Citation Nr: 21022306 Decision Date: 04/15/21 Archive Date: 04/15/21 DOCKET NO. 15-15 206 DATE: April 15, 2021 REMANDED Entitlement to service connection for a left knee disability, including psoriatic arthritis and joint deterioration, is remanded. REASONS FOR REMAND The Veteran had active duty service from July 1979 to July 1982. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a March 2014 rating decision issued by a Department of Veterans Affairs (VA) Regional Office (RO), which, in relevant part, continued the previous denial of service connection for psoriatic arthritis and joint deterioration of the left knee. The Veteran testified before the undersigned Veterans Law Judge (VLJ) at a hearing in October 2016. A copy of the transcript has been reviewed and associated with the claims file. In a September 2018 decision, the Board reopened and denied the claim of service connection for a left knee disability. The Veteran appealed and the US Court of Appeals for Veterans Claims (CAVC) issued a decision in December 2019, which vacated the Board’s denial and remanded the issue. Entitlement to service connection for a left knee disability, including psoriatic arthritis and joint deterioration, is remanded. Throughout the rating period on appeal, the Veteran has been diagnosed with a left knee strain and psoriatic arthritis. X-rays of the left knee in January 2015 revealed degenerative spurring, which was found to be consistent with psoriatic arthritis. November 2019 x-rays of the left knee were interpreted as revealing mild tricompartmental degenerative changes and suspected old injury/avulsion and/or degenerative sequelae adjacent to the right patella. The Veteran asserts that he injured his left knee in service when he ran into a pole during training. His service-treatment records reveal that he injured his left knee in March 1981 and was assessed with a twisted left knee and medial collateral ligament strain versus other soft tissue injury. Pursuant to the Board’s remand instructions, a VA examination was performed in November 2020 and an addendum opinion was issued in December 2020. The examiner assessed the Veteran with a left knee strain and concluded that it was not related to service. The examiner reasoned that the 2014 x-rays of his left knee were normal. After a review of the evidence, the Board finds that the November 2020 examination and December 2020 addendum report are insufficient to determine the present claim. In this regard, the examiner failed to review the June 2015 x-rays of the left knee or the updated November 2019 x-rays of the left knee, which revealed degenerative changes and suspected old injury. Moreover, the examiner did not perform any diagnostic testing and only referenced x-rays performed in 2014. Lastly, the examiner failed to acknowledge or discuss the Veteran’s in- service left knee injury. Accordingly, the Board finds that a new VA examination is warranted on remand. The matters are REMANDED for the following actions: 1. Obtain and associate with the claims file the Veteran’s updated VA treatment records from October 2020 to the present. 2. After completion of #1, schedule the Veteran for a VA examination, by an examiner who has not previously provided an opinion in this matter, to determine the nature and etiology of any left knee disability. The claims file, including a copy of this remand, should be reviewed and such review should be noted in the examination report. The examiner should identify any left knee disability found on examination and/or identified during the pendency of this claim, including psoriatic arthritis, left knee strain, and degenerative changes. For each diagnosed left knee disability, respond to the following: Is it at least as likely as not (probability of at least 50 percent) that the Veteran’s left knee disability had its onset in and/or is otherwise etiologically related to his period of active service? The examiner should provide a comprehensive rationale for each opinion provided. The examiner should discuss the Veteran’s assertions contained throughout the claims file, including his April 2008 statement and October 2016 hearing testimony, his left knee complaints contained in his service-treatment records, and the November 2019 x-rays noting tricompartmental degenerative changes and suspected old injury. The examiner is advised that the Veteran is competent to report his symptoms and history and such reports are to be considered in formulating any opinion. If any opinion cannot be given without resorting to speculation, the examiner should explain why and state whether the need to speculate is due to a deficiency in the state of general medical knowledge (no one could respond given medical science and the known facts), the record (additional facts are required), or the examiner does not have the knowledge or training.  As appropriate, the AOJ should conduct additional development or supplement the record. Eric S. Leboff Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board S. (Hurley) Merrick 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.