Citation Nr: 21077455
Decision Date: 12/29/21	Archive Date: 12/29/21

DOCKET NO. 17-06 287
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 October 1971 to January 1973. 

This matter comes before the Board of Veterans' Appeals (Board) from a February 2015 rating decision by a Department of Veterans Affairs (VA) Regional Office (RO).

1. Entitlement to service connection for a left knee disability.

The Veteran was afforded a VA examination in August 2021. The examiner noted complaints of left knee pain during service related to a leg length discrepancy, with the Veteran's left leg being noted to be shorter than his right. The examiner then stated that the leg length discrepancy clearly pre-existed the Veteran's period of service. However, no lower extremity disabilities generally, or a leg length discrepancy specifically, were noted on enlistment, and therefore the Veteran is presumed sound upon entry. 38 U.S.C. §§ 1111, 1132, 11137; 38 C.F.R. § 3.304. In order to rebut the presumption of soundness, it must be shown that a disability both clearly and unmistakably pre-existed service and clearly and unmistakably was not aggravated by such service. 38 U.S.C. § 1111; 38 C.F.R. § 3.304. As such, an addendum opinion is required. Stegall v. West, 11 Vet. App. 268 (1998).

The matters are REMANDED for the following action:

1. Obtain an addendum opinion from an appropriate clinician regarding the following: 

a)	Did the left knee disability, specifically the left leg length discrepancy, clearly and unmistakably (undebatably) preexist the Veteran's service?

b)	If yes, was it clearly and unmistakably not aggravated by service?

c)	If the examiner finds that the left knee disability either did not clearly and unmistakably preexist service or was not clearly and unmistakably not aggravated by service, is it at least as likely as not (a fifty percent probability or greater) that the left knee disability is causally related to the Veteran's active service?

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.