Citation Nr: 21021637 Decision Date: 04/13/21 Archive Date: 04/13/21 DOCKET NO. 16-32 708 DATE: April 13, 2021 REMANDED Service connection for a right knee disability is remanded. REASONS FOR REMAND The Veteran served on active duty from January 1974 to August 1977 in the U.S. Air Force. This matter comes before the Board of Veterans’ Appeals (Board) from a September 2013 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO). The Veteran testified before the undersigned Veterans Law Judge at a Board hearing in June 2019; a copy of the hearing transcript is of record. This matter was previously before the Board in November 2020, at which time the issue on appeal was remanded to obtain an addendum opinion. An opinion was obtained in December 2020; however, the Board finds that the opinion is inadequate for adjudication purposes. Although further delay is regrettable, the Board finds that remand is warranted to obtain an adequate VA opinion. Specifically, the December 2020 opinion only considered the Veteran’s right knee chondromalacia rather than all diagnosed disabilities throughout the appeal period, including degenerative joint disease, meniscal tear, and instability. Additionally, the opinion is speculative and does not adequately consider the Veteran’s contentions, including that he has had right knee pain since his in-service motorcycle accident and that his right knee disability is related to using a cast following his in-service motorcycle accident. Accordingly, remand is necessary to obtain an addendum opinion. The matter is REMANDED for the following action: Obtain an addendum opinion from an appropriate physician (in orthopedics), if possible one who has not previously seen the Veteran, to determine the nature and etiology of his right knee disability, to include degenerative joint disease, chondromalacia, meniscal tear, and instability. The claims file must be made available to the physician and review should be noted. If an examination is deemed necessary to respond to the questions presented, one should be scheduled. After complete review of the claims file, the physician should identify all diagnoses related to the Veteran’s claimed right knee disability throughout the appeal period. For each diagnosis, the physician should opine as to the following: (a.) Whether it is at least as likely as not (50 percent or greater probability) that the Veteran’s right knee disability had its onset during active service or is otherwise etiologically related to any in-service injury, event, or disease. (b.) Whether it is at least as likely as not (50 percent or greater probability) that the Veteran’s right knee disability is (1) proximately due to or (2) aggravated by his service-connected residuals of compound fracture of the right midfoot and residuals of right tibia fracture. In so opining, the physician should note that the Veteran’s December 1973 enlistment examination was normal and his subsequent service treatment records (STRs) specifically indicate that no knee problem existed prior to service. The physician should specifically consider the following evidence: • STRs documenting right knee pain, diagnosed as chondromalacia, and assignment to medical hold for one week in January and February 1974; • STRs documenting a right leg injury resulting from a motorcycle accident in 1975. In this regard, the physician should consider the Veteran’s contentions set forth in the December 2013 no, July 2016 Form 9, and June 2019 Hearing Transcript, including that his current right knee disability is related to the accident and wearing a cast on his leg for five months; • The Veteran’s testimony that his right knee pain has continued since the in-service motorcycle accident and that he self-treated his knee pain with over the counter medication; and • An x-ray in 2003 showing early degenerative joint disease. The physician must consider the Veteran’s medical history and lay statements. The physician is advised that an opinion based solely on lack of documentation since service is not sufficient and that the Veteran’s assertion of continuity of symptoms since service must be addressed in the opinion. The physician should not consider the previous opinions as evidence. The Board has specifically found those opinions inadequate. A complete rationale must be provided for all opinions offered. JOHN Z. JONES Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board T. Kernen, 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.