Citation Nr: 21077476 Decision Date: 12/29/21 Archive Date: 12/29/21 DOCKET NO. 18-24 055 DATE: December 29, 2021 REMANDED Entitlement to service connection for bilateral knee condition is remanded. Entitlement to service connection for bilateral hand condition is remanded. Entitlement to service connection for a back condition is remanded. Entitlement to service connection for a thyroid disability is remanded. Entitlement to service connection for facial rash is remanded. REASONS FOR REMAND The Veteran served on active duty from April 1969 to March 1971. This appeal comes to the Board of Veterans Appeals (Board) from an April 2016 rating decision issued by the Department of Veterans Affairs (VA) Regional Office (RO) in Indianapolis, Indiana. In July 2021, the Veteran testified before the undersigned Veterans Law Judge (VLJ). A hearing transcript is associated with the record. The VLJ held the record open for 90 days for the submission of supporting evidence. 1. Entitlement to service connection for bilateral knee condition is remanded. 2. Entitlement to service connection for bilateral hand condition is remanded. 3. Entitlement to service connection for a back condition is remanded. 4. Entitlement to service connection for a thyroid disability is remanded. 5. Entitlement to service connection for facial rash is remanded. Issues 1 5: The Veteran contends that his bilateral knee condition, back condition, bilateral hand condition, thyroid disability and facial rash are a result of his military service. With regard to his bilateral knee disability, he contends that, while stationed in Korea, he served as a medic and carried medical supplies along steep incline and carried stretchers with service members on them, weighing more than 100 pounds. See Hearing Transcript (July 2021). He stated that his knee pain began in service and has persisted since. Id. The Veteran's representative argued that the Veteran's duties contributed to him developing knee issues. Id. With regard to his hands, the Veteran contends that his condition began while he was in Fort Sam, Houston, and moving things around caused his hands to hurt. Id. He also contends that he has hand disability related to working in cold conditions, to include driving an armored carrier and opening the hatch to put the patients in resulting in a lot of pain. Id. With regard to his back condition, the Veteran contends that he first hurt his back in basic training in Ft. Ord, noting that they would pick each other up and he served in the medical field lifting and carrying stretchers that were heavy; he reported his condition later progressed until he sought treatment post service. Id. See also Form 9 (May 2018). With regard to his thyroid disability and facial rash, the Veteran contends these could be due to radiation, Agent Orange, or other chemical or device exposure in South Korea (at a missile site) where he was stationed for a long time. See Hearing Transcript (July 2021). The Veteran's representative argued that the Veteran was assigned for 14 weeks with a missile unit within t, or close to, the Demilitarized Military Zone (DMZ) in South Korea. Hearing Transcript (July 2021). By way of background, the Veteran's July 1968 pre-induction examination reflects normal findings and notes only stomach aches at night. See STR - Medical (July 1971). A May 1969 service treatment record (STR) reflects complaint of back painthe Veteran reported that three years earlier his physician told him he had a birth defect that could cause frequent back pain. X-rays at that time showed transverse process. In May 1969, the Veteran was evaluated by a Medical Board that found him fit for duty. Id. A February 1971 examination at separation shows that the Veteran reported stomach pain, tooth and gum pain, and recent gain or loss of weight; his physical was normal, including head, face, neck and scalp; mouth and throat; endocrine system; upper extremities; lower extremities; spine and other musculoskeletal; and skin. VA received the Veteran's original VA disability claim in March 1971, but it made no mention of any knee, back, hand, thyroid or rash condition. See VA Form 21-526 (March 1971). Post-service, a February 1972 VA treatment record shows arthritic pain in right knee; no diagnosis was shown. See Medical Treatment Record - Government Facility (February 1972). A May 2007 VA treatment records shows that the Veteran's prior medical history included thyroid nodule, for which he continued to be seen at VA. See CAPRI (December 2016). An April 2015 VA treatment note shows that the Veteran reported bilateral hand pain and left knee pain; it was assessed as left knee osteoarthritis and right hand joints tenderness. Id. Another April 2015 VA treatment note indicated degenerative joint disease of the knee and hands. Id. In May 2015, his left knee x-rays were reported to be normal. Id. In December 2015, left knee flap tear of the medial meniscus was noted. Id. November 2018 VA report of medical history shows atopic dermatitis, hand joint pain, knee pain, low back pain, osteoarthritis (without location identified), seborrheic keratosis (without location identified), thyroid cyst, and thyroid nodule. Id. A December 2020 active problems list included rosacea. See CAPRI (December 2020). To ensure that VA has met its duty to assist, the Board finds that remand is necessary for the following reasons. 38 U.S.C. § 5103A;38 C.F.R. § 3.159(c). First, the record reflects that there are outstanding non-VA treatment records. 