Citation Nr: 21006726 Decision Date: 02/05/21 Archive Date: 02/05/21 DOCKET NO. 14-14 597 DATE: February 5, 2021 REMANDED Service connection for a left knee disability, to include as secondary to the service-connected right knee disability, is remanded. REASONS FOR REMAND The Veteran served on active duty from November 1976 to November 1979. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a January 2013 rating decision by the Department of Veteran Affairs (VA) Regional Office (RO). In February 2017, the Veteran testified at a Board hearing before the undersigned Veterans Law Judge (VLJ). A transcript of the hearing has been associated with the claims file. This case was previously before the Board in January 2018. At that time, the Board remanded the case for additional development. Unfortunately, for the reasons discussed below, another remand is required. See Stegall v. West, 11. Vet. App. 268 (1998). During the period of the appeal, in a July 2019 Rating Decision, the RO granted service connection for a right hip disability. Therefore, that claim for service connection has been resolved and is no longer before the Board on appeal. See generally Grantham v. Brown, 114 F.3d 1156 (Fed. Cir. 1997); Barrera v. Gober, 122 F.3d 1030 (Fed. Cir. 1997). Service connection for a left knee disability is remanded. In a January 2020 VA examination report, the Veteran was diagnosed with bilateral degenerative joint disease (DJD) of the knees. The Veteran reported that during active service, he was hit by a Jeep and developed right knee pain. According to the Veteran, over time, his service-connected right knee disability caused his left knee condition. During the examination, the VA examiner noted that the Veteran’s right knee developed pain with prolonged standing and caused weakness in the knee. Additionally, the DJD in the right knee interfered with ambulation and prolonged standing and kneeling. The examiner opined that the Veteran’s left knee was less likely than not proximately due to or the result of his service-connected right knee. The rationale was that arthritis in one joint did not cause arthritis in another joint. A nexus was not established. Additionally, the examiner noted that DJD was caused by wear and tear on a joint and explained that DJD in one joint did not cause DJD in other joints. The cause of DJD in other joints was due to wear and tear on that specific joint. However, the VA examiner provided no opinion as to whether the Veteran’s service-connected right knee disability aggravated his left knee condition. Therefore, a remand is necessary because the January 2020 opinion is inadequate. The examiner’s opinion was conclusory and confusing. The Veteran is not claiming that the DJD in his right knee somehow spread to his left knee, he is claiming that because of his service-connected right knee, he altered his gait which caused him to develop DJD in his left knee. Additionally, no aggravation opinion was given. Because of this, a new VA opinion is necessary to determine whether the Veteran’s left knee condition was caused or aggravated by his service-connected right knee disability. The matters are REMANDED for the following actions: 1. Please note that, by law, ALL remanded claims must be processed expeditiously. 2. In accordance with the provisions of 38 C.F.R. § 3.159(c)(1), contact the Veteran for additional information about treatment for his condition and make efforts to obtain all VA and private treatment records concerning this claim. 3. Then, arrange for the Veteran’s file to be forwarded to a VA examiner for clarifying addendum opinion regarding the likely cause of the Veteran’s left knee condition. The examiner or consulting physician must review the entire record (including all updated records obtained pursuant to the above development order). Based on his or her review, the examiner or consulting physician should provide an opinion as to whether it is at least as likely as not (a 50 percent probability or greater) that the Veteran’s left knee condition is either directly related to active military service OR was proximately CAUSED BY or AGGRAVATED BY his service-connected right knee disability. The Board notes that in giving any opinion, the VA examiner should NOT comment on whether DJD in one knee can spread to another knee. The Veteran is alleging that his service-connected right knee DJD altered his gait and walking style which put more pressure on his left knee, causing that to develop DJD. In reaching any conclusion, the examiner is asked to consider a January 1978 service treatment record where the Veteran injured his left foot which was said to have been ongoing for approximately a year, which affected his left knee, a January 1981 diagnosis of DJD, and a September 2020 VA examination report where the examiner noted that “There is evidence of significant chronic gait impairment over many years requiring cane with chronic right knee.” 4. A detailed explanation (rationale) is requested for all opinions provided. (By law, the Board is not permitted to rely on any conclusion that is not supported by a thorough explanation. Providing an opinion or conclusion without a thorough explanation will delay processing of the claim and may also result in a clarification being requested). VICTORIA MOSHIASHWILI Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board J. Abrams, 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.