Citation Nr: 21010193 Decision Date: 02/24/21 Archive Date: 02/24/21 DOCKET NO. 17-23 641 DATE: February 24, 2021 REMANDED Entitlement to service connection for a right knee disability is remanded. Entitlement to service connection for a left knee disability is remanded. REASONS FOR REMAND The Veteran served on active duty with the United States Air Force from March 1969 to August 1971. These issues come before the Board of Veterans’ Appeals (Board) on appeal of a June 2015 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO). In October 2020, the Board remanded the claims for further development. 1. The claims of entitlement to service connection for right and left knee disabilities are remanded. The Veteran has current diagnoses of bilateral osteoarthritis, right knee degenerative joint disease, right knee tendonitis and right knee nerve sheath tumor. The Veteran contends that his knee disabilities were aggravated by his period of service due to continuous marching, physical training and other activities that he was required to perform. He reports ongoing knee pain. Both of the Veteran’s knees were found to be normal on entrance examination, however, on report of medical history completed in conjunction with the entrance examination, it was noted that the Veteran was involved in a 1967 accident with occasional bilateral knee pain and a question of Osgood Schlatter’s Disease. During service, a right knee arthrogram revealed a lateral meniscal tear. The Board had remanded the matter for an opinion as to whether a bilateral knee disability clearly and unmistakably existed prior to service and, if so, whether it was clearly and unmistakably not aggravated during service. A December 2020 VA medical opinion is confusing in that the examiner indicated that right and left knee disabilities pre-existed service without applying the proper standard for making such a determination (however, the examiner’s rationale indicates that the Veteran did not have pre-existing right and left knee disabilities). Moreover, the examiner determined that the Veteran’s current knee disabilities were not related to service as there were no recorded knee complaints on his service separation examination. Also, the examiner’s opinion did not take into consideration the Veteran’s lay statements of ongoing knee pain since service discharge. Because the examination report does not comply with the Board’s prior remand directives, the claims must be remanded again. The matters are REMANDED for the following action: Obtain an opinion from an appropriate examiner as to the questions posed below. If the examiner determines that the opinions requested may only be provided after examining the Veteran, then schedule the Veteran for an appropriate examination. The examiner should answer the following questions: (a) Does the evidence of record clearly and unmistakably show that the Veteran had right and/or left knee disabilities prior to his entry into active service? (b) If so, does the evidence clearly and unmistakably show that a preexisting right and/or left knee disabilities were not aggravated during the Veteran’s active service? (c) If the answer to either question is no, then is it at least as likely as not (a 50 percent or greater probability) that the Veteran’s current right and/or left knee disabilities are etiologically related to service or had its onset during the Veteran’s period of active military service? In rendering the opinion, the examiner must consider the consider and discuss all pertinent medical and other objective evidence, as well as all lay assertions, to include any assertions as to onset and continuity of right and left knee symptoms. (Continued on next page) The examiner is asked to explain the reasons behind any opinions expressed and conclusions reached. Evan M. Deichert Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board J. Henriquez, 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.