Citation Nr: 21015100 Decision Date: 03/16/21 Archive Date: 03/16/21 DOCKET NO. 16-11 390A DATE: March 16, 2021 REMANDED Entitlement to service connection for a bilateral ankle disorder, to include as secondary to service-connected bilateral knee disabilities, is remanded. REASONS FOR REMAND The Veteran served on active duty from March 1991 to August 1997. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a rating decision issued in June 2014 by a Department of Veterans Affairs (VA) Regional Office. Pursuant to the Veteran’s request, she was scheduled for a Board hearing before a Veterans Law Judge in August 2018. However, despite notice of the date and time of the hearing, she failed to report for it. 38 C.F.R. § 20.702(d). Thus, her request for a Board hearing is considered withdrawn. In September 2018, the Board remanded the Veteran’s claim for service connection for a bilateral ankle disorder for additional development and her claims for increased ratings for her bilateral knee for the issuance of a statement of the case. The former issue now returns for further appellate review; however, as the Veteran did not file a timely substantive appeal following the issuance of a statement of the case in October 2020, the latter issues are not properly before the Board. The Board notes that subsequent to the issuance of the supplemental statement of the case in August 2020, additional evidence, to include updated VA treatment records, have been associated with the file. The Veteran has not waived Agency of Original Jurisdiction (AOJ) consideration of such evidence. However, as her claim is being remanded, the AOJ will have an opportunity to consider such in the readjudication of her claim. Entitlement to service connection for a bilateral ankle disorder, to include as secondary to bilateral knee disabilities. In September 2018, the Board remanded the Veteran’s claim for service connection for a bilateral ankle disorder in order to afford her a VA examination so as to determine the current nature and etiology of such disorder. In this regard, the examiner was requested to note all current diagnoses of the bilateral ankle, and offer an opinion as to whether such were directly related to her military service or caused or aggravated by her service-connected bilateral knee disabilities. Thereafter, the Veteran was afforded a VA examination in August 2020, at which time she was diagnosed with bilateral ankle lateral collateral ligament sprain (chronic/recurrent) and history of right ankle fracture. However, the examiner opined that such disorder was less likely than not incurred in or caused by the claimed in-service injury, event, or illness, or caused or aggravated by her service-connected bilateral knee disabilities. While she adequately addressed direct service connection, the Board finds that an addendum opinion is necessary in regard to the secondary aspect of the Veteran’s claim. In this regard, the August 2020 VA examiner stated that the Veteran’s bilateral knee disabilities did not affect the ankles as arthritis in one joint does not cause arthritis in another. She further indicated that extensive research indicates that, unless gait is severely affected, one joint in the lower extremities does not cause another joint to be affected. The examiner explained that it was not unusual for two joints to share properties in the same person, but one joint’s disease does not “spread” to another or cause damage to it. However, the examiner did not address the Veteran’s contention that her bilateral ankles have been negatively impacted by the weakness and locking of her bilateral knees. Further, in such regard, she alleged that her right ankle fracture, which occurred in 2017, was as a result of a fall caused by her service-connected bilateral knee disabilities. Specifically, in an October 2017 VA treatment record, she reported that she fell on the porch after her left and right knees locked. Thus, a remand is necessary in order to obtain an addendum opinion addressing the secondary aspect of the Veteran’s claim in light of such contentions. The matters are REMANDED for the following action: Return the record to the VA examiner who provided the August 2020 opinion addressing the etiology of the Veteran’s bilateral ankle disorder. If she is not available, the record should be provided to an appropriate medical professional so as to render the requested opinion. Following a review of the record, the examiner should offer an opinion as to whether it is at least as likely as not (i.e., a 50 percent or greater probability) that the Veteran’s bilateral ankle disorder, currently diagnosed as bilateral ankle lateral collateral ligament sprain (chronic/recurrent) and history of right ankle fracture, was caused or aggravated by her service-connected bilateral knee disabilities. For any aggravation found, the examiner should state, to the best of their ability, the baseline of symptomatology and the amount, quantified if possible, of aggravation beyond the baseline symptomatology by the aggravation. In offering such opinion, the examiner should address the Veteran’s contention that her bilateral ankles have been negatively impacted by the weakness and locking of her bilateral knees, her allegation that her right ankle fracture, which occurred in 2017, was as a result of a fall caused by her service-connected bilateral knee disabilities, and the October 2017 VA treatment record wherein she reported that she fell on the porch after her left and right knees locked. A rationale for any opinion offered should be provided. A. JAEGER Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board K. Clark, 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.