Citation Nr: 21031303 Decision Date: 05/21/21 Archive Date: 05/21/21 DOCKET NO. 15-34 675 DATE: May 21, 2021 REMANDED Entitlement to service connection for degenerative arthritis of the lumbar spine, to include as secondary to service-connected bilateral knee disabilities is remanded. Entitlement to service connection for degenerative arthritis of the left hip, to include as secondary to service-connected bilateral knee disabilities is remanded. Entitlement to service connection for a bilateral foot disability secondary to service-connected bilateral knee disabilities is remanded. REASONS FOR REMAND The Veteran served on active duty with the United States Army from November 1997 to May 1998. These matters come before the Board of Veterans Appeals (Board) on appeal from an August 2012 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO) in St. Petersburg, Florida. The Veteran timely appealed the denials. In October 2019, the Veteran testified before the undersigned Veterans Law Judge (VLJ); a transcript of the hearing is of record. In a December 2019 Board decision, the Board granted service connection for a right hip disability, secondary to service-connected bilateral knees disabilities, and remanded the remaining claims for further development. In the May 2020 Board decision, the claims for service connection for degenerative arthritis of the left hip and lumbar spine and a bilateral foot disability were denied. The Veteran appealed the Board's decision to the United States Court of Appeals for Veterans Claims (CAVC or the Court). In January 2021 the Veteran and the Board filed a Joint Motion for Remand (Joint Motion), vacating the Board's decision and remanding the Veteran's claims. Entitlement to service connection for degenerative arthritis of the lumbar spine and left hip and service connection for a bilateral foot disability, to include as secondary to service-connected bilateral knee disabilities is remanded. The Veteran contends that her degenerative arthritis of the lumbar spine and left hip and bilateral foot disability is due to her service-connected bilateral knee disability. Service connection for a claimed disability may be established on a secondary basis for a disability that is proximately due to or the result of a service-connected disease or injury. 38 C.F.R. § 3.310(a). Establishing service-connection on a secondary basis requires evidence sufficient to show (1) that a current disability exists and (2) that the current disability was either (a) caused by or (b) aggravated by a service-connected disability. 38 C.F.R. § 3.310(a). Post remand, a December 2019 VA medical nexus opinion was obtained for the claims. The physician opined that the conditions claimed were less likely than not (less than 50 percent probability) proximately due to or the result of the Veteran's service-connected condition. However, for each opinion, aggravation was not addressed. The January 2021 JMR found that the December 2019 VA medical opinions are inadequate and non-compliant with the December 2019 remand as the examiner did not provide a rationale as to the secondary aggravation prong. See Stegall v. West, 11 Vet. App. 268, 271 (1998). Thus, an additional VA medical opinion by an appropriate clinician is needed to resolve the claim. The matters are REMANDED for the following action: 1. Obtain an addendum opinion from an appropriate clinician, if possible with joint and/or musculoskeletal expertise, who can adequately address the nature and etiology of the Veteran's joint disabilities, to include whether there is any relationship between them and her service-connected bilateral knee disability. Only arrange for the Veteran to undergo an examination if one is deemed necessary in the judgment of the physician/clinician designated to provide the opinion. The examiner must review the claims file in conjunction with the examination. Any tests or studies deemed necessary should be conducted, and the results should be reported in detail. (Continued on the next page) The clinician should provide an opinion as to whether it is at least as likely as not (at least a 50 percent probability) that the Veteran's left hip, back, and bilateral foot disability was either (a) caused or (b) aggravated (made worse) by the service-connected bilateral knee arthritis and left lower extremity tibial stress syndrome and fracture. The clinician should also consider and discuss all lay assertions, to include the Veteran's assertions as to the nature, onset, and continuity of symptoms. L. B. CRYAN Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Laroche, N. 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.