Citation Nr: 21026288 Decision Date: 04/30/21 Archive Date: 04/30/21 DOCKET NO. 19-03 031 DATE: April 30, 2021 REMANDED Entitlement to service connection for left knee osteoarthritis as secondary to a service-connected right knee disability is remanded. REASONS FOR REMAND The Veteran served on active duty in the U.S. Army from February 1966 to June 1968. This matter comes before the Board of Veteran’s Appeals (Board) on appeal from an October 2014 rating decision by a Department of Veterans Affairs (VA) Regional Office (RO). Entitlement to service connection for left knee osteoarthritis as secondary to a service-connected right knee disability The Veteran asserts he has left knee osteoarthritis that was caused or aggravated by his service-connected right knee disability. The Veteran is presently service-connected for right knee Osgood-Schlatter disease with osteoarthritis. At the August 2018 RO hearing, the Veteran testified that after service, he was self-employed for many years in a job that required carrying heavy boxes upstairs, and that he favored his service-connected right knee by stepping up with his left leg. He attributes his left knee osteoarthritis to years of favoring his right knee. See Hearing testimony, August 2018 at p.4, 9-10; see also Form 9, January 2019. The claims file includes VA treatment records dating back to October 2001. An October 2001 VA treatment record shows the Veteran complained of bilateral knee pain. X-rays revealed mild bilateral knee osteoarthritis. See Records, received March 2003 at p.1 and 9. More recently, a November 2018 VA treatment record shows x-rays revealed bilateral moderate to severe tricompartmental osteoarthritis, worse on the right. See CAPRI, received May 2019 at p.5 of 89. An October 2014 VA examination report shows the examiner diagnosed bilateral knee osteoarthritis and opined the left knee osteoarthritis it is less likely than not caused by the right knee. The examiner reasoned that the usual and customary factors that are present and predispose an individual to osteoarthritis are genetics and aging, and that the Veteran has documented osteoarthritis in multiple sites, including non-weight bearing joints. The examiner did not, however, elaborate regarding the cited genetics or the multiple sites of osteoarthritis, nor did the examiner address whether the Veteran’s left knee osteoarthritis was aggravated by his service-connected right knee condition. In this particular case, the Board finds the matter should be remanded for a new VA examination to allow for physical examination of both knees and for a medical opinion to clarify whether the Veteran’s left knee osteoarthritis was caused or aggravated by his service-connected right knee disability. The matters are REMANDED for the following action: 1. Afford the Veteran a VA examination to address the nature and etiology of his claimed left knee osteoarthritis. The complete claims folder must be provided to the examiner for review in conjunction with the examination, and the examiner must note that the claims folder has been reviewed. The examiner should opine as to whether it is “at least as likely as not” that the claimed left knee condition was caused or aggravated by the Veteran’s service-connected Osgood-Schlatter’s disease with osteoarthritis of the right knee. Direct the VA examiner’s attention to a recent November 2018 VA x-ray report. See CAPRI, received May 2019 at p.5. Explain to the VA examiner that the October 2014 VA examiner’s opinion failed to address aggravation, and the examiner very generally cited to genetics and “multiple sites” of osteoarthritis without any further elaboration. Any opinion must be accompanied by a complete rationale. J.W. FRANCIS Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board J. Juliano, 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.