instant claim of service connection for a left knee disability. In a May 2017 notice of disagreement, the Veteran asserted that her left knee disability was secondary to her service-connected right knee disability (alleging that favoring the right knee placed additional strain on the left knee. The Veteran's medical records show that in August 2016, she reported bilateral knee pain. A left knee x-ray showed mild osteoarthritis. On January 2017 VA knees examination, the examiner did not offer an opinion regarding the etiology of the Veteran's left knee disability, to include whether it was caused or aggravated by a service-connected disability (to include her service-connected right knee, lumbar spine, and bilateral pes planus disabilities). An opinion addressing the secondary service connection theory (encompassing consideration of all service-connected orthopedic disabilities) is necessary. The matter is REMANDED for the following: 1.With assistance from the Veteran (by identifying providers and submitting any authorizations to obtain any private outstanding medical records pertaining to evaluations and treatment she received) obtain all outstanding records (and available not already in the claims file) she received for her left knee and already-service-connected orthopedic disabilities) . 2.Then, arrange for the Veteran's record to be forwarded to an appropriate clinician (in orthopedics) for review and an opinion regarding the nature and likely etiology of her current left knee disability. [If further examination of the Veteran is deemed necessary for an opinions sought, it should be arranged.] The consulting clinician should: a. Identify by diagnosis each current left knee disability shown by the record (or found on examination, if one is conducted). b. Identify the likely etiology for each left knee disability diagnosed. Specifically, is it at least as likely as not that it was caused or aggravated by the Veteran's service-connected orthopedic disabilities, to include her right knee, lumbar spine, and bilateral pes planus disabilities? c. If a diagnosed left knee disability is determined to have not been caused or aggravated by a service-connected disability, identify the etiology for the disability that is considered to be more likely, and explain why that is so. All opinions must include rationale that cites to supporting factual data and medical principles. The rationale should reflect consideration of the findings by the VA examiner, the Veteran's medical records, and her assertion that her left knee disability is due to her favoring her right knee. GEORGE R. SENYK Veterans Law Judge Board of Veterans' Appeals Attorney for the Board T. Berryman, 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.