Citation Nr: 21009909 Decision Date: 02/23/21 Archive Date: 02/23/21 DOCKET NO. 16-60 274 DATE: February 23, 2021 REMANDED Entitlement to service connection for a left knee disability is remanded. Entitlement to service connection for a right knee disability is remanded. REASONS FOR REMAND The Veteran served on active duty from February 1980 to December 1986 and from September 2004 to October 2005. This matter comes to the Board of Veterans’ Appeals (Board) on appeal from a July 2014 rating decision issued by Regional Office (RO) of the Department of Veterans Affairs (VA). A July 2019 Board decision denied service connection for right and left knee disabilities. The Veteran appealed the Board’s decision to the United States Court of Appeals for Veterans Claims. In a September 2020 Order, the Court granted a Joint Motion for Partial Remand, vacating the Board’s decision, and remanded the matter to the Board for actions consistent with the Joint Motion. 1. Entitlement to service connection for a left knee disability is remanded. 2. Entitlement to service connection for a right knee disability is remanded. The Veteran asserts that a bilateral knee disability is the result of service. In a September 2014 statement, the Veteran stated that a bilateral knee disability was not caused by “any one catastrophic situation but from daily physical demands over many years.” The Veteran stated “physical demands” in service included fitness training which required running on hard pavement in combat boots; and job duties as a track and wheel mechanic and recovery specialist which required “kneeling, crouching, crawling, and climbing up and down from large equipment.” The Veteran stated that he reported bilateral knee pain in 1984 and was told that he “could have early stages of arthritis, but no tests were run, or treatment suggested.” He stated that he was told to take aspirin and after 17 years of knee pain, he left the Reserves. The Veteran submitted three buddy statements confirming that the Veteran complained of bilateral knee pain while in service. The service medical records are incomplete. The first relevant post-service medical records begin with an August 2012 new patient visit at the Clermont County VA Clinic in Orlando. In a November 2013 authorization and consent to release information form, the Veteran stated that he “ha[d] only been seen by the VA clinic in Orlando, FL.” The Veteran has asserted that in-service duties caused a current bilateral knee disability. However, the Veteran has not been provided a VA examination to determine any possible relationship between a bilateral knee disability and service. The Board finds that while the Veteran's lay and buddy statements may not be competent to be dispositive of the claim, those statements are sufficient to overcome the low threshold necessary to trigger VA's duty to provide an examination. McLendon v. Nicholson, 20 Vet. App. 79 (2006). Therefore, remand is necessary for a VA examination to determine the etiology of a bilateral knee disability. The matters are REMANDED for the following action: 1. After obtaining any necessary releases, obtain all relevant VA and private treatment records not already associated with the claims file. All attempts to locate records must be documented in the claims file. (Continued on the next page)   2. Then, schedule the Veteran for a VA examination to determine the nature and etiology of a bilateral knee disability. The examiner must review the claims file, to include a copy of this Remand, and should note that review in the report. A complete history, to include the Veteran’s work history and any sports-related activities, should be elicited from the Veteran. The examiner should opine whether it is at least as likely as not (50 percent probability or greater) that any right or left knee disability had its onset in service. The examiner must discuss the lay statements that knee pain began in service; knee pain was related to training, running on hard pavement in combat boots, kneeling, crouching, crawling, and climbing up and down from large equipment; in 1984, at the age of 24, the Veteran was advised that bilateral knee pain could be early arthritis; and knee pain has continued since separation from service. The examiner is advised that the service medical records are incomplete, and an opinion based on the absence of treatment records without consideration of a competent lay statements is incomplete. The Veteran reported that he only sought treatment at one VA medical center beginning in 2012. The examiner is asked to discuss whether or not the gap between service and diagnosis of a bilateral knee disability, to include arthritis, is supportive of direct service connection. The examiner should also opine whether it is at least as likely as not (50 percent probability or greater) that any right or left knee arthritis manifested within one year of separation from service. The examiner must discuss the clinical significance, if any, of the gap in time between service and diagnosis of a bilateral knee disability. A clearly stated rationale with references to the record, diagnostic tests, and any medical literature should be provided. Harvey P. Roberts Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board E.O., Associate 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.