Citation Nr: 21076236 Decision Date: 12/23/21 Archive Date: 12/22/21 DOCKET NO. 18-43 161 DATE: December 23, 2021 REMANDED Service connection for a back disability is remanded. Service connection for a right knee disability is remanded. REASONS FOR REMAND The Veteran served on active duty from March 1976 to November 1977. This case is before the Board of Veterans' Appeals (Board) on appeal from an October 2014 Department of Veterans Affairs (VA) rating decision. In September 2021, the Veteran testified before the undersigned Veterans Law Judge at a virtual hearing. He presented testimony on three issues, including service connection for degenerative joint disease of the left hip. The agency of original jurisdiction (AOJ) already granted service connection for a left hip disability, to include trochanteric pain syndrome, degenerative joint disease, internal derangement and piriformis syndrome, in a January 2020 rating decision. This was a full grant of the benefit sought on appeal. Therefore, the issue of service connection for degenerative joint disease of the left hip is not before the Board. AB v. Brown, 6 Vet. App. 35, 38 (1993). 1. Service connection for a back disability is remanded. The Veteran seeks service connection for a back disability on direct and secondary bases. At hearing, he testified that he injured his back doing upside down lifts in bootcamp and when a drill instructor threw him up against a doorknob. He testified that he has received continuous care for his back since then. He asserted that service-connected bilateral plantar fasciitis has affected his back as well. Shortly after the hearing, the Veteran submitted a February 2020 medical opinion from his chiropractor ("Dr. M.K."). Dr. M.K. concluded that service-connected left hip dysfunction has changed the Veteran's gait and weightbearing posture, which in turn led to degenerative disc disease of the lumbar spine. However, the Board finds that Dr. M.K. did not provide supporting data or a reasoned medical explanation for this conclusion. Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 301 (2008). To date, the Veteran has not received a VA examination of his back. The record contains competent evidence of a current disability, evidence of an in-service injury, and "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." However, there is insufficient medical evidence on file to decide the claim. As such, remand to the AOJ for an examination is necessary. McLendon v. Nicholson, 20 Vet. App. 79, 81 (2006). 2. Service connection for a right knee disability is remanded. The Veteran also seeks service connection for his right knee on direct and secondary bases. He testified that he was diagnosed with a patellar disorder right after bootcamp and noted that service treatment records show complaints of right knee pain. He also testified that the service-connected plantar fasciitis has affected his knees. In another February 2020 opinion, Dr. M.K. wrote that the Veteran's right knee pain and osteoarthritis are caused by left hip dysfunction and plantar fasciitis. Dr. M.K. again noted that left hip dysfunction has resulted in gait and posture changes, but did not elaborate on this point. Dr. M.K. offered no explanation as to how plantar fasciitis contributed to the Veteran's knee problems. The Board finds that this opinion, like the opinion above, lacks supporting data and a reasoned medical rationale. Nieves-Rodriguez, 22 Vet. at 301. The Veteran received VA knee/lower leg examinations in September 2014 and February 2020. However, the VA medical opinions on file do not address whether the claimed right knee disability is proximately due to or aggravated by the Veteran's service-connected disabilities. See El Amin v. Shinseki, 26 Vet. App. 136, 140 (2013). Remand for an addendum opinion is warranted. The Board by this remand makes no determination, expressed or implied, concerning the credibility of any statements on file. The matters are REMANDED for the following action: 1. Schedule the Veteran for an examination by an appropriate clinician to determine the nature and etiology of the claimed back disability. After reviewing the claims file, including this remand, the examiner must provide an opinion on the following questions: (a.) Is it at least as likely as not (50 percent or greater probability) that the claimed back disability was incurred in service or is otherwise related to service? (b.) Is it at least as likely as not (50 percent or greater probability) that the claimed back disability is proximately due to the Veteran's service-connected bilateral plantar fasciitis? (c.) Is it at least as likely as not (50 percent or greater probability) that the claimed back disability is aggravated beyond its natural clinical course by the Veteran's service-connected plantar fasciitis? (d.) Is it at least as likely as not (50 percent or greater probability) that the claimed back disability is proximately due to the Veteran's service-connected bilateral hip disabilities? (e.) Is it at least as likely as not (50 percent or greater probability) that the claimed back disability is aggravated beyond its natural clinical course by the Veteran's service-connected bilateral hip disabilities? In doing so, the examiner must clearly consider and discuss the Veteran's September 2021 testimony and other lay statements about his in-service injuries and about the onset and course of his symptoms. The examiner must also consider and discuss the medical evidence submitted by the Veteran in September 2021, including the private medical opinion from "Dr. M.K." 2. Obtain an addendum medical opinion on the nature and etiology of the claimed right knee disability. Schedule the Veteran for another in-person examination only if the examiner deems it necessary to provide the requested opinion. After reviewing the claims file, including this remand, the examiner must provide an opinion on the following questions: (a.) Is it at least as likely as not (50 percent or greater probability) that the claimed right knee disability was incurred in service or is otherwise related to service? (b.) Is it at least as likely as not (50 percent or greater probability) that the claimed right knee disability is proximately due to the Veteran's service-connected bilateral plantar fasciitis? (c.) Is it at least as likely as not (50 percent or greater probability) that the claimed right knee disability is aggravated beyond its natural clinical course by the Veteran's service-connected plantar fasciitis? (d.) Is it at least as likely as not (50 percent or greater probability) that the claimed right knee disability is proximately due to the Veteran's service-connected bilateral hip disabilities? (e.) Is it at least as likely as not (50 percent or greater probability) that the claimed right knee disability is aggravated beyond its natural clinical course by the Veteran's service-connected bilateral hip disabilities? In doing so, the examiner must clearly consider and discuss the Veteran's September 2021 testimony and other lay statements about his in-service injuries and about the onset and course of his symptoms. The examiner must also consider and discuss the medical evidence submitted by the Veteran in September 2021, including the private medical opinion from "Dr. M.K." 3. Review the medical opinions above to ensure substantial compliance with the Board's directives. Take any necessary corrective action. 4. Readjudicate the Veteran's claims. If either claim remains denied, issue a supplemental statement of the case, and allow the Veteran and his representative the opportunity to respond. Then return to the Board for further appellate review. KELLI A. KORDICH Veterans Law Judge Board of Veterans' Appeals Attorney for the Board D.Z. Wall, 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.