Citation Nr: 21024772 Decision Date: 04/26/21 Archive Date: 04/26/21 DOCKET NO. 20-25 511A DATE: April 26, 2021 REMANDED Entitlement to a right knee condition, to include a total knee replacement, is remanded. REASONS FOR REMAND The Veteran served in the U.S. Navy, on active duty from April 1962 to April 1966. This claim comes before the Board of Veterans’ Appeals (Board) from a September 2018 rating decision issued by a Department of Veterans Affairs (VA) Regional Office (RO) denying service connection for the Veteran’s right knee condition. The undersigned Veterans Law Judge presided over a Board hearing in April 2021. A transcript of the hearing is of record. Entitlement to service connection for a right knee condition, to include a total knee replacement, is remanded The Veteran seeks service connection for a right knee condition, to include a total knee replacement. Specifically, he asserts that he injured his right knee in December 1962 while ice skating on leave during active duty service. The Veteran’s March 1962 enlistment exam list his joints and musculoskeletal system as “normal”. An October 1963 treatment note reflects his right knee injury as occurring two years prior – before service. A subsequent treatment note from September 1964 lists the Veteran as reporting he suffered from right knee pain for “four” years, also indicating its onset prior to service. However, during his April 2021 hearing, he testified that his September 1964 statement was misinterpreted, that he meant he had suffered from right knee pain “for years” instead of “four years”. The evidence of record contains an April 1966 letter that reinforces the Veteran’s assertion. In this letter just prior to separating from the Navy, he writes that he has “a bad leg. I hurt it ice skating and for [four] years now they haven’t found out what’s wrong.” The Veteran underwent a VA examination in August 2018. The examiner diagnosed him with right knee degenerative arthritis, while noting mild weakness and gait imbalance as residuals of his total right knee replacement. After reviewing the claims file and examining the Veteran, the examiner was asked whether the Veteran’s right knee condition, “which clearly and unmistakably existed prior to service,” was aggravated beyond its natural progression by service. To which the examiner responded that it was less likely than not. However, there is not clear and unmistakable evidence that his right knee condition predated service. As a general rule, a veteran is presumed to have ben sound upon entry into the military, except as to conditions noted at the time of acceptance, examination, or enrollment, or where clear and unmistakable evidence demonstrates that the condition existed before acceptance and enrollment, and was not aggravated by such service. 38 U.S.C. § 1111; Wagner v. Principi, 370 F.3d 1089, 1096 (Fed. Cir. 2004). In this case, no right knee problems were noted on the Veteran’s military induction examination, and it is reasonable to presume that this type would have been noted if present. Moreover, the Veteran has submitted a letter contemporary to service, in which he discusses his right knee injury occurring in 1962. Finally, he has testified that the injury referenced in his service treatment records occurred during active service. Consequently, the Veteran is entitled to the presumption of soundness. As a result, the VA examiner was not asked the correct question. Rather, the examiner should be asked whether the Veteran’s current right knee condition is at least as likely as not etiologically related to his complaints of right knee pain during service. For purposes of this question, the examiner must assume that the Veteran’s right knee was sound when he entered service. Therefore, the Board will remand this claim for an addendum opinion to answer the proper question. The matters are REMANDED for the following action: 1. Obtain an addendum opinion from an appropriate clinician regarding whether the Veteran’s right knee condition is at least as likely as not related to service. The examiner should assume that the Veteran’s health was sound upon entrance into service. 2. The RO should undertake any other development deemed necessary in order to readjudicate the Veteran’s right knee condition. If the claim on appeal is denied, the RO should return this claim to the Board for further appellate review. B.T. KNOPE Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board T. McDonald