Citation Nr: A21020652 Decision Date: 12/29/21 Archive Date: 12/29/21 DOCKET NO. 191223-51656 DATE: December 29, 2021 REMANDED Entitlement to service connection for a right shoulder disability, characterized as right shoulder rotator cuff tendonitis with degenerative joint disease, is remanded. Entitlement to service connection for a right knee disorder, characterized as a right knee strain with degenerative joint disease, is remanded. Entitlement to service connection for a left knee disorder, characterized as a left knee stain with degenerative arthritis, is remanded. Entitlement to service connection for a back disorder, characterized as a lumbosacral strain, is remanded. REASONS FOR REMAND The Veteran served on active duty from August 1976 to May 1995. The rating decision on appeal was issued in April 2019 and constitutes an initial decision. Therefore, the modernized review system, also known as the Appeals Modernization Act, applies. In the Veteran's December 2019 notice of disagreement, he elected the Direct Review option. Accordingly, the Board may only consider the evidence of record at the time of the AOJ decisions on appeal. 38 C.F.R. § 20.301. In this case, the Veteran has not submitted any evidence related to the claims on appeal since the April 2019 rating decision was issued. In an October 2020 decision, the Board, among other things, denied the Veteran's claims seeking service connection for a right shoulder disorder, a right knee disorder, a left knee disorder, and a back disorder. The Veteran appealed this decision to the United States Court of Appeals for Veterans Claims (Court). In August 2021, the Court granted a Joint Motion for Remand (JMR), vacating the Board's decision and returning the Veteran's seeking service connection for those disorders to the Board. The JMR indicates that the Board erred when it relied on inadequate medical opinions by the April 2019 VA examiner. Specifically, the JMR indicates that the opinions of the April 2019 VA examiner were inadequate because they lacked well-reasoned medical explanations for the negative nexus opinions and failed to sufficiently address chronicity and continuity of symptoms of the Veteran's right shoulder, right knee, left knee, and back disorders. Thus, the JMR directed the Board to remand the Veteran's appeal to obtain new VA medical opinions concerning whether his right shoulder, right knee, left knee, and back disorders are related to his active duty service, to include chronicity and continuity of symptoms, and to obtain well-reasoned medical rationales for the opinions concerning whether those disorders are related to his active duty service. 1. Entitlement to service connection for a right shoulder disability, characterized as right shoulder rotator cuff tendonitis with degenerative joint disease is remanded. 2. Entitlement to service connection for a right knee disorder, characterized as a right knee strain with degenerative joint disease is remanded. 3. Entitlement to service connection for a left knee disorder, characterized as a left knee stain with degenerative arthritis is remanded. 4. Entitlement to service connection for a back disorder, characterized as a lumbosacral strain is remanded. The Board concludes that a remand is required to obtain addendum opinions concerning whether the Veteran's right shoulder disorder, right knee disorder, left knee disorder, and back disorder are etiologically related to his active duty service. Specifically, the April 2019 VA examiner's opinions that the Veteran's right shoulder disorder, right knee disorder, left knee disorder, and back disorder were less likely than not incurred in or caused by active duty service was inadequate for multiple reasons. First, the examiner's rationales in support of those opinions were conclusory and failed to adequately explain why the Veteran's current disorders were not related to in-service disorders, or injuries, including the following: with respect to a right shoulder disorder, a May 1987 service treatment record reflects that he injured his right shoulder, with respect to a right knee disorder, a November 1976 service treatment record documents that he was diagnosed with a right knee strain and an August 1990 service treatment record documents that he was diagnosed with cellulitis; with respect to a left knee disorder, an October 1983 service treatment record reflects that he was diagnosed with chronic left knee pain and a May 1993 service treatment record reflects that he reported complaints of bilateral knee pain and assessed with overuse syndrome of the bilateral knees; and with respect to a back disorder, multiple service treatment records from June 1977 through September 1977 document reports of back pain, a lumbosacral strain, and a hospital admission for treatment of his symptoms. The April 2019 VA examiner's rationales are inadequate because they recounted these treatment records, but did not offer any medical explanation as to why his current disorders are related to those in-service injuries or disorders. Additionally, the examiner did not adequately address the Veteran's lay statements concerning chronicity or a continuity of symptoms, merely stating that there were not additional service treatment records or post-military medical records to support chronicity or continuity. Accordingly, the Board concludes that the April 2019 VA examinations were inadequate and addendum opinions concerning the etiology of the Veteran's right shoulder disorder, right knee disorder, left knee disorder, and back disorder are required. See Barr v. Nicholson, 21 Vet. App. 303, 311 (2007). The matters are REMANDED for the following action: 1. Obtain any and all treatment records from the Memphis VA Medical Center in Memphis Tennessee since November 2006, and any other VA facility from which the Veteran has received treatment. If the Veteran has received additional private treatment, he should be afforded an appropriate opportunity to submit the medical records of such treatment. 2. The AOJ should return the claims file to the VA examiner who performed the April 2019 Shoulder and Arm Conditions, Knee and Lower Leg, and Back Conditions VA examinations (or a comparably qualified physician if that examiner is no longer available) to obtain addendum opinions. The claims file, including any new records, should be provided to the examiner. The examiner is asked to provide an opinion as to whether it is at least as likely as not (a 50 percent or greater probability) that the Veteran's right shoulder disorder, right knee disorder, left knee disorder, and back disorder are etiologically related to (i.e., caused by or aggravated by) the Veteran's active duty service. In providing the foregoing opinions, the examiner should address whether the Veteran's service treatment records, including the following treatment records show that the Veteran's current right shoulder, right knee, left knee, and back disorders were incurred in or caused by his active duty service: a May 1987 service treatment record, which reflects that he injured his right shoulder; November 1976 and August 1990 service treatment records, which reflect that he reported symptoms of and/or was diagnosed with right knee injuries or disorders during his active duty service; October 1983 and May 1993 service treatment records, which reflect that he reported symptoms of and/or was diagnosed with left knee injuries or disorders during his active duty service; and multiple service treatment records from June 1977 through September 1977, which reflect that he reported symptoms of and/or was diagnosed with a back injury or disorder during his active duty service. The examiner should also address the Veteran's lay statement regarding chronicity or a continuity of symptoms of his right shoulder, right knee, left knee, and back disorders, including providing an explanation as to why such statements are not credible if the examiner does not opine that these disorders are etiologically related to the Veteran's active duty service. B.T. KNOPE Veterans Law Judge Board of Veterans' Appeals Attorney for the Board M. Crosnicker, Associate Counsel