Citation Nr: 21013428 Decision Date: 03/09/21 Archive Date: 03/09/21 DOCKET NO. 15-03 923A DATE: March 9, 2021 REMANDED Entitlement to service connection for a left knee disability, to include as secondary to service-connected right knee and lumbar spine disabilities, is remanded. REASONS FOR REMAND The Veteran served on active duty from September 1981 to 1985. This matter is before the Board of Veterans’ Appeals (Board) on appeal from a July 2014 rating decision by the Agency of Original Jurisdiction (AOJ). The appeal was previously remanded in October 2018 for further development. In light of the request for any additional treatment records, obtaining of the requested medical opinions, and further adjudicatory actions taken by the Agency of Original Jurisdiction (AOJ), the Board finds that there has been substantial compliance with the prior remand directives. Stegall v. West, 11 Vet. App. 268 (1998); D'Aries v. Peake, 22 Vet. App. 97 (2008); Dyment v. West, 13 Vet. App. 141 (1999). Entitlement to service connection for a left knee disability, to include as secondary to service-connected right knee and lumbar spine disabilities is remanded. In November 2014, December 2014, and February 2015 written statements, the Veteran claimed that service connection for a left knee disability is warranted because the disability is related an injury in service or is secondary to a service-connected right knee disability. In a February 2021 brief, the representative asserted that there is a link between a left knee disability and a service-connected back disability. The representative stated that pain and functional loss related to the back and right knee caused an altered gait and left knee instability resulting in the meniscus tear injury. The Board regrets the need to remand the matter. However, the Board is unable to adjudicate the Veteran’s case without additional information. No VA examiner has provided a opinion concerning the relationship of any current left knee disability to a service-connected back disability. VA's duty to assist includes, in appropriate cases, the duty to conduct a thorough and contemporaneous medical examination which is accurate and fully descriptive. McLendon v. Nicholson, 20 Vet. App. 79 (2006); Green v. Derwinski, 1 Vet. App. 121 (1991). The matters are REMANDED for the following action: 1. Obtain any VA treatment records not already associated with the claims file. 2. Ask the Veteran to identify any other knee treatment records and to authorize VA to obtain those records for association with the claims file. 3. Then, schedule the Veteran for examination to determine the nature and cause of any left knee disability. The examiner must review the record and should note that review in the report. The examiner should address the Veteran’s November 2014 and December 2014 written statements and the February 2021 appellate brief describing the left knee injury during service, the resulting pain, and a belief that the current disability is either directly related to a service injury or was caused or aggravated by service-connected right knee disability and lumbar spine disabilities and associated altered gait. The examiner must specifically consider and address the Veteran’s left knee symptoms and their onset, and the Veteran’s history of post-service left knee injuries including meniscal tears with associated worker’s compensation evaluation. A detailed rationale should be provided. a) Identify all current left knee disabilities, to include pain with associated functional impairment. b) Is it at least as likely as not (a 50 percent or better probability) that any left knee disability (to include pain with functional impairment) had its onset in or is otherwise related to the Veteran’s service? c) Is it at least as likely as not (a 50 percent or better probability) that any left knee disability (to include pain with functional impairment) was caused by service-connected lumbar spine and right knee disabilities, to include any altered gait associated with those disabilities? d) Is it at least as likely as not (a 50 percent or better probability) that any left knee disability (to include pain with functional impairment) has been aggravated (increased in severity beyond the natural progress of the disorder) by service-connected lumbar spine and right knee disabilities, to include any altered gait associated with those disabilities? Harvey P. Roberts Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board D. Duke, 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.