Citation Nr: 21076254 Decision Date: 12/23/21 Archive Date: 12/22/21 DOCKET NO. 16-14 947 DATE: December 23, 2021 REMANDED Service connection for a right knee disability is remanded. REASONS FOR REMAND The Veteran served on active duty from December 1970 to December 1973. This matter is before the Board of Veterans' Appeals (Board) on appeal from an October 2013 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO). In January 2019, the Veteran and his wife appeared at a video conference hearing before the undersigned Veterans Law Judge (VLJ). A transcript of the hearing has been associated with the record. In July 2019 and July 2020, the Board remanded the claim for further evidentiary development. Service connection for a right knee disability is remanded. Once VA has provided a VA examination, it is required to provide an adequate one, regardless of whether it was legally obligated to provide an examination in the first place. Barr v. Nicholson, 21 Vet. App. 303 (2007). A medical examination report must contain not only clear conclusions with supporting data, but also a reasoned medical explanation connecting the two. See Nieves-Rodriguez v. Peake, 22 Vet. App. 295 (2008); Stefl v. Nicholson, 21 Vet. App. 120, 124 (2007). In February 2021, the Veteran was afforded a VA examination and the examiner diagnosed right total knee replacement. The examiner provided a negative nexus opinion. The examiner acknowledged that an April 1973 service treatment record (STR) documented a knee injury. The examiner's rationale for the negative nexus opinion was that the Veteran's medical records after the April 1973 STR were silent for a right knee condition, symptoms, or treatment until 2000. The Board finds this opinion to be inadequate. The examiner's rationale is limited to relying on an absence of medical evidence while ignoring the Veteran's competent lay evidence. Namely, the examiner stated that the Veteran's medical records after April 1973 were silent for any treatment for his right knee, but the Veteran has reported that his right knee continued to trouble him after an in-service parachuting injury. See Miller v. Wilkie, 32 Vet. App. 249, 258-60 (2020). Additionally, at the January 2019 hearing, the Veteran's spouse testified that she had met the Veteran in 1974 and that she remembers him complaining about pain in the right knee since she met him. The Veteran's spouse is also competent to provide testimony regarding her observations. As such, the Board finds the February 2021 VA opinion to be inadequate as it did not consider this evidence of pain in the knee continuing since service. This matter is REMANDED for the following actions: 1. Obtain and associate with the claims file VA treatment records from January 2021 to the present. 2. After completing the development above, forward the Veteran's claims file to the February 2021 examiner, or another appropriate clinician if the February 2021 examiner is unavailable, for review and an addendum opinion regarding the nature and etiology of any right knee disability. If the reviewing clinician determines another examination, including via telehealth, is needed, then such should be scheduled. The reviewing clinician must opine whether any right knee disability is at least as likely as not (a 50 percent or greater probability) related to an in-service injury, event, or disease, including an injury while parachuting and completing approximately 40 parachute jumps. In providing this opinion, the reviewing clinician should consider to be credible the Veteran and his spouse's statements that his right knee continued to trouble him after an in-service parachuting injury. A complete rationale for all opinions must be provided. If the clinician cannot provide a requested opinion without resorting to speculation, it must be so stated, and the clinician must provide the reasons why an opinion would require speculation. The clinician must indicate whether there was any further need for information or testing necessary to make a determination. Additionally, the clinician must indicate whether any opinion could not be rendered due to limitations of knowledge in the medical community at large and not those of the particular examiner. M. SORISIO Veterans Law Judge Board of Veterans' Appeals Attorney for the Board S. Patel, 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.