Citation Nr: 21015121 Decision Date: 03/16/21 Archive Date: 03/16/21 DOCKET NO. 14-08 228 DATE: March 16, 2021 REMANDED The claim of entitlement to service connection for a right knee disability is remanded. The claim of entitlement to service connection for a back disability is remanded. The claim of entitlement to a total disability rating due to individual unemployability (TDIU) is remanded. REASONS FOR REMAND The Veteran served on active duty from June 1976 to June 1979. This appeal is from an August 2011 rating decision. In August 2017, the Board denied these claims. The Veteran appealed to the U.S. Court of Appeals for Veterans Claims, which vacated the Board’s decision in August 2019, as discussed in more detail below. 1. The claim of entitlement to service connection for a right knee disability is remanded. In an August 2019 memorandum decision, the Court found the Board relied on an inadequate VA examination report. The November 2015 VA examiner did not adequately discuss the Veteran’s medical history. Specifically, a November 1984 medical record shows the Veteran had a two-year history of “periodic anterolateral knee discomfort and swelling after athletic activities,” which was not adequately discussed by the VA examiner, who instead indicated that the Veteran’s 1984 work injury was the cause of his current disability. The Board notes that, although one injury may be a likely cause of a disability, simply stating that fact without consideration of the in-service injury is insufficient to deny service connection. The Board notes that the Veteran was given a VA examination in May 2018 that addressed whether the right knee was related to the Veteran’s service-connected left ankle. That examiner appears to have relied extensively on the November 2015 VA examiner’s opinion. Accordingly, an updated opinion on secondary service connection should also be obtained. 2. The claim of entitlement to service connection for a back disability is remanded. 3. The claim of entitlement to a total disability rating due to individual unemployability (TDIU) is remanded. These claims are inextricably intertwined with the claim for service connection for the right knee. The Veteran asserts his back is related to his knee, which has been found by a VA examiner. Accordingly, determination of whether his knee is related to service is essential. As far as the claim for TDIU, the outcome of his service connection claims will likely have an impact on eligibility. The matters are REMANDED for the following action: 1. Obtain updated VA treatment records. 2. After the completion of directive 1, forward the claims file to an appropriate examiner for a report on whether it is as likely as not (50/50 probability or greater) that any right knee disability is related to service. The Veteran asserts that he fell off a tank hatch and injured his right knee during service. He has also asserted it is related to his service-connected left ankle. The examiner is asked to elicit from the Veteran a detailed history of his symptoms in and since service. In regard to direct service connection, the examiner is directed to a November 1984 medical treatment record that indicated the Veteran had, at that point, a two-year history “periodic anterolateral knee discomfort and swelling after athletic activities,” which the Veteran asserts is from a fall during service. He reports that he complained of his right knee at separation and that he has had persistent symptoms since then. In regard to secondary service connection, the examiner is asked whether the Veteran’s left ankle caused or aggravated any right knee disability. The examiner is advised that “aggravation” means to cause any increase in severity that is beyond the normal progression of the disability and it need not be permanent in nature.   The examiner is advised that attributing any current disability to another injury without discussion of the in-service injury (or service-connected disability) is not dispositive of the request. All opinions must be supported with explanation. Nathaniel J. Doan Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board A. Gibson 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.