Citation Nr: 21076231 Decision Date: 12/22/21 Archive Date: 12/22/21 DOCKET NO. 15-45 915 DATE: December 22, 2021 REMANDED Entitlement to service connection for a right knee disability is remanded. REASONS FOR REMAND The Veteran served on active duty from July 1980 to October 1980. This matter is before the Board of Veterans' Appeals (Board) on appeal from a rating decision issued in February 2014 by a Department of Veterans Affairs (VA) Regional Office (RO). 1. Entitlement to service connection for a right knee disability. The Board remanded the current appeal in May 2021 to obtain a medical examination and opinion concerning the etiology of the Veteran's right knee disability. In pertinent part, the Board requested that the examiner identify all current right knee disabilities, and then opine as to whether each diagnosed disability was causally related to the Veteran's service. The examination and opinion were obtained in August 2021. In the examination report, the examiner noted current diagnoses of a right knee meniscal tear and a right knee strain. However, in providing the opinion the examiner focused exclusively on the diagnosed meniscal tear, and did not address the noted right knee strain. While based on the provided date of 1980 for the right knee strain it appears that this is the Veteran's alleged in-service right knee injury, the examiner did not explain whether the right knee strain diagnosis was a historical or current diagnosis. Stegall v. West, 11 Vet. App. 268, 271 (1998). Furthermore, in stating that the right knee meniscal tear was less likely than not related to service the examiner stated that there was no evidence of a right knee disability or other physical issue that prevented the Veteran from completing basic training. However, as discussed above the examiner specifically noted that the Veteran sustained a right knee strain in 1980, based presumably on the Veteran's reports of stepping in a hole and twisting her knee while performing physical training. As such, the opinion and examination report appear to be internally inconsistent. In light of the above issues, the Board finds that a remand for a new examination and opinion is necessary. The matters are REMANDED for the following action: 1. Obtain all outstanding VA treatment records from June 2021 forward. 2. Schedule the Veteran for a VA examination to determine the nature and etiology of the Veteran's right knee disability. The examiner should answer the following: a) Identify all current right knee disabilities. The examiner should clearly indicate if a listed diagnosis is a historical, and not current, diagnosis. b) For each identified current disability, is it at least as likely as not (a fifty percent probability or greater) that the right knee disability is causally related to the Veteran's active service? Attention is invited to the following: (1) an August 2021 VA examination noting a diagnosis of a right knee meniscal tear in 2006 and a right knee strain in 1980 (labelled "C&P Exam" uploaded 8/31/21); (2) the Veteran's assertions that she stepped in a hole and injured her knee in 1980 while in service (labelled "C&P Exam" uploaded 8/31/21); (3) August 1980 treatment records showing treatment for left knee chondromalacia (labelled "STR - Medical" pgs. 13, 14, 19 uploaded 4/24/14); and (4) a January 2006 private treatment record showing the Veteran reported right knee pain for several months with no specific injury and diagnosing a right knee meniscal tear (labelled "Medical Treatment Record - Non-Government Facility" pg. 2 uploaded 1/27/06). A detailed rationale for the opinion must be provided. The examiner is reminded that the term "as likely as not" does not mean "within the realm of medical possibility," but rather that the evidence of record is so evenly divided that, in the examiner's expert opinion, it is as medically sound to find in favor of the proposition as against it. LESLEY A. REIN Veterans Law Judge Board of Veterans' Appeals Attorney for the Board C. Wendell, 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.