Citation Nr: 21075204 Decision Date: 12/17/21 Archive Date: 12/17/21 DOCKET NO. 15-01 438 DATE: December 17, 2021 REMANDED Service connection for a right knee condition is remanded. REASONS FOR REMAND The Veteran served on active duty from October 1994 to October 1998. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a June 2013 rating decision issued by the Department of Veterans Affairs (VA) Regional Office (RO). These matters were before the Board in October 2018, February 2021, and July 2021 and were remanded for further development. Service connection for a right knee condition is remanded. The Veteran contends that he developed increasing pain in his knees during active duty. He contends that he visited sick bay for such pain, however, he was told that the pain was not due to serious injury. He asserts that he ignored the pain without seeking medical treatment until approximately 2012. See March 2012 Statement in Support of Claim. Pursuant to the Board's October 2018 remand instructions, the Veteran was afforded a VA examination for his right knee in August 2019. The examiner noted a diagnosis of right knee patellofemoral pain syndrome. The Veteran reported that during a PT session, he experienced swelling and soreness in his right knee. After examination of the Veteran and review of the claims file, the examiner opined that it was less likely than not that the Veteran's right knee condition was causally related to service. As a rationale, the examiner explained that there are no records found in the records presented for review of any diagnosis or treatment of right knee condition during and since his military service. The Veteran was afforded a March 2021 VA examination which did not address the Veteran's lay statements as requested by the Board's February 2021 remand instructions and hence it was remanded for an additional examination in July 2021. Subsequently, the Veteran was afforded a September 2021 VA examination during which the conducting physician opined that it was less likely than not that the Veteran's right knee condition was causally related to service. As a rationale, the physician explained that a review of the Veteran's service treatment records and separation examination in 1998 show no evidence of knee complaints. Unfortunately, there has not been substantial compliance with the Board's previous remand directives regarding the issue of entitlement to service connection for sleep apnea and another remand is required. See Stegall v. West, 11 Vet. App. 268, 271 (1998). The examiner was advised that the Veteran was competent to report symptoms of increasing pain in the right knee during active service which have persisted since that time. While the examiner acknowledged the Veteran's lay contention, he did not state whether his right knee condition is medically consistent with the knee pain at the end of his enlistment in 1998. As such, the Board cannot assign probative value to the September 2021 VA examiner's opinion because their opinion was based solely upon the absence of documentation in service or after service. Dalton v. Nicholson, 21 Vet. App. 23 (2007); Barr v. Nicholson, 21 Vet. App. 303, 312 (2007). Accordingly, a remand is required to obtain a supplemental VA opinion. The matters are REMANDED for the following action: 1. Please note that this Veteran's case has been advanced on the docket and, by law, ALL remanded claims must be processed expeditiously. 2. Provide the Veteran with new VA examination by an appropriate physician to determine the cause of the Veteran's diagnosed right knee condition. The Veteran's claims file, all electronic records, and a copy of this remand must be reviewed by the examiner, and the examiner must state that this evidence was reviewed in the examination report. All pertinent symptoms and findings must be reported in detail. All indicated tests and studies must be accomplished. 3. Based upon a complete review of the evidence of record, the VA examiner should answer the following: a. Is at least as likely as not (i.e., a 50 percent probability or more) that the Veteran's right knee condition, was caused or incurred as a result of the Veteran's active-duty service? The examiner must consider and discuss all pertinent evidence in the claims file, to include the Veteran's lay statements regarding in-service and post-service symptomatology. Specifically, the examiner must discuss the Veteran's lay statement indicating that he developed increasing pain in the right knee during active-duty service which has persisted since that time. The examiner is advised that the Veteran is competent to report such symptoms, as they are capable of lay observation. b. Assuming the Veteran's lay report is accurate, is his current right knee condition medically consistent with right knee pain at the end of his enlistment in 1998? A complete rationale for all opinions must be provided. David Gratz Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Alexander Bahus 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.