Citation Nr: 21022465 Decision Date: 04/15/21 Archive Date: 04/15/21 DOCKET NO. 08-33 855A DATE: April 15, 2021 REMANDED Entitlement to service connection for a left knee disorder, to include as secondary to the service-connected right knee disability, is remanded. Entitlement to a total rating based on individual employability due to service-connected disabilities (TDIU) prior to August 16, 2016, is remanded. REASONS FOR REMAND The Veteran had active military service from November 1988 to June 1991. This matter is on appeal from a July 2007 rating decision and was previously remanded by the Board of Veterans’ Appeals (Board) in April 2013 and April 2016. The Board also remanded the issue of service connection for epilepsy, which was granted in a June 2017 rating decision. Thus, the issue is no longer on appeal. Additionally, a June 2020 rating decision granted TDIU effective August 15, 2016. As this does not constitute a full grant of the claim, the issue of entitlement to TDIU prior to August 15, 2016, remains on appeal. 1. Entitlement to service connection for a left knee disorder The Board cannot make a fully-informed decision on the issue of service connection for a left knee disorder because no VA examiner has provided an opinion addressing the Veteran’s reports of ongoing pain since service. The Veteran was provided a VA examination in May 2017; a negative nexus opinion was provided. The rationale is that there is no medical evidence to support the left knee condition being sustained in service, and that the claims file had no evaluation for the left knee. However, the Veteran’s June 1991 separation examination shows that he reported his knees were painful when jogging, and the Veteran has consistently reported having bilateral knee pain since service. See, e.g., August 1999 and March 2001 VA examinations. Further, the absence of evidence is not a sufficient rationale for a negative nexus opinion. Remand is necessary for an addendum opinion addressing his assertions. 2. Entitlement to TDIU prior to August 16, 2016 As noted above, the Board is remanding the issue of service connection for a left knee disorder. The claim for TDIU must also be remanded since it could be affected by the outcome of his service connection claim. The matters are REMANDED for the following action: 1. In accordance with the provisions of 38 C.F.R. § 3.159(c)(1), make efforts to obtain all records identified by the Veteran, including any outstanding VA treatment records. 2. Obtain an addendum medical opinion from the May 2017 VA knee and lower leg conditions examiner (or, if unavailable, from a medical professional with appropriate expertise) to determine the etiology of the diagnosed left knee strain. The examiner is requested to review the record and offer an opinion as to whether it is at least as likely as not (i.e., probability of approximately 50 percent) that the diagnosed left knee strain is related to the Veteran’s military service. The examiner must consider the Veteran’s June 1991 separation examination showing a report of bilateral knee pain; the August 1999 and March 2001 VA examinations with diagnoses of patellofemoral syndrome and retropatellar pain syndrome, respectively; and the Veteran's reports of left knee pain since service. The examiner is reminded that the absence of evidence is not a sufficient rationale for a negative nexus opinion. A complete rationale should be given for all opinions and conclusions expressed. K. Anderson Acting Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board L. Barstow, 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.