Citation Nr: A21020540 Decision Date: 12/27/21 Archive Date: 12/27/21 DOCKET NO. 210409-151599 DATE: December 27, 2021 REMANDED Entitlement to service connection for a left knee disability, secondary to the service-connected left ankle strain with peroneus brevis tenosynovitis, is remanded. REASONS FOR REMAND The Veteran had active service from October 1968 to October 1972. This matter comes before the Board of Veterans' Appeals (Board) on appeal of a March 2021 rating decision. Service connection for a left knee disability, secondary to service-connected left ankle strain with peroneus brevis tenosynovitis The February 2021 Compensation and Pension (C&P) examination and associated opinions are not adequate to provide an adjudication. Consequently, there is a pre-decisional duty to assist error in this case, and the matter must be remanded for an additional VA opinion. In her November 2020 claim, the Veteran requested service connection for a left knee disability generally. The February 2021 C&P examination report, while mentioning arthritis in the medical history section, focuses exclusively on her diagnosis of a left knee meniscal tear with post-surgical residual pain. However, the limited and isolated nature of the Veteran's arthritis is the reason that her private treating providers from 2020 noted there was a possibility of a connection between her service-connected left ankle condition and her left knee condition. The February 2021 opinion addresses only the matter of causation and indicates that the Veteran's left knee condition was less likely than not proximately due to her service-connected ankle disability (and associated scar), reasoning that the biomechanics were such that a knee disability would affect the ankle and not the other way around. However, this rationale lacks detail and does not address the conflicting private opinions that reasoned the possibility existed that the Veteran's left knee arthritis may have been caused by her left ankle disability. Similarly, the March 2021 addendum opinion addresses aggravation of the meniscal condition only. The Veteran's claim was not so limited, and therefore an additional opinion is required to consider her left knee disability more generally. Accordingly, this matter is REMANDED for the following action: Obtain an addendum opinion from an appropriate clinician regarding whether the Veteran's left knee disability (to include the post-surgical residuals of the meniscal condition and arthritis) are at least as likely as not related to, proximately due to the service-connected left ankle disability, or aggravated beyond its natural progression by the service-connected left ankle disability or its associated scar. In rendering the opinion, the clinician's attention is directed to the statements by non-VA providers in 2020 who indicate the possibility of such a connection based on the isolated nature and extent of the Veteran's left knee arthritis. A rationale for a negative opinion should address those statements and state with sufficient detail any reason for disagreement with those opinions. No action is required of the Veteran until she is notified by VA. However, she is advised of her obligation to cooperate in ensuring the duty to assist is satisfied. Kowalski v. Nicholson, 19 Vet. App. 171 (2005). The Veteran also is advised that she has the right to submit additional evidence and argument with respect to this matter. Kutscherousky v. West, 12 Vet. App. 369 (1999). This appeal must be afforded prompt treatment. THERESA M. CATINO Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Steven H. Johnston, 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.