Citation Nr: 21074081 Decision Date: 12/14/21 Archive Date: 12/14/21 DOCKET NO. 18-08 995 DATE: December 14, 2021 REMANDED Service connection for a left knee disability is remanded. Service connection for a right knee disability is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Army from April 1966 to March 1968 and from November 1990 to June 1991, including service in Southwest Asia, with additional reserve service. This matter comes before the Board of Veterans' Appeals (Board) on appeal from an August 2016 rating decision from the Department of Veterans Affairs (VA) Regional Office (RO). This matter was previously before the Board in April 2019 when it was remanded for additional development. 1. Service connection for a left knee disability is remanded. 2. Service connection for a right knee disability is remanded. The Veteran contends that his bilateral knee conditions are related to service and his service in the Gulf War. See June 2017 Veteran correspondence. In support of his claim, the evidence of record shows the Veteran has a current bilateral knee diagnoses, including arthritis, and subsequently underwent left total knee replacement (June 2016) and right total knee replacement (October 2016). See also May, June and October 2016 private treatment records. As noted above, this case was previously before the Board in April 2019 when it was remanded for additional development, to include affording the Veteran VA examinations. Subsequently, the record shows that the Veteran failed to report to his VA examination. However, the record is not clear if the Veteran was properly notified of the scheduled examination, or the date his exam was scheduled. Additionally, the Veteran and his representative notified the Board that they did not receive notification of the scheduled examinations and would be willing to report for future examinations. See October 2021 correspondence. Because the Veteran had good cause for missing the examination, remand is necessary to reschedule him for a VA examination. See 38 C.F.R. § 3.655. Therefore, the case is remanded for another examination that complies with the instructions of this decision, as well, as the Board's April 2019 remand. Further, the Veteran is on notice that when entitlement to a benefit cannot be established without a current VA examination, and a claimant, without good cause, fails to report for such examination in conjunction with an original compensation claim, the claim shall be rated based on the evidence of record. The matters are REMANDED for the following action: 1. Obtain any outstanding VA treatment records. 2. With any necessary assistance from the Veteran, obtain any outstanding relevant private treatment records. 3. Notify the Veteran that he may submit additional lay statements from herself and from other individuals who have first-hand knowledge, and/or were contemporaneously informed of his in-service and post-service bilateral knee disabilities. The Veteran should be provided an appropriate amount of time to submit this lay evidence. 4. Schedule the Veteran for a VA examination (or telehealth interview, review of the record, etc. if an in-person examination is not feasible) to determine the nature and etiology of his right and left knee disabilities. All indicated tests and studies should be conducted, and all findings reported in detail. The examiner is asked to address the following: (a) Please state whether the Veteran's right and left knee symptoms are attributable to a known clinical diagnosis. If the Veteran does not now have, but previously had any such condition, when did that condition resolve? In this regard, the examiner is directed to the post-service diagnoses of bilateral knee arthritis and left total knee arthritis (June 2016) and right total knee arthritis (October 2016). (b) Is the Veteran's disability pattern consistent with: (1) a diagnosable but medically unexplained chronic multi-symptom illness of unknown etiology, (2) a diagnosable chronic multi-symptom illness with a partially explained etiology, or (3) a disease with a clear and specific etiology and diagnosis? (c) If, after reviewing the Veteran and the claims file, you determine that the Veteran's disability pattern is either a diagnosable chronic multi-symptom illness with a partially explained etiology ((b)(2) above), or a disease with a clear and specific etiology and diagnosis ((b)(3) above), then please opine as to whether it is at least as likely as not related to environmental exposures experienced by the Veteran during service in Southwest Asia. (d) Is it at least as likely as not that any diagnosed right or left knee disability had its onset directly during the Veteran's service or is otherwise causally related to any event or circumstance of service, including environmental exposures during service in Southwest Asia during the Persian Gulf War? In offering all opinions, the examiner must specifically acknowledge the Veteran's competent report of right and left knee symptomatology since his service in Southwest Asia. The examiner must provide a rationale for any and all opinions expressed, which should be set forth in a legible report. If an opinion cannot be rendered without resorting to speculation, that should be explained. Jarrette A. Marley Acting Veterans Law Judge Board of Veterans' Appeals Attorney for the Board M. Alvarado- 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.