Citation Nr: 21026125 Decision Date: 04/29/21 Archive Date: 04/29/21 DOCKET NO. 15-10 444 DATE: April 29, 2021 REMANDED Entitlement to service connection for a lumbar spine disability is remanded. Entitlement to service connection for a left knee disability is remanded. REASONS FOR REMAND The Veteran served on active duty from May 1956 to May 1959. This matter comes to the Board of Veterans’ Appeals (Board) on appeal from a September 2013 rating decision by the Regional Office (RO) of the Department of Veterans Affairs (VA). The Veteran died in April 2015 during the pendency of the appeal. In April 2016 the RO determined that the Veteran’s surviving spouse is an eligible substitute claimant. This case was previously before the Board in June 2018 and May 2020, on which occasions the claims were remanded. 1. Entitlement to service connection for a lumbar spine disability is remanded. 2. Entitlement to service connection for a left knee disability is remanded. Upon review of the claims file, the Board has determined that further development is necessary before the Veteran’s claim can be adjudicated. 38 U.S.C. § 5103A; 38 C.F.R. § 3.159. In November 2019 the VA obtained addendum opinions regarding whether the Veteran’s current lumbar spine and left knee disabilities are related to service, wherein a VA examiner opined that his disabilities were less likely than not related to service. In rendering a decision, the examiner noted the Veteran’s reports of back and knee injuries in May 1957 while serving at Osan Air Force Base. However, the examiner concluded that the Veteran’s musculoskeletal disabilities were not related to service primarily because there is “very limited information regarding continuous record of consult, evaluation or treatment . . .” for his disabilities. (11/1/2019, C&P Exam, p. 2). The Board finds that the November 2019 opinion is inadequate for evaluation purposes. While the examiner did acknowledge the Veteran’s lay reports of chronic musculoskeletal disabilities following his claimed in-service injury, the examiner erroneously dismissed these reports due to a lack of contemporaneous medical evidence. VA must give “due consideration” to “all pertinent medical and lay evidence” in evaluating a claim for disability.  Davidson v. Shinseki, 581 F.3d 1313, 1316 (Fed. Cir. 2009).  Nothing in the regulatory or statutory provisions require both medical and competent lay evidence.  Indeed, competent lay evidence can be sufficient in and of itself to substantiate a disability claim.  See Buchanan v. Nicholson, 451 F.3d 1331, 1335 (Fed. Cir. 2006). Here, the Veteran reported that he had “major problems with [his] back and knees . . .” following an in-service accident. The Veteran is competent to report the claimed in-service accident and continuation of his symptoms following the accident, as he has firsthand knowledge of these facts. While the November 2019 examiner was correct in noting that there was a lack of contemporaneous medical evidence of treatment for the claimed disabilities following service, the examiner erred in dismissing the Veteran’s competent lay reports without further rationale, particularly given that the Veteran’s service records were destroyed in a fire. As the November 2019 examiner failed to consider the Veteran’s competent lay evidence, the opinion is inadequate. Therefore, the claims must be remanded for addendum opinions. The matters are REMANDED for the following action: 1. Obtain an addendum opinion from an appropriate clinician regarding whether the Veteran’s lumbar spine disability is at least as likely as not related to service, to include being knocked over a large wooden table after being electrocuted while working with electronic equipment. (7/7/2014, NOD, p. 1). In providing the requested opinion, consider the Veteran’s description of his in-service injury and symptoms as well as his post-service symptoms. If there is any medical reason to accept or reject the proposition that the Veteran had his reported injury and symptoms in service and thereafter represented the onset of his current disability, this should be noted. Stated another way, do the Veteran’s reports about his symptoms align with how the currently diagnosed disability is known to develop or are the Veteran’s reports generally inconsistent with medical knowledge or implausible? If it is not possible to provide an opinion without speculation, the examiner must 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), a deficiency in the record (additional facts are required), or the examiner (does not have the knowledge or training). 2. Obtain an addendum opinion from an appropriate clinician regarding whether the Veteran’s left knee disability is at least as likely as not related to service, to include being knocked over a large wooden table after being electrocuted while working with electronic equipment. (7/7/2014, NOD, p. 1). In providing the requested opinion, consider the Veteran’s description of his in-service injury and symptoms as well as his post-service symptoms. If there is any medical reason to accept or reject the proposition that the Veteran had his reported injury and symptoms in service and thereafter represented the onset of his current disability, this should be noted. Stated another way, do the Veteran’s reports about his symptoms align with how the currently diagnosed disability is known to develop or are the Veteran’s reports generally inconsistent with medical knowledge or implausible? (Continued on the next page)   If it is not possible to provide an opinion without speculation, the examiner must 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), a deficiency in the record (additional facts are required), or the examiner (does not have the knowledge or training). Marissa Caylor Acting Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board R. Glenn, 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.