Citation Nr: 21073008 Decision Date: 12/07/21 Archive Date: 12/07/21 DOCKET NO. 14-41 035 DATE: December 7, 2021 REMANDED Entitlement to service connection for left knee disorder is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Air Force from December 1975 to November 1995. This case was previously remanded by the Board most recently in May 2021 when it was remanded to obtain a new VA medical opinion to address whether the Veteran's current left knee disorder is related to his military service. Pursuant to the May 2021 Board remand, a medical opinion was obtained in August 2021, and the examiner opined that the Veteran's left knee disorder was less likely than not related to an in-service event or injury, to specially include frequent kneeling as an aircraft mechanic during service. As rationale, the examiner explained that he was unable to find post-service evidence of treatment for a chronic left knee condition. He referenced the Veteran's in-service treatment for a left knee injury in 1987, but noted that this injury had resolved by retirement because the Veteran's retirement examination was silent concerning the left knee. He therefore concluded that there were no service treatment record findings for his current left knee condition to be related to an in-service injury or event. Regarding whether the Veteran's current left knee disorder was related to the kneeling he did as an aircraft mechanic, the examiner stated that if that activity was the cause, he would assume both knees would be claimed. The Board finds that the rationale provided by the August 2021 VA examiner to support his negative nexus opinion is inadequate for decision-making purposes. While the VA examiner recognized the 1987 in-service left knee injury, the examiner did not discuss his competent and credible assertions that this condition has continued from service to the present. See February 2010 VA Form 21-4138, Statement in Support of Claim. The Board notes that the mere absence of contemporaneous medical documentation of treatment does not alone render lay testimony not credible. Buchanan v. Nicholson, 451 F.3d 1331, 1336 (Fed. Cir. 2006). The Veteran is competent to report left knee problems since his active service. See Layno v. Brown, 6 Vet. App. 465, 469 (1994). Moreover, although the examiner acknowledged his lay statement relating his current left knee condition to the frequent kneeling he did as an aircraft mechanic, he dismissed this statement solely because the Veteran's claim did not concern both knees. Whether the Veteran's right knee was also affected by the frequent in-service kneeling is immaterial to this claim as he is already service-connected for a right knee disability. By focusing on the fact that the Veteran was not claiming a right knee disability related to in-service frequent kneeling, the examiner failed to address whether frequent kneeling during service caused the Veteran's current left knee disability. Because the August 2021 VA examiner's opinion is inadequate for decision-making purposes, the matter must be remanded for an additional addendum opinion. See Barr v. Nicholson, 21 Vet. App. 303, 312 (2007). The matter is REMANDED for the following action: 1. Forward the claims file, including a copy of this remand, to a qualified examiner to obtain an addendum opinion as to the nature and etiology of the Veteran's left knee disability. All pertinent evidence of record must be made available to and reviewed by the examiner. If the examiner determines that an examination is necessary, one should be scheduled. After reviewing the record, the examiner is asked to determine whether it is as likely as not (50 percent or greater probability) that the Veteran's current left knee disability manifested in service or is otherwise causally or etiologically related to his military service, to include frequent kneeling as an aircraft mechanic during service. The examiner should not use the absence or lack of left knee complaints reflected in incomplete service treatment records as the basis for a negative opinion. The examiner should also note that an in-service diagnosis is not required for service connection. Service connection may be granted for any disease diagnosed after discharge, when all the evidence establishes that the disease was incurred in service. 38 C.F.R. § 3.303(d). A clear rationale for all opinions expressed must be provided and should reflect consideration of the Veteran's lay statements concerning the onset and continuity of his symptoms. 2. Thereafter, readjudicate the issue on appeal. James Springer Acting Veterans Law Judge Board of Veterans' Appeals Attorney for the Board E. Fairlie, 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.