Citation Nr: 21077448 Decision Date: 12/29/21 Archive Date: 12/29/21 DOCKET NO. 17-07 157 DATE: December 29, 2021 REMANDED Entitlement to service connection for a right knee disability is remanded. Entitlement to service connection for a left knee disability is remanded. REASONS FOR REMAND The Veteran served on active duty from September 1986 to August 1994. The matters are before the Board of Veterans' Appeals (Board) on appeal from a January 2015 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO). In January 2019, the Board remanded the claims for further development. Unfortunately, the remand orders have not been complied with. The Board itself errs in failing to ensure compliance. Stegall v. West, 11 Vet. App. 268, 271 (1998). Therefore, another remand is necessary in this matter. 1. Entitlement to service connection for a left and right knee disability. In July 2021, the Board remanded the claim to obtain an addendum opinion concerning the etiology of the left and right knee disabilities, and specifically stated that the examiner should address the Veteran's statements regarding leg pain since service. In August 2021, a VA examiner opined that it was less likely than not that the Veteran's left and right knee disabilities were causally related to his period of service, noting that the Veteran's separation medical examination did not reflect any knee issues. The examiner then further stated that the Veteran's arthritis was not diagnosed until 2019, and that it was more likely due to the natural aging process. However, the examiner failed to address the Veteran's report of swollen or painful joints generally, and right knee pain specifically, on his June 1994 separation report of medical history, as well as the Veteran's statements concerning persistent knee pain since service. As such, the Board finds that the opinion does not substantially comply with the prior Board remand, and therefore another remand is required for a new opinion concerning the left and right knees. Id. The matters are REMANDED for the following action: Obtain a medical opinion regarding the etiology of the Veteran's left and right knee arthritis. The examiner should answer the following: a) Is it at least as likely as not (a fifty percent probability or greater) that the left knee arthritis is causally related to the Veteran's active service? b) Is it at least as likely as not (a fifty percent probability or greater) that the right knee arthritis is causally related to the Veteran's active service? In answering (a) and (b), the examiner must address (1) the Veteran's report of swollen or painful joints and right knee pain on his July 1994 separation report of medical history, and (2) the Veteran's reports of persistent knee pain since service. Attention is also invited to an in-service notation of an October 1989 MCL sprain. 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. CHRISTOPHER A. WENDELL Acting Veterans Law Judge Board of Veterans' Appeals Attorney for the Board D. Lauritzen, 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.