Citation Nr: 21021790 Decision Date: 04/14/21 Archive Date: 04/14/21 DOCKET NO. 19-05 991A DATE: April 14, 2021 REMANDED Entitlement to service connection for a bilateral knee disability is remanded. REASONS FOR REMAND The Veteran served on active duty from July 1969 to July 1973. This matter came before the Board of Veterans Appeals (Board) on appeal from a June 2016 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO). The Veteran testified before the undersigned Veteran’s Law Judge during an April 2021 hearing. Entitlement to service connection for a bilateral knee disability The Veteran contends that his bilateral knee disability is due to his work as an aircraft crewmember while in service, or that it is caused or aggravated by his service-connected right foot disability. A January 2019 VA examination diagnosed bilateral knee osteoarthritis but found that it was not due to service. As a rationale, the examiner stated that jumping off airplane wings would cause either an acute injury or no injury, there was no evidence of knee complaints in service, and that since the Veteran was never seen for his knees a significant knee injury was eliminated. However, the Board notes that March 1971 service treatment records contain a medical examination which found mild genu varus, or outward bowing at the knee. The Board notes that the examination is marked as an entrance examination but actually occurred nearly 2 years after the Veteran entered service. The January 2019 examination is silent for consideration of this in-service knee diagnosis. In addition, the opinion did not address whether the Veteran’s knee diagnosis was caused or aggravated by his service-connected right ankle disability. At the April 2021 Board hearing, the Veteran reported that he favored his injured right ankle when jumping off airplanes in service, trying to land on the left foot. Remand for a new examination is therefore required to address both the Veteran’s in-service knee diagnosis and the question of secondary service connection. In addition, at the January 2019 hearing, the Veteran’s representative raised the question of whether the Veteran’s in-service diagnosis of genu varus constituted a congenital deformity that was aggravated by service. This should therefore also be addressed upon remand. The matters are REMANDED for the following action: 1. Schedule the Veteran for an appropriate VA examination, to determine the etiology of any current bilateral knee disability. The examiner should review the file and provide a complete rationale for all opinions expressed. The following opinions are requested: a) With regards to the March 1971 diagnosis of genu varus, please address whether this constituted a congenital deformity and explain why or why not. If it is found to be a congenital deformity, please indicate whether it was likely aggravated by service. b) For any current bilateral knee disability found to be diagnosed, the examiner should provide an opinion as to whether it is at least as likely as not (50 percent or greater probability) that any such disability is related to the Veteran’s active service, to include his duties as an aircraft crewperson such as regularly jumping off of airplanes, or whether it was caused or aggravated by his service-connected right ankle disability. In providing the opinion, the examiner should consider and discuss any lay statements of record, to include the Veteran’s statements regarding the onset and persistence of his symptoms. The examiner is advised that competent lay statements should not be disregarded merely because they are unaccompanied by contemporaneous medical evidence. 2. If upon completion of the above action the appeal remains denied, the case should be returned to the Board after compliance with appellate procedures. E. I. VELEZ Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board A. Arnold 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.