Citation Nr: 21028856 Decision Date: 05/12/21 Archive Date: 05/12/21 DOCKET NO. 17-50 880 DATE: May 12, 2021 REMANDED Entitlement to service connection for left knee disability is remanded. Entitlement to service connection for left ankle disability is remanded. REASONS FOR REMAND The Veteran served on active duty from March 1978 to May 1988. This matter comes before the Board of Veteran's Appeals (Board) from a January 2015 rating decision issued by the Department of Veterans Affairs (VA) Regional Office (RO). In March 2021, the Veteran testified at a video hearing before the undersigned Veterans Law Judge (VLJ). A copy of the hearing transcript is of record. 1. Entitlement to service connection for left knee disability is remanded. Unfortunately, the Veteran's claims must be remanded for additional development. The Veteran asserts entitlement to service connection for a left knee disability. A review of the Veteran's STRs shows that he reported left knee pain and swelling in April 1986. The physician noted no trauma and slight effusion. A follow-up examination a couple days later shows that the Veteran reported that his pain and swelling resolved. The Veteran was afforded a VA examination in August 2017. The VA examiner noted a diagnosis of bilateral knee strain. The Veteran reported that his condition began during service after repetitive physical training and mandated sports. He further stated that he began compensating his weight onto his other leg, and began noticing pain within the joint and knee cap. Following a review of the Veteran's claims file and a physical examination, the VA examiner opined that the Veteran's left knee strain is less likely than not incurred in or caused by the left knee effusion during service. In support of this opinion, the VA examiner noted a 28-year gap from when the Veteran first reported knee pain in service in 1986 until he reported knee pain in 2014 during a VA examination. On review, the Board finds the August 2017 VA examiner's opinion inadequate for deciding this claim because the examiner failed to afford the Veteran's competent and credible lay statements regarding the onset and continuity of his symptoms proper consideration. Furthermore, the Veteran's private medical records show reports of left knee pain prior to 2014, which the VA examiner did not address. See, e.g., September 2012 Private Treatment Record. Therefore, remand is warranted to afford the Veteran another VA examination to determine whether his left knee disability is directly related to his active military service. 2. Entitlement to service connection for left ankle disability is remanded. The Veteran asserts entitlement to service connection for a left ankle disability. A review of the Veteran's STRs shows that he reported breaking his ankle prior to service. See January 1978 STR. However, he did not identify which ankle and a physical examination showed normal lower extremities. The Veteran was afforded a VA examination in August 2017. The VA examiner noted a diagnosis of bilateral lateral collateral ligament sprain. The Veteran reported that his condition began in service playing mandated military sports and military physical exercises and training. The Veteran stated that he rolled and twisted his ankle multiple times, and saw military doctors to get bandages, ice, and pain medication. Following a review of the Veteran's claims file and a physical examination, the VA examiner opined that the Veteran's left ankle condition (which clearly and unmistakably existed prior to service) was not aggravated beyond its natural progression by service. In support of this opinion, the VA examiner reasoned that there was limited evidence to suggest an ongoing condition or aggravation during the Veteran's service. The Board notes that the VA examiner only opined as to aggravation of a preexisting disability. The Veteran has submitted an April 2021 private medical opinion from a podiatric surgeon whom the Veteran has been seeing since October 2019. The private podiatric surgeon reported that the Veteran's current findings from MRI, x-ray, and his own examination show a chronic insufficiency of his lateral collateral ligaments and he has a symptomatic osteochondral lesion of the medial talus, both consistent with chronic changes after an old inversion type ankle injury which would be consistent with what the Veteran described during his service. The Board notes that the private podiatric surgeon did not have access to the Veteran's medical records and based his opinion solely on the Veteran's lay statements. As such, it is awarded little probative value. The Board notes that the Veteran did not identify which ankle he broke prior to service during his January 1978 examination. Furthermore, the Veteran has testified that he has never broken his left ankle. See March 2021 Hearing Transcript. The Veteran testified that he hurt his ankle on two separate occasions during service. The first injury occurred when he slipped on oil and rolled his ankle. The second injury occurred while playing basketball in a competition against other squadrons. Id. The Veteran's lay statements are presumed credible. Therefore, because the Veteran's left ankle disability did not clearly and unmistakably preexist service, remand is warranted to afford him another VA examination to determine whether his left ankle disability is directly related to his active military service. The matters are REMANDED for the following action: 1. Schedule the Veteran for an examination to provide an opinion as to the nature and etiology of the Veteran's left knee disability that has been present during the period on appeal. After reviewing the record, to include the Veteran's lay testimony, the examiner is asked to address the following: Is it at least as likely as not (a 50 percent probability or greater), that the Veteran's left knee disability, to include all diagnoses, were caused by service, or are otherwise related to the Veteran's military service, to include the left knee injury noted in the Veteran's April 1986 STR? All opinions provided must be thoroughly explained and an adequate rationale for any conclusions reached must be provided. If any requested opinion cannot be provided without resort to speculation, the medical professional should state and explain why an opinion cannot be provided without resort to speculation. 2. Schedule the Veteran for an examination to provide an opinion as to the nature and etiology of the Veteran's left ankle disability that has been present during the period on appeal. After reviewing the record, to include the Veteran's lay testimony, the examiner is asked to address the following: Is it at least as likely as not (a 50 percent probability or greater), that the Veteran's left ankle disability, to include all diagnoses, were caused by service, or are otherwise related to the Veteran's military service? All opinions provided must be thoroughly explained and an adequate rationale for any conclusions reached must be provided. If any requested opinion cannot be provided without resort to speculation, the medical professional should state and explain why an opinion cannot be provided without resort to speculation. 3. Then, readjudicate the claims on appeal. If a decision is adverse to the Veteran, issue a supplemental statement of the case, allow appropriate time for response, and return the case to the Board. KRISTI L. GUNN Veterans Law Judge Board of Veterans' Appeals Attorney for the Board A. C. Slaughter, 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.