Citation Nr: 21009054 Decision Date: 02/18/21 Archive Date: 02/18/21 DOCKET NO. 15-02 728 DATE: February 18, 2021 REMANDED Entitlement to service connection for a right knee disability, to include degenerative joint disease is remanded. REASONS FOR REMAND The Veteran served on active duty from July 1985 to August 1998 and from December 2001 to July 2003. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from an August 2013 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO) and was previously remanded by the Board in November 2018 to obtain a new VA examination and medical opinion, as well as any pertinent outstanding private treatment records. Entitlement to service connection for a right knee disability, to include degenerative joint disease and rheumatoid arthritis The Veteran contends that his right knee disability is due to his active duty service. A review of the record reveals diagnoses of right knee mild degenerative joint disease, right knee rheumatoid arthritis and residuals right knee pain, post arthroplasty. See July 2019 and June 2013 VA Knee Examination Reports. Pursuant to the November 2018 remand, the Veteran underwent a VA knee examination in July 2019, in connection with which the examiner opined that it was less likely than not that the Veteran’s right knee rheumatism and total knee replacement are related to service, including the Veteran’s noted in-service injuries and treatment for such. The examiner’s rationale lists the in-service complaints involving the Veteran’s right knee, notes the November 2011 diagnosis of rheumatoid arthritis in his knees and notes that right knee arthritis was diagnosed eight years after separation in 2003. The Board finds that the July 2019 opinion is inadequate as it did not address the specific issues directed by the Board in the November 2018 remand. Specifically, the opinion does not address whether any signs and symptoms noted in service were initial manifestations of r the Veteran’s rheumatoid arthritis or were initial manifestations of a separate and distinct right knee arthritic disorder, did not consider the February 2015 letter from the Veteran’s private physician, Dr. C.B.B., and did not consider the Veteran’s lay statements regarding onset of symptomatology and any continuity of symptomatology/self-medication since onset and/or since separation from service. For the above reasons, the Board finds that the November 2018 remand instructions were not completed. See Stegall v. West, 11 Vet. App. 268, 270-71 (1998) (holding that remand by the Board confers upon a veteran, as a matter of law, the right to compliance with the Board’s remand order). Also, the record indicates Dr. C.B.B. reported that the Veteran was a patient since separation from service, that he treated the Veteran for at least a 10-year period for continued bilateral knee complaints of persistent pain and effusion and that the Veteran was under the care of a rheumatologist, but neither Dr. C.B.B.’s nor any private rheumatologist’s treatment records are of record. In May 2019, VA requested that the Veteran identify any private treatment records relevant to his right knee disorders which are not already of record, specifically to include Dr. C.B.B. and/or any private rheumatologist, and requested the necessary releases to obtain those records. To date, no response from the Veteran is of record. While the Veteran will be afforded another opportunity to provide the information to obtain relevant private treatment records which may support his claim, the Board emphasizes that he has a duty to assist and cooperate with VA in developing evidence. The duty to assist is not a one-way street. Wood v. Derwinski, 1 Vet. App. 190 (1991); Hayes v. Brown, 5 Vet. App. 60 (1993) (VA’s duty to assist is not a one-way street; if a veteran wants help, he cannot passively wait for it in those circumstances where his own actions are essential in obtaining evidence). The matter is REMANDED for the following action: 1. Ask the Veteran to identify any private treatment that he may have had for his right knee disorders, to include rheumatoid arthritis, which is not already of record, to specifically include Dr. C.B.B. and/or any private rheumatologist that has treated the Veteran since separation from service. After securing the necessary releases, attempt to obtain and associate those identified treatment records with the claims file. For private treatment records, make at least two (2) attempts to obtain records from any identified sources. If any identified records cannot be obtained and further attempts would be futile, such should be noted in the claims file and the Veteran should be notified so that he can make an attempt to obtain those records on his own behalf. 2. After all available records have been associated with the file, schedule the Veteran for a VA examination to determine the nature and etiology of his right knee disorders, including degenerative joint disease. The record, to include a copy of this Remand, should be made available to, and be reviewed by, the examiner in conjunction with the examination. All tests deemed necessary should be conducted and the results reported. a) The examiner should identify all right knee disorders that are present. b) For each right knee disorder found, to include degenerative joint disease, the examiner is asked to opine whether such disorder at least as likely as not (i.e., a 50 percent or greater probability) began in service, within one year of separation from service, or is otherwise the result of military service, to include the Veteran’s noted in-service complaints of and treatment for his right knee. c) The examiner should also indicate whether the Veteran’s current right knee symptoms are part and parcel of his rheumatoid arthritis, and if so, whether his rheumatoid arthritis began during military service, within one year of separation from service, or is in any way related to service. The examiner should also specifically indicate whether any signs and symptoms noted in service, i.e., the Veteran’s right knee symptoms of pain, popping, crepitus and stiffness, were initial manifestations of his rheumatoid arthritis. Finally, the examiner must also specifically consider and discuss Dr. C.B.B.’s February 2015 letter, as well as the Veteran’s lay statements regarding onset of symptomatology and any continuity of symptomatology/ self-medication since onset and/or separation from service. A clear rationale must support all opinions. The examiner is to explain in detail the underlying reasoning for his or her opinion, to include citing to relevant evidence, supporting factual data, prior medical opinions, and medical literature, as appropriate. If any requested opinion cannot be provided without resorting to mere speculation, the examiner must explain why a more definitive response is not possible or feasible. 3. After completing the above, and any other development as may be indicated, the Veteran’s claim should be readjudicated based on the entirety of the evidence. C. CRAWFORD Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board S. Battaile 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.