Citation Nr: 21022170 Decision Date: 04/14/21 Archive Date: 04/14/21 DOCKET NO. 15-44 693 DATE: April 14, 2021 REMANDED Entitlement to service connection for a bilateral knee disorder is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Air Force from April 1975 to December 1982. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from an August 1983 rating decision issued by a Department of Veterans Affairs Regional Office (RO). The August 1983 rating decision initially denied the Veteran’s claim for lack of a current disability. The Veteran did not perfect an appeal of the RO’s decision and the decision became final. Subsequently, the Veteran submitted new and material evidence, namely a 2011 diagnosis for degenerative joint disease and a 2012 diagnosis for a left knee medial meniscus tear. In February 2019, the Board granted the Veteran’s petition to reopen a claim for service connection for a bilateral knee disorder and remanded the reopened claim for a new VA examination. The case now returns to the Board. Entitlement to service connection for bilateral knee disorder is remanded. The Veteran contends that his bilateral knee disorder is related to his service. Specifically, he contends that his current bilateral knee disorder is the result of an injury sustained in service while carrying a heavy object up a flight of stairs. Pursuant to the Board’s February 2019 remand, the Veteran was then afforded another VA examination in January 2020. The January 2020 examiner clarified the Veteran’s current knee-related diagnoses and opined that it less likely than not that the Veteran’s bilateral knee disorders were incurred in or caused by the Veteran’s active military service. The examiner opined that the Veteran’s service treatment records did not document any chronic and ongoing knee issues incurred in or caused by the Veteran’s active military service that would serve as a nexus for service connection for his current claimed bilateral knee disorders and that his medical records do not support that any currently diagnosed condition related to the Veteran’s claimed bilateral knee disorders. The examiner acknowledged the Veteran’s multiple complaints of knee pain while in service and his in-service diagnosis of chondromalacia. However, the examiner explained that the Veteran’s knee issues in service were not chronic and were not related to any of the Veteran’s post-service complaints and treatments for knee pain. Regrettably, the Board finds the January 2020 examination to be inadequate as well and thus finds that another remand is necessary. The January 2020 opinion provided a negative nexus opinion and stated that the in-service knee complaints were acute and transitory. However, this opinion did not discuss the specific in-service complaints of knee pain and in-service diagnosis of chondromalacia as directed by the Board. This opinion is inadequate and as such, a remand is warranted to provide the Veteran with an adequate addendum opinion that discusses the Veteran’s in-service complaints of knee pain and in-service diagnosis of chondromalacia. The matters are REMANDED for the following action: 1. The Veteran should be given the opportunity to identify any outstanding private or VA treatment records relevant to the claim on appeal. After obtaining any necessary authorization from the Veteran, all outstanding records should be obtained, to include updated VA treatment records. For private treatment records, make at least two (2) attempts to obtain records from any identified sources. If any such records are unavailable, inform the Veteran and his representative and afford him an opportunity to submit any copies in their possession. For federal records, all reasonable attempts should be made to obtain such records. If any records cannot be obtained after reasonable efforts have been made, issue a formal determination that such records do not exist or that further efforts to obtain such records would be futile, which should be documented in the claims file. The Veteran must be notified of the attempts made and why further attempts would be futile, and allowed the opportunity to provide such records, as provided in 38 U.S.C. § 5103A(b)(2) and 38 C.F.R. § 3.159(e). 2. Following the receipt of outstanding records, obtain an addendum opinion as to the etiology of the Veteran’s left and right knee disorder. The examiner must specify in the report that these records have been reviewed. The examiner is to provide a detailed review of the Veteran's pertinent medical history, current complaints, and the nature and etiology of any diagnosed left and right knee disorders. The need for further in-person examination is left to the discretion of the examiner. The examiner should respond to the following: For each and every knee disorder diagnosed, is it at least as likely as not (50 percent or greater) that the disorder is related to the Veteran's active military service? The examiner should specifically address the Veteran's assertions that he injured his knees when he experienced an accident carrying a pool table up a flight of stairs and that he has had worsening knee pain and problems ever since. Specifically discuss the Veteran's multiple complaints of knee pain in service and in-service diagnosis of chondromalacia and all post-service complaints and treatments for knee pain. The examiner should specifically address the impact, if any, of the Veteran’s reported fall down the stairs in 2011 or 2012 as noted in an August 2016 VA treatment note. A complete and fully explanatory rationale must be provided for any opinion offered. If any opinion cannot be rendered without resorting to speculation, the examiner must state whether the need to speculate is caused by a deficiency in the state of general medical knowledge, i.e., no one could respond given medical science and the known facts, or by a deficiency in the record or the examiner, i.e., additional facts are required, or the examiner does not have the needed knowledge or training. KRISTY L. ZADORA Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Kashif I. Ali, 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.