38 U.S.C. § 5103A(b), (c); 38 C.F.R. § 3.159(b), (c)(1); see also Sullivan v. McDonald, 815 F.3d 786 (Fed. Cir. 2016). In September 2021, the Veteran submitted multiple VA 21-4142a General Release for Medical Provider Information and VA 21-4142 Authorization for Release of Information forms for various medical providers. See VA 21-4142 Authorization for Release of Information (September 2021). The evidence does not show that VA has made reasonable attempts to obtain these records. The Board notes, however, that one request was submitted and returned as the request was accompanied with only VA 21-4142 and without VA 21-4142a. Additionally, the Veteran has not been notified of the RO's inability to obtain the identified private treatment records, for which the Veteran submitted copies of VA Form 21-4142, Authorization for Release of Information and VA 21-4142a General Release for Medical Provider Information. Second, the Veteran identified additional VA treatment records that may be outstanding, including from Dr. U. S. See Correspondence (May 2021). Furthermore, the Veteran previously reported receiving treatment at San Francisco VA Medical Center beginning in around October 2001. See VA 21-4138 Statement In Support of Claim (April 2018). However, while prior to the Veteran's statement, the RO had requested those records, the Report of General Information does not conclusively show that the search was properly conducted because the response suggests that the request was unclear. See VA 21-0820 Report of General Information (March 2018). Third, VA treatment records reflect that non-VA (outside) medical records were received and scanned into the "VistA Imaging" system. However, the record does not include copies of those scanned records. Therefore, remand is necessary to associate copies of these scanned records with the claims file. 38 U.S.C. § 5103A(b), (c); 38 C.F.R. § 3.159(c); see also Sullivan v. McDonald, 815 F.3d 786 (Fed. Cir. 2016). Lastly, In September 2021, the Veteran filed a VA 10-5345 Request for and Authorization to Release Medical or Health Information. The Veteran stated that he received treatment from VA Palo Alto from 2000 to 2018; VA San Antonio from 1983 to 2000; VA Tulare from 2000 to 2018; VA Monterey from 1971 to 1985, and from 2000 to 2021; and VA McClellan from 1983 to 2000 and 2018 to 2021. See VA 10-5345 Request for and Authorization to Release Medical or Health & 10-5345 Request For and Authorization to Release Medical or Health Information (September 2021). The Board finds that no subsequent attempts have been made to obtain these records and the record does not show that these record do not exist or are otherwise not available/found. The Board notes the Veteran's and his representative's general argument that the Veteran's service treatment records (STRs) are incomplete. See Hearing Transcript (July 2021). However, a review of the available STRs reflects that they include enlistment and separation examination reports, treatment notes for various conditions. Thus, on remand, the Veteran should be afforded an opportunity to identify any specific records that he believes are missing or absent. If any are identified, the originating agency should undertake efforts to request such records from appropriate sources/repositories and notify the Veteran of the outcome of such efforts. The Veteran, and his representative, is reminded that VA's duty to assist is a two-way street. If the Veteran wishes help, he cannot passively wait for it in those circumstances where he may or should have information that is essential in obtaining the relevant evidence. Wood v. Derwinski, 1 Vet. App. 190, 193 (1991). In remanding this appeal, the Board makes no finding, implicit or otherwise, as to the credibility of the Veteran's assertions. Neither the Veteran's credibility nor any lack thereof should be presumed in this remand. The matters are REMANDED for the following action: 1. Ask the Veteran to complete a VA Form 21-4142 for all non-VA medical providers seen for bilateral knee condition, back condition, bilateral hand condition, thyroid disability and facial rash since his discharge from active service, to include from Dr. K. S., Dr. H. C., Dr. A. H., Dr. V. H., Dr. M. A., Dr. E. M., Dr. M. R., V.G., Dr. D. R., Dr. B. B., Dr. K. Y. and Dr. V. S.. Make two requests for the authorized records from all identified sources, unless it is clear after the first request that a second request would be futile. 2. Obtain all VA treatment records dated from December 2020 to the Present, and all medical documents scanned into the claims file from the VistaA Imaging system. Please request VA treatment records from VA Palo Alto from 2000 to 2018; VA San Antonio from 1983 to 2000; VA Tulare from 2000 to 2018; VA Monterey from 1971 to 1985, and from 2000 to 2021; and VA McClellan from 1983 to 2000 and 2018 to 2021. If any identified records are not obtainable (or none exist), (a) this should be documented in the claims file and (b) the Veteran should be notified and given the opportunity to provide copies of the records. (Continued on the next page) 3. Afforded the Veteran an opportunity to identify any specific service treatment records (STRs) that he believes are missing or absent given his recent Board testimony. If any are specifically identified by the Veteran, the originating agency should undertake efforts to request such records from appropriate sources/repositories and notify the Veteran of the outcome of such efforts. 4. Conduct all other development deemed necessary and readjudicate. C.A. SKOW Veterans Law Judge Board of Veterans' Appeals Attorney for the Board E. M. Pesin 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.