Citation Nr: 21015304 Decision Date: 03/17/21 Archive Date: 03/17/21 DOCKET NO. 17-42 608 DATE: March 17, 2021 REMANDED Entitlement to service connection for left knee disability is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Air Force from October 1974 to October 1978. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a July 2015 rating decision by a Department of Veterans Affairs (VA) Regional Office (RO) in Houston, Texas. In January 2020, the Veteran testified before the undersigned Veterans Law Judge. A transcript of the hearing is associated with the claims file. In March 2020, the Board remanded the claim to obtain a new VA examination with opinions on direct and secondary service connection. Entitlement to service connection for left knee disability. The Veteran contends that his left knee disability is related to service. The Veteran underwent a VA examination in November 2020, which showed a diagnosis of left knee strain status-post arthroscopy. Regarding aggravation, the examiner opined the Veteran’s (claimed condition/diagnosis) is not at least as likely as not aggravated beyond its natural progression by the service-connected left ankle. The examiner stated that after performing physical exam and reviewing medical records, it is less likely as not that the Veteran’s current left knee condition was aggravated beyond its natural progression by the left ankle injury that occurred during service. The examiner stated that records did not show any evidence of chronic left knee pain or any longitudinal complaints of a left knee condition during active duty. Additionally, the examiner stated that there are no records of left knee complaints until 2015, 38 years later, when the Veteran mis-stepped and caused an injury to the knee. Thus, the examiner concluded, it is less likely as not that the current left knee would have aggravated beyond its natural progression without signs or symptoms of progressive and repetitive complaints during military service. Although cognizant that additional rationale was provided in a different area of the report, this additional rationale appears to address whether the left knee affected the left ankle; this is the opposite of the requested opinion. The matter is REMANDED for the following action: 1. Obtain updated VA treatment records. 2. Following a review of the record and copy of this remand, an examiner is asked to provide a supplemental opinion on secondary service connection as follows: Is it at least as likely as not that the Veteran’s left knee disability was caused by or aggravated beyond its natural progression by his service-connected bilateral ankle disability?   “Aggravated” means to cause any increase in severity that is beyond the normal progression of the disability. Nathaniel J. Doan Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board K. Wilson, 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.