Citation Nr: 21028659 Decision Date: 05/11/21 Archive Date: 05/11/21 DOCKET NO. 18-43 152 DATE: May 11, 2021 REMANDED Entitlement to service connection for a right knee disability is remanded. REASONS FOR REMAND The Veteran had active duty service from June 1981 to September 1994. This appeal comes to the Board of Veterans' Appeals (Board) from a rating decision, dated January 2016, issued by a Department of Veterans Affairs (VA) Regional Office. The Veteran timely appealed. The appeal has previously been before the Board. In July 2019, the Board remanded the appeal for additional development. Entitlement to service connection for a right knee disability is remanded. Although the Board regrets the additional delay, the Veteran's claim must be remanded before the Board is able to make a determination on the merits. Specifically, the Board finds that additional supporting evidence is required in developing the Veteran's claim. The Veteran contends that her right knee disability is due to her service. While in service, she was diagnosed with patellofemoral syndrome of the right knee. See Service Treatment Record (STR) dated June 1988. In a February 2016 Notice of Disagreement (NOD), the Veteran wrote, "This condition has been part of my life since my active duty time in 1988. I am still being treated for this condition at the VA Medical Center...I live in constant pain and my quality of life has declined to almost nothing." In a July 2019 BVA decision, the Board remanded the Veteran's right knee disability claim for a VA examination. The VA examiner was asked to opine whether it was at least as likely as not the Veteran's right knee disability was related to her diagnosis of patellofemoral syndrome in her June 1988 STRs. Thereafter, the Veteran was provided a VA examination regarding knee and lower leg conditions in October 2019. At that time there was no right knee diagnosis provided, but there was slight evidence of pain on passive range of motion at the right knee joint. The VA examiner provided that the Veteran's claimed condition was less likely than not incurred in or caused by the claimed in-service injury, event, or illness. The examiner reasoned, "After a thorough review of the Veteran's medical records...it was determined, there is NO evidence of right knee/bilateral patellofemoral syndrome/shin splint or continuity of care demonstrated in medical records." Medical treatment records during the appeal period show multiple diagnoses for the right knee, including patellofemoral syndrome of the right knee, chronic pain in the right knee, mild prepatellar bursitis, internal derangement, and hypertrophic synovitis. Additionally, the Veteran had surgery on her right knee in both April 2020 and May 2020. In an April 2020 lay statement, the Veteran wrote, "I have been diagnosed with patellar femoral syndrome on active duty since June 30, 1988...Also, on active duty I was prescribed Motrin, along with physical therapy and I continue to follow that regiment until this day." In this case, given the fact that a current disability has been established, contrary to the findings made by the October 2019 VA examiner, the Veteran must be provided a new VA examination to determine whether a causal relationship exists between the Veteran's current right knee disability and her in-service injury. Accordingly, the matter is REMANDED for the following action: 1. Request a medical opinion addressing the Veteran's right knee disability. In-person examination is not required unless deemed necessary by the examiner. For purposes of this examination, there is evidence of a current disability, specifically patellofemoral syndrome of the right knee, chronic pain in the right knee, mild prepatellar bursitis, internal derangement, and hypertrophic synovitis. Based upon a review of the entirety of the claims file, the examiner is requested to provide an opinion as to the following question: (a.) Identify all diagnoses of the Veteran's right knee present at any time since September 2015, to include patellofemoral syndrome of the right knee, chronic pain in the right knee, mild prepatellar bursitis, internal derangement, and hypertrophic synovitis. (b.) For each identified diagnosis, is it at least as likely as not (i.e. probability of 50 percent or greater) that it was incurred during her active military service or is otherwise related to her service, to include the in-service diagnosis of patellofemoral syndrome of the right knee noted on June 29, 1988? (Continued on the next page) Explanations for all opinions must be provided. The examiner is asked to cite to the pertinent evidence of record, including clinical records and the Veteran's statements regarding the history of her symptoms. LAURA E. COLLINS Veterans Law Judge Board of Veterans' Appeals Attorney for the Board K. Bristor 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.