Citation Nr: 21027097 Decision Date: 05/04/21 Archive Date: 05/04/21 DOCKET NO. 15-45 915 DATE: May 4, 2021 REMANDED Entitlement to service connection for a right knee disability is remanded. REASONS FOR REMAND The Veteran served on active duty from July 1980 to October 1980. This appeal comes before the Board of Veterans' Appeals (Board) on appeal from a rating decision of a Department of Veterans Affairs (VA) Regional Office (RO). In March 2019, the Board remanded the claim to obtain an additional VA examination and medical opinion. Entitlement to service connection for a right knee disability is remanded. The Veteran contends that she has a right knee disability related to her service. Specifically, she asserts that she injured her right knee during bootcamp at Fort McClellan. See VA 21-4138 Statement in Support of Claim (June 2014). As explained below, to ensure that VA has met its duty to assist, remand is necessary to afford the Veteran another opportunity to attend a VA examination. Pursuant to the Board's remand, the Veteran was scheduled for a VA examination on December 13, 2019, but she failed to attend. When a claimant, without "good cause," fails to report for a scheduled examination or reexamination scheduled in conjunction with an original compensation claim, the claim shall be rated based on the evidence of record. 38 C.F.R. § 3.655. Here, the record shows there was less than a 2-week window between the date the RO requested the examination and the date the Veteran failed to show for the scheduled examination. Additionally, it is unclear whether the Veteran was properly notified of the date, time, and place of the VA examination as there is no evidence in the claims file indicating a notification letter was sent to a verified address or any documentation showing the Veteran was notified by telephone. Therefore, the Board finds the Veteran should be afforded another opportunity to present for a VA examination to determine the nature and etiology of her right knee disability, and whether any such condition is related to in-service injury or disease. The Board reminds the Veteran that the "duty to assist is not always a one-way street" and that she has an obligation to actively participate, to include attending a scheduled VA examination. She is expected to cooperate in the efforts to adjudicate the claim, and her failure to do so would subject her to the risk of an adverse adjudication based on an incomplete and underdeveloped record. See Wood v. Derwinski, 1 Vet. App. 190, 193 (1991); Kowalski v. Nicholson, 19 Vet. App. 171, 178 (2005). Ultimately, the Veteran has the responsibility to present and support a claim for benefits under the laws administered by the Secretary, 38 U.S.C. § 5107(a), and she must accept the legal consequences if she fails to do so. In remanding these matters, the Board makes no finding, implicit or otherwise, as to the credibility of the Veteran's assertions. Neither the Veteran's credibility nor any lack thereof should be presumed in this remand. The matter is REMANDED for the following action: 1. Ask the Veteran to complete a VA Form 21-4142 for all non-VA medical providers seen for her right knee disability. Make two requests for the authorized records from all identified sources, unless it is clear after the first request that a second request would be futile. 2. Obtain the Veteran's VA treatment records from March 2020 to the Present. 3. Schedule the Veteran for an examination by an appropriate clinician to determine the nature and etiology of her right knee disability. Notice of the examination should be sent to the Veteran's verified address. The claims file, including a complete copy of this REMAND, should be made available to the clinician and reviewed. The medical opinion should, at a minimum, reflect consideration of (i) the documented history; (ii) the lay contentions; and (iii) medical evidence of record to include evidence that is favorable and unfavorable. The clinician must address the following: (a.) Based on review of the record and interview with the Veteran, detail her reported right knee symptoms, including the nature, onset, progression and severity. If any medical history provided by the Veteran as to onset, progression, and severity of symptoms is rejected, then a full explanation for such is required. The examiner is not required to accept the Veteran's theory that her right knee symptoms first manifested during service and persisted following separation from service if this is incongruous with the record; however, the examiner is required to fully explain why he or she disagrees with the Veteran's theory of onset/causation. (b.) Clarify all diagnoses related to the Veteran's right knee, to include (i) any residual conditions related to her January 2006 medial meniscal tear of the right knee and subsequent arthroscopic surgery, or; (ii) any related functional impairment if it diminishes the body's ability to function under the ordinary conditions of daily life including employment even where it is not diagnosed. (c.) Whether it is at least as likely as not that any right knee disability (1) began during active service, or (2) is related to an in-service injury, event, or disease, including but not limited to her report of injury during boot camp. NOTE (1): An adequate medical opinion may not be predicated solely on the absence of an in-service diagnosis or documented complaints/findings. NOTE (2): The medical opinion should identify and explain the relevance or significance, as appropriate, of any history, clinical findings, medical knowledge or literature, etc., relied upon in reaching the conclusion(s). 4. Ensure that the VA medical opinion obtained includes a complete rationale for the conclusions reached. The medical opinion must support the conclusions reached with an analysis that is adequate for the Board to consider and weigh against other evidence of record; medical opinions must contain not only clear conclusions with supporting data, but also a reasoned medical explanation connecting the two. If an opinion cannot be expressed without resort to speculation, ensure that the clinician so indicates and discusses why an opinion is not possible, to include whether there is additional evidence that could enable an opinion to be provided, or whether the inability to provide the opinion is based on the limits of medical knowledge. (Continued on the next page) 5. Readjudicate. C.A. SKOW Veterans Law Judge Board of Veterans' Appeals Attorney for the Board S. Krunic, 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.