Citation Nr: 21030345 Decision Date: 05/18/21 Archive Date: 05/18/21 DOCKET NO. 15-18 452 DATE: May 18, 2021 REMANDED Entitlement to service connection for a right knee disability is remanded. Entitlement to service connection for a cervical spine disability is remanded. REASONS FOR REMAND The Veteran served on active duty from July1982 to December 1982 and from December 1986 to May 1992. The matter comes before the Board of Veterans' Appeals (Board) on appeal from an October 2012 rating decision by a Department of Veterans Affairs (VA) Regional Office (RO). In August 2018, the Veteran testified at a videoconference hearing before the undersigned Veterans' Law Judge (VLJ). A copy of the hearing transcript has been reviewed and is associated with the claims file. In October 2020, the Board remanded the issues for further evidentiary development with directions to obtain an addendum opinion addressing the nature and etiology of the Veteran's right knee and cervical spine disabilities. The matter has returned to the Board for an appellate review. The Board notes that additional evidence was submitted after the March 2021 Supplemental Statement of the Case (SSOC). The Board may not consider additional evidence not previously reviewed by the AOJ unless a waiver of initial AOJ review is obtained from the Veteran. See Disabled American Veterans, et. al. v. Secretary of Veterans Affairs, 327 F.3d 1339 (Fed. Cir. 2003); 38 C.F.R. § 20.1304 (c). However, for all substantive appeals received on or after February 2, 2013, if, either at the time or after the AOJ receives a substantive appeal, the claimant or the claimant's representative submits evidence to either the AOJ or the Board for consideration in connection with the issues on appeal (as the case here), such evidence shall be subject to initial review by the Board unless the claimant or the claimant's representative requests in writing that the AOJ initially review such evidence. See Section 501 of the Honoring America's Veterans and Caring for Camp Lejeune Families Act of 2012, Public Law (PL) 112-154 (amending 38 U.S.C. § 7105 by adding new paragraph (e)). 1. Entitlement to service connection for a right knee disability is remanded. 2. Entitlement to service connection for a cervical spine disability is remanded. The Board regrets the additional delay but finds that remand for development to attempt to obtain outstanding treatment records identified by the Veteran is required. In April 2021, the Veteran asserted that she received treatment for manipulation 1 area and cervical spine condition from the Apex Village Chiropractic, in July and possibly August of 1998; but that she was unable to obtain/locate the medical record for the care that she received. See April 2021 VA 21-4138 Statement in Support of Claim. In addition to her lay assertions, the Veteran submitted a receipt noting treatment from the above medical practice. The Board notes that no medical records relating to treatment from the Apex Village Chiropractic for the period of treatment from July to August of 1998 are of record. These are pertinent to the Veteran's service connection claims as they tend to indicate continued symptomatology of her disabilities. On remand VA must attempt to secure any medical records associated with that period of treatment and obtain an addendum opinion considering any new evidence received. The matters are REMANDED for the following action: 1. Obtain outstanding relevant VA treatment records and associated them the claims file. 2. Contact the Veteran requesting any additional relevant private treatment records, to include records from the Apex Village Chiropractic, or request authorization to obtain them, if authorization has not already been obtained. If authorization is received, obtain the Veteran's Apex Village Chiropractic. All records received should be associated with the claims file. The AOJ should make a formal finding of unavailability if the records are unable to be obtained. 3. After all available records have been associated with the Veteran's file, obtain an addendum opinion addressing the etiology of the Veteran's right knee and cervical spine disabilities considering the new evidence. The Veteran's claims file must be made available to the examiner for review of the case and a notation to the effect that this record review took place must be included in the report of the examiner. The examiner must further specifically address the following questions: (a). Is it at least as likely as not (probability of 50 percent or more) that the Veteran's right knee disability began in service, or is otherwise related to military service? (b). Is it at least as likely as not (probability of 50 percent or more) that the Veteran's right knee disability is due to or a result of her service-connected back disability? (c). Is it at least as likely as not (probability of 50 percent or more) that the Veteran's right knee disability has been aggravated (i.e. increased in severity or worsened beyond its natural progress) due to her service-connected back disability? 3. Also obtain an addendum opinion regarding the etiology of the Veteran's cervical spine disability. After reviewing the Veteran's claims file, the examiner must specifically address the following questions: (a). Is it at least as likely as not (probability of 50 percent or more) that the Veteran's cervical spine disability began in service, or is otherwise related to military service? (b). Is it at least as likely as not (probability of 50 percent or more) that the Veteran's cervical spine disability is due to or a result of her service-connected back disability? (c). Is it at least as likely as not (probability of 50 percent or more) that the Veteran's cervical spine disability has been aggravated (i.e. increased in severity or worsened beyond its natural progress) due to her service-connected back disability? A complete, well-reasoned rationale must be provided for any opinion offered. 4. After undertaking any other development deemed appropriate, readjudicate the issues on appeal. If any benefit sought is not granted, the Veteran and her representative must be furnished with a supplemental statement of the case and afforded an opportunity to respond. DAVID L. WIGHT Veterans Law Judge Board of Veterans' Appeals Attorney for the Board N. M. Rogers, 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.