Citation Nr: 21074922 Decision Date: 12/16/21 Archive Date: 12/16/21 DOCKET NO. 18-42 876A DATE: December 16, 2021 REMANDED Entitlement to service connection for a right knee disorder is remanded. Entitlement to service connection for a lower back disorder is remanded. Entitlement to service connection for bilateral shin splints is remanded. REASONS FOR REMAND The Veteran served on active duty from June 2011 to June 2016. He served honorably in the U.S. Marine Corps, including foreign and sea service. The Board thanks the Veteran for his service to our country. The Veteran testified before the undersigned at a Board videoconference hearing in December 2021. 1. Entitlement to service connection for a right knee disorder is remanded. 2. Entitlement to service connection for a lower back disorder is remanded. 3. Entitlement to service connection for bilateral shin splints is remanded. A remand is necessary for opinions as to the nature and etiologies of the Veteran's right knee, lower back, and shin splint disorders. In a phone screenshot dated January 2018, relayed by the Veteran to be text messages sent by him to his mother, he stated that he had shin splints. In another phone screenshot indicated to be January 2016 text messages between the Veteran and his mother, he stated that his back was becoming a problem. Told by his mother to see a corpsman, he responded that the corps would try to keep him away from the battalion aid station and that the battalion aid station would not do anything. In a phone screenshot indicated to be from April 2016, the Veteran stated that he had fluid build-up in his right knee and had to get it drained. In April 2016 service treatment records, he reported falling on his right knee days earlier. The provider noted that an orthopedic doctor recommended compression, plain film, and antibiotics therapy and suggested that it "may be" prepatellar bursitis. In a separation report of medical history signed in May 2016, the Veteran endorsed recurrent back pain and problems, stating that he had lower back pain when jogging at any pace for over 10 minutes or sitting down for longer than 5 minutes. In the physician's summary, the examiner noted lower back pain, exertional and positional, and that he had never been seen for the pain. In January 2017 VA examination reports, the provider noted diagnoses of lumbar strain and bilateral shin splints. The examiner noted right knee effusion which had resolved. However, in November 2017 the Veteran submitted photographs dated November 2017 which appear to show right knee swelling. In a December 2017 private treatment record, a private provider noted that there is clearly some fluid in the prepatellar bursa and rendered an impression of right knee traumatic prepatellar bursitis with chondromalacia patella. The Board notes that the Veteran filed claims for the disorders in late June 2016, less than 3 weeks after separation. As there is evidence of right knee, lower back, and bilateral shin splints disorders current during the period on appeal and evidence that they may be related to service, remands are warranted for opinions as to their natures and etiologies. The matters are REMANDED for the following action: 1. Please secure for the record copies of complete updated clinical records (any not already of record) of all VA and non-VA treatment the Veteran has received for the disabilities on appeal. Please ask the Veteran to provide the releases necessary for VA to secure private treatment records. 2. After the action requested in paragraph 1 is complete, please refer the claim to an appropriate clinician for a medical opinion as to the nature and etiology of the right knee, lower back, and bilateral shin splints disorders. The Veteran's claims-file must be made available to and reviewed by the clinician. The clinician is requested to respond to the following: (a.) For each right knee disorder current during the period on appeal, including right knee traumatic prepatellar bursitis with chondromalacia patella (diagnosed after two post-service falls in 2017), is the disorder at least as likely as not (a 50 percent or greater probability) related to or had its incurrence in service, including a documented fall on his right knee in service resulting in effusion, swelling, and fluid wave as well as erythema? (b.) For each lower back disorder current during the period on appeal, including lumbar strain, is the disorder at least as likely as not (a 50 percent or greater probability) related to service, including reports at separation from service ot recurrent back pain when jogging at any pace for over 10 minutes or sitting down for longer than 5 minutes? (c.) For the Veteran's shin splints disorder, is the disorder at least as likely as not (a 50 percent or greater probability) related to related to or had its incurrence in service? If the basis of a negative opinion is the absence of evidence of treatment in the Veteran's in-service medical records, the examiner must explain whether (1) treatment for the disorder or its symptoms would have been noted in the Veteran's treatment records at the time; and (2) the Veteran would have sought treatment for the disorder or its symptoms at the time, particularly in light of the following: The Veteran's September 2018 statement that his right knee, lower back, and bilateral shin splints symptoms occurred during his last deployment on a ship, where medical attention was limited and discouraged. Sea service is documented. The Veteran's mother's March 2019 statement that he had mentioned that his unit would be punished at times for somebody seeking medical attention. (d.) In responding to questions (a.), (b.), and (c.) above, the clinician is requested to explain whether evidence of in service symptoms align with how the respective disorders are known to develop. For the purposes of rendering the opinions above, the clinician is to take as fact the Veteran's and other lay evidence. The Board makes no credibility determinations at this time. ONLY IF the clinician determines that an examination is necessary for the addendum opinion, the Veteran should be scheduled for an appropriate VA examination to determine the nature and etiology of the disorder. The clinician must explain the rationale for all opinions in detail, citing to supporting clinical data and/or medical literature, as appropriate. The clinician should take into consideration that the Veteran is competent to report in service and post-service symptom experiences; other witnesses are competent to report observable symptoms. If the clinician cannot provide an opinion without resorting to speculation, the clinician should provide an explanation as to why this is so and note what, if any, additional evidence would permit such an opinion to be made. M. C. GRAHAM Veterans Law Judge Board of Veterans' Appeals Attorney for the Board M. Vashaw, 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.