Citation Nr: 21012916 Decision Date: 03/05/21 Archive Date: 03/05/21 DOCKET NO. 19-09 774 DATE: March 5, 2021 REMANDED Entitlement to service connection for a lumbar spine condition is remanded. Entitlement to service connection for a left knee condition is remanded. REASONS FOR REMAND The Veteran served on active duty from January 1951 to January 1954. This appeal is before the Board of Veterans’ Appeals (Board) from a February 2019 rating decision from a Department of Veterans Affairs (VA) Regional Office (RO). The Board notes, the Veteran withdrew his request for a Board hearing in February 2021. Turning to the evidence of record, the service personnel records indicate the Veteran engaged in combat with the enemy and his MOS was listed as “Tank Crewman.” In his February 2019 notice of disagreement, he alleged that he hurt his back and knees while jumping off tanks in-service and he has experienced pain ever since. As the Veteran is eligible for the combat presumption and his injuries are consistent with his in-service duties, the Board presumes he suffered in-service lumbar spine and left knee injuries (assuming there is not clear and convincing evidence to the contrary). See 38 U.S.C. § 1154(b). In an August 1, 2019 Congressional correspondence sent to the Board, the form states that “a doctor 30 years ago to him [his back and knee pain are] service-connected.” Consistent with VA’s duty to assist, VA must provide a medical examination when there is evidence of (1) a current disability; (2) an in-service injury; (3) some indication that the claimed disability may be associated with the established injury; and (4) insufficient competent evidence of record for VA to make a decision. See McClendon v. Nicholson, 20 Vet. App. 79, 84 (2006). Here, the evidence of record contains insufficient competent medical evidence for the Board to render a decision. The evidence reflects he has current lumbar spine and left knee conditions; suffered in-service injuries; and contains an indication his disabilities may be the result of active duty service, as contained in the Veteran’s description that a doctor told him 30 years ago that his back and knee pain are related to service. As such, the Board’s duty to assist has been triggered and a remand is necessary to determine the nature and etiology of the Veteran's lumbar spine and left knee conditions. These matters are remanded for the following actions: 1. Schedule the Veteran for a VA examination(s) to determine the nature and etiology of the Veteran’s lumbar spine and left knee condition. Specifically, the examiner is asked to respond to the following question: For any lumbar spine and/or left knee conditions diagnosed or for functional impairment observed; whether it is at least as likely as not (i.e., 50 percent probability or more) that any such diagnosis(es) or functional impairment(s) were incurred in or the result of his reported combat-related injuries sustained during active duty service? Note: All opinions are to be accompanied by a rationale consistent with the evidence of record. A discussion of the pertinent evidence, relevant medical treatises, and generally accepted medical principles is requested. If the examiner cannot provide an opinion without resorting to speculation, she shall provide complete explanations stating why this is so. In so doing, the examiner shall explain whether any inability to provide a more definitive opinion is the result of a need for additional information, or that she has exhausted the limits of current medical knowledge in providing an answer to that particular question. 2. After the above is complete, readjudicate the Veteran’s claims. JONATHAN B. KRAMER Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Law Clerk, Tyler R. Masters 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.