Citation Nr: 21076185 Decision Date: 12/22/21 Archive Date: 12/22/21 DOCKET NO. 18-53 092 DATE: December 22, 2021 REMANDED Entitlement to service connection for a left knee disability is remanded. Entitlement to service connection for a right ankle disability is remanded. Entitlement to service connection for an umbilical hernia is remanded. REASONS FOR REMAND The Veteran had honorable active service with the United States Army from January 2002 to August 2003 and July 2004 to December 2005. The Veteran also had service in the Army reserves. This matter is before the Board of Veterans' Appeals (Board) on appeal from an August 2017 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO). The Veteran testified at a virtual hearing before the undersigned Veterans Law Judge (VLJ) in January 2021. A written transcript of the hearing has been prepared and is associated with the claims file. 1. Entitlement to service connection for a left knee disability is remanded. See section 2. 2. Entitlement to service connection for a right ankle disability is remanded. Although further delay is regrettable, a remand is necessary for an adequate VA opinion. The Veteran testified that he had chronic pain in his left knee and right ankle since service. As for the left knee, he reported he had treatment in service for left knee injuries, including a torn ACL. As for the right ankle, the Veteran testified that he injured his right foot and right ankle during a march. He reported that during service he had treatment for his right ankle including some time in a CAM walker boot. The VA must provide an examination when there is: (1) competent evidence of a current disability or persistent or recurrent symptoms of a disability; (2) evidence establishing that an event, injury, or disease occurred in service or establishing certain diseases manifesting during an applicable presumptive period for which the claimant qualifies; (3) an indication that the disability or persistent or recurrent symptoms of a disability may be associated with the Veteran's service or with another service-connected disability, but (4) insufficient competent medical evidence on file for VA to make a decision on the claim. See McLendon v. Nicholson, 20 Vet. App. 79 (2006); 38 C.F.R. § 3.159(c)(4)(i) (2018). While, the medical records are unclear as to whether the Veteran has a current left knee or right ankle diagnosis, the Veteran has reported persistent or recurrent symptoms of a disability. He testified that he had pain in his left knee and right ankle since service. The Veteran's service records also supported an in-service event, injury, or disease. In particular, the Veteran had surgeries on his left knee during service. He also had treatment for his right ankle during service. In fact, during service in December 2005, a Report of Medical Assessment noted that the Veteran had chronic left knee pain status post two knee surgeries. See STR-Medical received July 2017. Considering the totality of the evidence, the record contains insufficient competent medical evidence, to decide the claim. Therefore, the VA must provide a competent medical opinion. 3. Entitlement to service connection for an umbilical hernia is remanded. The Board finds that the VA must also provide an examination for the Veteran's claim of service connection for a hernia for similar reasons as discussed above to his left knee and right ankle. The Veteran testified that he had a hernia during the end of his service. He explained that it occurred while he was overseas. He dealt with the pain while he was deployed and had the hernia treated shortly after leaving service. While the Veteran had a hernia repair surgery, he testified that he had ongoing symptoms and that he could not do sit ups. In September 2006, within a year of the Veteran leaving service, he had a surgery to treat an umbilical hernia. See CAPRI received August 2017. The Board noted that the Veteran's active problems list continued to list his umbilical hernia during the relevant time period. Therefore, the VA must provide a competent medical opinion. The matters are REMANDED for the following action: 1. Update medical treatment records, including VA and any relevant private treatment records. 2. Verify the Veteran's service dates, taking all appropriate actions to obtain any potentially missing service treatment records. The Rating Decision code sheets noted that the Veteran had active service in the Army from July 2004 to December 2005. However, records suggested that the Veteran also had active service from January 2002 to August 2003. 3. After completing all the above, schedule the Veteran for a VA examination to assess his claim of entitlement to service connection for a left knee and right ankle disability. A complete copy of the claims file must be made available to the examiner. The examiner must consider the Veteran's lay reports of observable symptomatology. The examiner must also take a history regarding the symptoms from the Veteran. After a thorough review of the medical and lay evidence of record, the examiner should address the following: (a.) List any and all conditions with which the Veteran is presently diagnosed as to his left knee. The examiner should also comment on whether medical records or service treatment records document any left knee diagnoses. Please consider that the Veteran reported chronic left knee pain during service and that he testified that he has had left knee pain since service. Please also consider and discuss that VA treatment records contained an active problem list, which noted he had a sprain of the cruciate ligament of the knee. (b.) Is it at least as likely as not (i.e. a probability of 50 percent or more) that the Veteran's left knee condition had its onset during active service or within one year of separation from service, or, otherwise resulted from active military service? The examiner should provide a complete rationale for all opinions provided. (c.) List any and all conditions with which the Veteran is presently diagnosed as to his right ankle. The examiner should also comment on whether medical records or service treatment records document any right ankle diagnoses. Please consider that the Veteran testified that he has had right ankle pain since service. (d.) If the Veteran has a diagnosis of a right ankle condition, is it at least as likely as not (i.e. a probability of 50 percent or more) that the right ankle condition had its onset during active service or within one year of separation from service, or, otherwise resulted from active military service? The examiner should provide a complete rationale for all opinions provided. 4. Then also schedule the Veteran for a VA examination to assess his claim of entitlement to service connection for an umbilical hernia. A complete copy of the claims file must be made available to the examiner. The examiner must consider the Veteran's lay reports of observable symptomatology. The examiner must also take a history regarding the symptoms from the Veteran. After a thorough review of the medical and lay evidence of record, the examiner should address the following: (a.) If the Veteran has a diagnosis of an umbilical hernia, or continuing symptoms from an umbilical hernia, is it at least as likely as not (i.e. a probability of 50 percent or more) that the umbilical hernia condition had its onset during active service or within one year of separation from service, or, otherwise resulted from active military service? The examiner should provide a complete rationale for all opinions provided. 5. A complete rationale must be provided for all opinions offered. If an opinion cannot be offered without resort to mere speculation, the examiner must fully explain why this is the case and identify what additional evidence, if any, would allow for a more definitive opinion. 6. If any benefit sought on appeal is not granted, the Veteran and his representative should be provided a Supplemental Statement of the Case (SSOC) and afforded the requisite opportunity to respond before the case is returned to the Board. B. MULLINS Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Associate Counsel, C. Parnell 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.