Citation Nr: 21075303 Decision Date: 12/20/21 Archive Date: 12/20/21 DOCKET NO. 18-06 706 DATE: December 20, 2021 REMANDED Service connection for a left knee disability is remanded. REASONS FOR REMAND The Veteran had active service in the U.S. Air Force from October 1969 to March 1979. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a September 2014 rating decision. It was previously denied by the Board in a December 2019 decision. The Veteran appealed that decision to the U.S. Court of Appeals for Veterans Claims (Court). Pursuant to a July 2021 memorandum decision, the Court vacated that denial and remanded the matter back to the Board for further adjudication. Service connection for a left knee disability Service treatment records show the Veteran injured his left knee playing basketball in September 1973. Additional records dated through 1979 show ongoing complaints for recurring left knee pain, diagnosed as chondromalacia patella. An orthopedist diagnosed patellofemoral arthritis in June 1979, but an arthrogram ordered by the orthopedist subsequently showed normal findings. The Board denied the claim in December 2019. It found that the Veteran had a current diagnosis of degenerative joint disease (DJD) which did not manifest during service or within one year of service. It also found that there was no continuity of symptomatology since service. Finally, it found that current DJD was not related to the findings in service based on September 2009 and August 2014 VA medical opinions. In its July 2021 decision, the Court noted that the Veteran is seeking service connection for "permanent impairment" of the left knee caused by chondromalacia diagnosed in service. The Court discerned that he is asserting that he has a current left knee disability caused by chondromalacia that is separate from DJD. Pain in the absence of a presently-diagnosed condition can cause functional impairment, which may qualify as a disability under 38 U.S.C. § 1110. Saunders v. Wilkie, 886 F.3d 1356, 1368 (Fed. Cir. 2018). The Court noted that the September 2009 and August 2014 VA examiners described functional impairment of the left knee with pain. It concluded that the Board committed prejudicial error by not considering the Veteran's claim more broadly, to include whether there is a current left knee disability other than DJD that is related to in-service chondromalacia. In sum, the evidence establishes a diagnosis of only chondromalacia during service, and a diagnosis of only DJD after service, and the competent medical evidence is against finding a link between the two. However, per the Court's decision, further inquiry is necessary to determine whether functional impairment in the left knee, including pain and limitation of motion, is a residual of the in-service chondromalacia and not the currently diagnosed DJD. Therefore, a new examination is required. The matter is REMANDED for the following action: Schedule the Veteran for a VA examination for his left knee disability. The examiner must review the claims file, and provide a response to the following: a. List all current diagnoses associated with the Veteran's left knee. b. For each diagnosed condition, is it at least as likely as not related to service, including chondromalacia patella diagnosed during service? c. Is any current pain, limitation of motion, or other functional impairment at least as likely a residual of chondromalacia patella from service, and unrelated to the current diagnoses? JOHN Z. JONES Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Shamil Patel, 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.