Citation Nr: 21015642 Decision Date: 03/18/21 Archive Date: 03/18/21 DOCKET NO. 16-59 660 DATE: March 18, 2021 REMANDED Service connection for arthritis of the right knee.   REASONS FOR REMAND The Veteran served on active duty from February 1971 to April 1971. The case is on appeal from a July 2015 rating decision. In July 2020, the Veteran testified at a Board hearing. Service connection for arthritis of the right knee. The Veteran contends that his right knee disorder preexisted service and was aggravated by such. Alternatively, if his right knee condition is found to have not preexisted service, he asserts the disorder is directly related to service. The Veteran’s service treatment records (STRs) show that the February 1971 enlistment examination indicated the Veteran had right knee condition and underwent a 1969 surgery to remove cartilage from the right knee after a football injury. The February 1971 STR also noted the right knee was stable and had full range of motion. In the February 1971 report of medical history, the Veteran indicated he had been asymptomatic since his recovery after his right knee surgery. Thereafter, March 1971 records show the Veteran experienced right knee effusion which led to his separation from service shortly thereafter. A March 1971 STR indicated the Veteran reported a sore right knee and that his knee was “very bad.” The Veteran’s separation examination in March 1971 noted right knee effusion. He was placed on a temporary profile which recommended no marching standing or walking over 10 minutes without rest, as well as no running, jumping, crawling, bending, kneeling or lower extremity calisthenics. As noted, he was medically separated from service in April 1971 due to his right knee disability. Following the April 2015 claim, the Veteran submitted a May 2015 statement in which he reported the rigorous training required in service exacerbated his prior right knee injury. He stated this resulted in later surgeries to try to gain normal mobility with no success. The Veteran was afforded a June 2015 VA examination in which he was diagnosed with right knee degenerative arthritis. The Board notes he also underwent a prior total right knee replacement in 2000. The examiner opined the Veteran’s preexisting right knee disorder was not aggravated beyond its natural progression during service. She stated the Veteran’s current knee disorder is the natural progression of the preexisting knee injury from 1969 to 1970. The examiner indicated there is no evidence to support that the Veteran’s short time in service aggravated his right knee condition beyond its natural progression. She noted chronicity of a right knee condition is not supported from his 1971 separation until treatment in 2000 and any history of surgery is not related to a permanent aggravation of the knee condition during service. The Veteran was afforded a July 2020 Board hearing in which he testified that he had torn cartilage in his right knee in 1969, underwent surgery and had no further issues until his entry into service. The Veteran stated the activities required during basic training aggravated his knee, including repetitive marching and running. The Veteran reported continuing knee pain following his separation from service through the present. The Veteran’s representative stated he may have been sound upon his entry into service, as his entrance examination showed a stable right knee with full range of motion and no symptomatology. The Board finds the June 2015 VA opinion is not entirely sufficient to adjudicate the claim. The examiner did not fully discuss the Veteran’s STRs which showed in-service right knee problems for the Veteran and led to his early separation from service. The Board finds that an additional opinion is warranted to address the pre-existing right knee condition. Additionally, the theory of direct service connection for any non-pre-existing condition should be addressed. The matters are REMANDED for the following action: Schedule the Veteran for a VA examination (or telehealth interview, records review, etc., if an in-person examination is not feasible) by an orthopedist to determine the nature and etiology of any right knee disorder. The examiner should address the following: (a) Identify the Veteran’s current right knee condition(s). (b) For the right knee condition noted at entrance, provide an opinion as to whether: (i) it is at least as likely as not that the pre-existing right knee condition increased in severity during service (beyond any temporary flare-up. (ii) if so, whether it is medically undebatable that any increase in severity was due to the natural progress of the disease. (c) Regardless of the above, is it at least as likely as not (50 percent probability or greater) that any right knee condition that was not pre-existing, had its onset during, or is otherwise related to, service? The examiner should address the Veteran’s pre-service right knee surgery in 1969, along with the STRs which show right knee complaints and treatment leading to the Veteran’s separation from service. A complete rationale or explanation should be provided for any opinion reached. RYAN T. KESSEL Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board B. Isaacs, 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.