Citation Nr: 21027742 Decision Date: 05/11/21 Archive Date: 05/11/21 DOCKET NO. 18-01 233 DATE: May 11, 2021 REMANDED Entitlement to service connection for a right knee disorder is remanded. REASONS FOR REMAND The Veteran served honorably in the United States Army from November 1984 to April 1988. This issue come before the Board of Veterans' Appeals (Board) on appeal from an April 2017 rating decision issued by a Department of Veterans Affairs (VA) Regional Office (RO). In June 2020, the Veteran testified at a Board hearing before the undersigned Veterans Law Judge. The transcript is of record. 1. Entitlement to service connection for a right knee disorder. As an initial matter, the Board notes that, while service connection was treated as a reopened new and material evidence claim by the RO in the rating decision on appeal, new VA generated evidence was received within one year of a May 2016 rating decision that denied service connection for a right knee disorder. As such, the May 2016 rating decision did not become final. The Board also notes the evidence was subsequently reviewed in the rating decision on appeal. Therefore, the Board will proceed with a de novo review of the appeal. The Veteran contends that his right knee disorder is due to his military service. A review of his service treatment records (STRs) note complaints of right knee pain in December 1986 and again in April 1987. However, there were no subsequent complaints or treatment for right knee issues documented in the STR's. The Veteran underwent a VA examination in March 2017. The examiner found that the Veteran did not have a current diagnosis for a right knee disorder. The examiner noted the Veteran's reports of in-service injury of falling on his right knee with current pain complaints. However, the examiner found that there was no subjective or objective evidence of a right knee condition continuum from service. The examiner then gave a negative opinion that the right knee disorder was the result of military service. The examiner noted that the STRs were silent as to a chronic right knee condition. She also noted that while the Veteran experienced in-service right knee complaints, there was a pattern of a lack of evidence of a chronic knee disability and of a continuum of the right knee pain noted in service. Further, the examiner found that there was no subjective or objective medical data after service of a chronic right knee condition. Finally, the examiner noted that the in-service knee pain had resolved and that the Veteran's current complaints are a separate and district process which are not related to service. No other opinions or rationale were provided. The VA has a duty to assist veterans in developing their claims for benefits. 38 C.F.R. § 3.159. The duty to assist including providing a medical examination when necessary to decide a claim. 38 C.F.R. § 3.159 (c)(4). When VA undertakes to provide a VA examination or obtain a VA opinion, it must ensure that the examination or opinion is adequate. Barr v. Nicholson, 21 Vet. App. 303, 312 (2007). Significantly, the Veteran testified at the Board hearing that he injured his right knee while playing basketball in service and has experienced continuous and worsening pain complaints in his right knee since service. In addition, he denied any prior or subsequent injuries to his right knee. Furthermore, he testified that he did not complain about his right knee because "they don't want you to complain about stuff." The undersigned found the Veteran to be truthful and credible in his testimony. However, the VA examiner did not address or consider this evidence of continuity of symptomology when formulating the etiology opinion. Based on the inadequacy of the VA examination, the Board must remand this matter to obtain addendum VA medical opinion that address all the evidence of record, including the Veteran's truthful and credible testimony regarding continuous symptomology since service. The matter is REMANDED for the following action: 1. Obtain updated VA and/or pertinent private treatment records to the extent possible. If such records are unavailable, the Veteran's claims file must be clearly documented to that effect and the Veteran notified in accordance with 38 C.F.R. § 3.159 (e). 2. Arrange for an addendum opinion from a suitably qualified health care professional with regard to the etiology of the right knee disorder. Only schedule another examination (or a telehealth interview if an in-person examination is not feasible) of the Veteran if the examiner determines that this is necessary to provide the requested opinions. The examiner must review the Veteran's claims file and make a notation that the claims file has been reviewed. Based on a review of the record, and a new examination if necessary, the examiner must address the following: Whether it is at least as likely as not (a 50 percent or greater probability) that the Veteran's right knee disorder was incurred in or otherwise related to active duty? In answering this question the examiner must assume that the Veteran's testimony regarding an in-service knee injury and continuity of knee symptomology along with current symptomology to be true and credible. The term "at least as likely as not" does not mean within the realm of medical possibility, but rather that the medical evidence both for and against a certain conclusion is so evenly divided that it is as medically sound to find in favor of such a conclusion as it is to find against it. In rendering this opinion, the examiner is advised that the Veteran is competent to report his symptoms and history. Such reports must be acknowledged and considered in formulating any opinion. A complete rationale must be provided for all opinions presented. If the medical professional cannot provide an opinion without resorting to mere speculation, he or she shall provide a complete explanation for why an opinion cannot be rendered. In so doing, the medical professional shall explain whether the inability to provide a more definitive opinion is the result of a need for additional information, or that he or she has exhausted the limits of current medical knowledge in providing an answer to that particular question(s). G. A. WASIK Veterans Law Judge Board of Veterans' Appeals Attorney for the Board J.T. Massey, 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.