Citation Nr: 21028469 Decision Date: 05/11/21 Archive Date: 05/11/21 DOCKET NO. 14-19 597 DATE: May 11, 2021 REMANDED Entitlement to service connection for right knee disability, to include as secondary to a service connected left leg amputation below the knee is remanded. Entitlement to service connection for low back disability, to include as secondary to service connected left leg amputation below the knee is remanded. REASONS FOR REMAND The Veteran served on active duty from March 1958 to November 1962 in the United States Navy. The Veteran died in October 2020. The appellant has been substituted as claimant in this appeal. See Correspondence (March 2021). These matters come before the Board of Veterans' Appeals (Board) on appeal from a September 2011 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO). In June 2017, the Board remanded the appeal. Subsequently, a September 2019 Board decision denied service connection for right knee and low back disabilities. See BVA Decision (September 2019). The Veteran appealed the September 2019 Board decision to the United States Court of Appeals for Veterans Claims (Court). The Court granted a Joint Motion for Partial Remand (JPMR), vacating and remanding the right knee and back claims to the Board. 1. Entitlement to service connection for right knee disability, to include as secondary to a service connected left leg below knee amputation is remanded. 2. Entitlement to service connection for low back disability, to include as secondary to service connected left leg below knee amputation is remanded. Issues:1-2: The Veteran contended that he has right knee and low back disorders due to an in-service motorcycle accident; or that the conditions are aggravated by his left leg below knee amputation. The record shows that the Veteran sustained a traumatic amputation of his left lower extremity below the knee in service. A May 1964 rating decision granted service connection for left leg amputation. In March 2011, the Veteran reported to VA that he had right knee and low back disability due to a left leg accident and/or left. See VA Form 21-4128 (March 2011). Service connection may be established on a secondary basis for a disability which is proximately due to, or the result of, a service-connected disability. 38 C.F.R. § 3.310(a). Secondary service connection may also be established for a disorder which is aggravated by a service-connected disability; compensation may be provided for the degree of disability (but only that degree) over and above the degree of disability existing prior to the aggravation. 38 C.F.R. § 3.310(b); Allen v. Brown, 8 Vet. App. 374 (1995). In order to prevail on the issue of secondary service connection, the record must show: (1) evidence of a current disability; (2) evidence of a service-connected disability; and (3) medical nexus evidence establishing a connection between the service-connected disability and the current disability. See Wallin v. West, 11 Vet. App. 509, 512 (1998); see also Allen, supra. To ensure that VA has met its duty to assist, remand is necessary to decide the appeal. 38 U.S.C. § 5103A; 38 C.F.R. § 3.159(c). Although VA obtained a September 2017 VA medical opinion addressing secondary service connection, the opinion did not address the aggravation prong of secondary service connection. See El-Amin v. Shinseki, 26 Vet. App. 136, 141 (2013) (finding inadequate a medical opinion as to secondary service connection because it addressed causation but not aggravation). Unfortunately, the opinion focused on whether the service-connected left leg amputation caused the claimed right knee and back conditions. Therefore, the September 2017 VA medical opinion is inadequate to decide the appeal. When VA undertakes to provide a VA examination or obtain an opinion, it must ensure that it is adequate. Barr v. Nicholson, 21 Vet. App. 303, 311 (2007). Accordingly, the matters are REMANDED for the following action: 1. Obtain the Veteran's VA treatment records for the period from July 2018 to his death in October 2020. 2. Obtain an addendum opinion to address whether the Veteran diagnosed right knee and/or low back conditions (i.e. degenerative disc disease and facet joint arthritis of the lumbar spine; patellar spurring of the right knee) is at least as likely as not aggravated beyond its natural progression by service-connected disability. If yes, a pre-aggravation baseline level of disability must be provided. 3. Readjudicate. C.A. SKOW Veterans Law Judge Board of Veterans' Appeals Attorney for the Board M. A. Macek, 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.