Citation Nr: 21027624 Decision Date: 05/06/21 Archive Date: 05/06/21 DOCKET NO. 17-44 876 DATE: May 6, 2021 REMANDED Entitlement to service connection for a right knee condition is remanded. Entitlement to service connection for a left knee condition is remanded. Entitlement to service connection for recurring rashes is remanded. REASONS FOR REMAND The Veteran had active military service from July 1979 to September 1992. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a November 2012 rating decision of a VA Regional Office (RO). The Veteran testified before the undersigned Veterans Law Judge at a January 2020 hearing before the Board of Veterans' Appeals (Board). In an April 2020 decision, the Board remanded these claims for additional VA examinations on the nature and etiology of the claimed conditions. The Board finds the August 2020 VA examinations inadequate for adjudication purposes. The VA examiner's etiology opinions for the claimed rash condition are based entirely on the lack of in-service treatment for the claimed condition. The VA examiner's etiology opinions for the claimed knee conditions note in-service complaints and treatment for knee pain, but they conclude that the current conditions are not a continuation of in-service pain. The examiner does not discuss the Veteran's lay statements, other evidence of record, or provide sufficient reasoning for their conclusions for any of the claimed conditions. Addressing these matters was the primary reason why these claims were remanded. Therefore, the Board concludes that the August 2020 VA examination reports are inadequate for adjudication purposes. For these reasons, the Board finds that there has not been substantial compliance with the Board's April 2020 remand directives, and these claims must be remanded again. Stegall v. West, 11 Vet. App. 268 (1998). The matters are REMANDED for the following action: 1. Obtain a VA addendum medical opinion from the physician who conducted the August 2020 VA examination for knee and lower leg conditions, or from another qualified physician. It should be noted that the Veteran is competent to attest to factual matters of which he had first-hand knowledge. If there is a medical basis to support or doubt the history provided by the Veteran, the examiner should provide a fully reasoned explanation. The examiner is asked to address the following: (a.) Identify and diagnose any current (at any point during appeal period) bilateral knee condition; and (b.) For any diagnosed knee conditions, provide an opinion as to whether such diagnosis at least as likely as not (a 50 percent or greater probability) had its onset during or is otherwise related to any event or injury during the Veteran's active service. The examiner must discuss the Veteran's lay statements and other relevant evidence of record. It is not sufficient to note the gap in documented treatment between active service and the first post-service knee complaints. All opinions must be supported by a detailed rationale. 2. Obtain a VA addendum medical opinion from the physician who conducted the August 2020 VA examination for skin conditions, or from another qualified physician. It should be noted that the Veteran is competent to attest to factual matters of which he had first-hand knowledge. If there is a medical basis to support or doubt the history provided by the Veteran, the examiner should provide a fully reasoned explanation. The examiner is asked to address the following: (a.) Please identify any diagnosable dermatological disability attributable to the Veteran throughout the period on appeal; and (b.) For each diagnosis identified, the examiner should opine as to whether it is at least as likely as not (a 50 percent probability or greater) that the condition arose during or as a result of the Veteran's active service. (c.) If the Veteran has any symptomatology that is not attributable to a known clinical diagnosis, the examiner should opine as to whether it is at least as likely as not (a 50 percent probability or greater) that there are chronic symptoms due to any undiagnosed illness, or a medically unexplained chronic multi-symptoms illness resulting from service in Southwest Asia during the Gulf War. If so, the examiner should also comment on the severity of the symptomatology and report all signs and symptoms necessary for evaluating the illness under the rating criteria. The examiner must discuss the Veteran's lay statements and other relevant evidence of record. It is not sufficient to base the etiology opinions solely on the lack of documented in-service treatment for the claimed condition. All opinions must be supported by a detailed rationale. A. C. MACKENZIE Veterans Law Judge Board of Veterans' Appeals Attorney for the Board E. Hicks, 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.