Citation Nr: 21020963 Decision Date: 04/08/21 Archive Date: 04/08/21 DOCKET NO. 15-31 726 DATE: April 8, 2021 REMANDED Entitlement to service connection for a right knee disorder is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Air Force from May 1992 to September 1995. This matter originally came before the Board of Veterans’ Appeals (Board) on appeal from an August 2014 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO) in San Diego, California. The Veteran was notified of her right to a personal hearing before the Board, but the Veteran declined. The matter was most recently before the Board in April 2019. The Board finds that there has not been substantial compliance with the Board’s previous remand directives and another remand is necessary. Stegall v. West, 11 Vet. App. 268 (1998) (holding that a Court or Board remand confers upon the appellant the right to compliance with that order). 1. Entitlement to service connection for a right knee condition, is remanded. The Veteran contends that service connection is warranted for her right knee condition because it was caused when she served on active duty in the United States Air Force. After observing that the Veteran had a current diagnosis of a right knee condition, the Board previously remanded this issue to afford the Veteran a VA examination. A VA examination was conducted post-remand in October 2019. The examiner opined that the Veteran’s claimed condition was less likely than not due to grueling physical fitness regime on active duty and provided a rationale that there is no evidence in the medical records, that the claimant’s physical fitness tests were beyond the regular, as the service treatment records (STRs) are silent about complaints of musculoskeletal complaints that would undoubtedly exist if the exercise was extremely strenuous. However, the examination is inadequate as the examiner failed to consider a July 2015 private opinion from Dr. R.E. and based the rationale for the negative opinion specifically on the lack of STRs, and not the entire evidence of record, including the Veteran’s lay statements and contentions, which are not specifically noted within the opinion provided. Furthermore, in May 2020, the Veteran submitted additional evidence in the form of article citations to support her contention that physical activity during military training generally causes osteoarthritis, and that it also caused her right knee condition. Thus, an addendum opinion is needed to consider the additional evidence upon remand. Where VA provides the Veteran with an examination in a service connection claim, the examination must be adequate. Barr v. Nicholson, 21 Vet. App. 303, 311 (2007). Accordingly, the matter is REMANDED for the following action: 1. Obtain an addendum opinion from an appropriate clinician regarding the Veteran’s claimed right knee condition. The examiner must review the entire claims file, including the Veteran’s lay statements and contentions, the July 2015 private opinion by Dr. R.E., the articles cited by the Veteran in the May 2020 Correspondence, and a copy of this Remand. The examiner is asked to provide a response to the following: a. Is the Veteran’s right knee disability at least as likely as not related to service, including physical training during active duty? b. Is it at least as likely as not that the Veteran’s right knee osteoarthritis (1) began during active service, (2) manifested within one after discharge from service, or (3) was noted during service with continuity of the same symptomatology since service? Provide a rationale to support the opinion(s). In providing the requested opinion, consider the Veteran’s description of her claimed in-service injury and symptoms as well as her post-service symptoms. If there is any medical reason to accept or reject the proposition that the Veteran’s reported injury and symptoms in service and thereafter represented the onset of her current disability, this should be noted. Stated another way, do the Veteran’s reports about her symptoms align with how the currently diagnosed disability is known to develop or are the Veteran’s reports generally inconsistent with medical knowledge or implausible? 2. The RO must ensure the required actions have been accomplished (to the extent possible) in compliance with this Remand. If any action is not undertaken, or is taken in a deficient manner, corrective action must be undertaken prior to readjudication, before the claims file is returned to the Board. See Stegall, supra. 3. Readjudicate the Veteran’s claim, with application of all appropriate laws, regulations, and case law, and consideration of any additional information obtained as a result of this remand. If the decision remains adverse to the Veteran, she and her representative should be furnished a supplemental statement of the case (SSOC) and afforded an appropriate period of time within which to respond thereto. KRISTI L. GUNN Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board S. Khan, 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.