Citation Nr: 21077265 Decision Date: 12/29/21 Archive Date: 12/29/21 DOCKET NO. 17-24 282 DATE: December 29, 2021 REMANDED Entitlement to service connection for a left knee disability is remanded. REASONS FOR REMAND The Veteran served on active duty from January 1981 to January 1985. This matter comes before the Board of Veterans' Appeals (Board) on appeal from an August 2016 rating decision issued by a Department of Veterans Affairs (VA) regional office. It was remanded by the Board in June 2020 and August 2021 and is now before the Board again for adjudication. Two VA medical opinions have been obtained regarding the etiology of the Veteran's left knee disability. Both opinions indicate that the disability is not related to the Veteran's service. As requested by the Board in the August 2021 remand, a VA addendum opinion was obtained in September 2021. The opinion contains a rationale that is, in substance, solely based on an absence of contemporaneous medical records in and since service. Regarding the Veteran's contentions that his left knee disability was caused by wear and tear on his knees due to working as a welder, the examiner simply stated that "the statement by the claimant in year 2017: this is subjective narrative history that does not constitute a medical fact." The examiner did not explain why it was or was not likely that the Veteran's work as a welder caused his current left knee disability. The Board cannot determine that lay evidence lacks credibility merely because it is unaccompanied by contemporaneous medical evidence. Buchanan v. Nicholson, 451 F.3d 1331, 1331 (Fed. Cir. 2006). The Board also notes that the term "disability" in 38 U.S.C. § 1131 refers to the functional impairment of earning capacity, not the underlying cause of said disability, and in the context of a veteran's disability claim, pain may be considered a disability if it diminishes the body's ability to function, whether that pain is diagnosed as connected to a current underlying condition or not. See Saunders v. Wilkie, 886 F.3d 1356 (Fed. Cir. 2018). Thus, knee pain causing functional loss may itself be a considered a disability, but it does not seem that the examiner took this into consideration. Considering the foregoing, the Board finds that another remand is necessary for an additional addendum opinion. The matters are REMANDED for the following action: Obtain an addendum opinion from an appropriate clinician to address the etiology of the Veteran's left knee disability. If an examination is deemed necessary to respond to the question presented, one should be scheduled. If a diagnosis cannot be provided at any point in time, but the Veteran's condition manifested in symptoms that caused functional impairment, then the examiner should consider them a "disability" for the purpose of providing the requested opinion(s) below. The examiner is asked, specifically, to provide a response to the following: (a.) Is the left knee disability (including any pain causing functional loss) at least as likely as not related to an in-service injury, event, or disease, including work as a welder during his active service, which involved working on his knees for extended periods, and frequently and repetitively going from kneeling to standing? (b.) Is it at least as likely as not that the left knee disability (including any pain causing functional loss) manifested within one year after discharge? The examiner should consider and discuss all pertinent evidence of record, including, but not limited to, the in-service September 1983 complaint of left leg pain and the October 1983 report of a history of joint pain. Provide a rationale to support the opinion(s). The examiner should be advised that the absence of contemporaneous service treatment records showing complaints of or treatment for a left knee disability, alone, is an insufficient rationale for a negative nexus opinion. (Continued on the next page) In providing the requested opinion, consider the Veteran's description of his in-service injury and symptoms as well as his post-service symptoms. If there is any medical reason to accept or reject the proposition that the Veteran's reported injury and symptoms in service and thereafter, represented the onset of his current disability, this should be noted. A. J. Spector Veterans Law Judge Board of Veterans' Appeals Attorney for the Board C. Banks, 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.