Citation Nr: 21022691 Decision Date: 04/19/21 Archive Date: 04/19/21 DOCKET NO. 17-44 296 DATE: April 19, 2021 REMANDED Entitlement to service connection for a bilateral knee condition is remanded. REASONS FOR REMAND The Veteran had active service from July 2004 to February 2005, from December 2006 to February 2008 and from August 2009 to November 2010. The Veteran testified at an April 2021 Board hearing held before the undersigned via videoconference. 1. Entitlement to service connection for a bilateral knee condition is remanded. A remand is required for an adequate VA examination. The RO did not provide the Veteran with an examination. Such development is necessary if the information and evidence of record does not contain sufficient competent medical evidence to decide the claim, but (1) contains competent evidence of diagnosed disability or recurrent symptoms of disability, (2) establishes that the Veteran suffered an event, injury or disease in service, or has a presumptive disease during the pertinent presumptive period, and (3) indicates that the claimed disability may be associated with the in-service event, injury, or disease, or with another service-connected disability. 38 C.F.R. § 3.159(c)(4); McLendon v. Nicholson, 20 Vet. App. 79, 83-86 (2006) (noting that the third element establishes a low threshold and requires only that the evidence “indicates” that there “may” be a nexus between the current disability or symptoms and active service, including equivocal or non-specific medical evidence or credible lay evidence of continuity of symptomatology). Here, according to VA treatment records from February 2016, August 2016, and October 2016, the Veteran was diagnosed with patellofemoral pain syndrome, knee pain with patellar tilt and tendinosis, and patellar tendinitis. An MRI from June 2016 also indicated that the Veteran exhibited mild high riding of the patella with lateral tilt and subluxation along with moderate to severe superolateral Hoffa's fat pad consistent with patellar tendon lateral femoral condyle friction syndrome/patellar maltracking. Correspondence from the Veteran’s peer who was deployed in Afghanistan with her, indicated that the Veteran suffered from knee pain during deployment. He also attested to the rocky and difficult terrain in Afghanistan that likely contributed to the Veteran’s knee problems. A separate correspondence was submitted by another fellow soldier in which he described their physically demanding missions. He stated that he and the Veteran often carried heavy loads while walking long distances. He also described a specific mission in which the Veteran was forced to carry a 100-pound load and run 500 meters, resulting in back and knee problems. The soldier noted that the Veteran sought treatment for pain symptoms and was placed on modified duty. The Board finds that these competent and credible statements are sufficient to suggest that the Veteran’s current knee condition may be related to service. Because there is evidence of currently diagnosed disabilities, an in-service event, and an indication that the current disabilities may be associated with the in-service event, remand for a VA examination is required. The matters are REMANDED for the following action: 1. Obtain any outstanding VA and private treatment records. 2. Provide the Veteran with an appropriate examination to determine the etiology of her bilateral knee condition. An explanation for all opinions expressed must be provided. The examiner is asked to provide an opinion regarding whether it is at least as likely as not (50 percent or greater probability) that the bilateral knee condition had onset in, or is otherwise related to, active military service, to include as due to performing physically demanding duties on the rocky terrain in Afghanistan. The examiner is asked to specifically address the Veteran’s lay statements regarding knee pain and the correspondence submitted by the Veteran’s peers regarding in-service knee issues. The examiner must take the Veteran’s lay statements about service in Afghanistan as true. H.M. WALKER Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board AK 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.