Citation Nr: 21031725 Decision Date: 05/24/21 Archive Date: 05/24/21 DOCKET NO. 15-16 946 DATE: May 24, 2021 REMANDED Entitlement to service connection for left knee degenerative joint disease, to include as secondary to service-connected right knee disability, is remanded. REASONS FOR REMAND The Veteran served on active duty from April 1963 to April 1967. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a November 2011 rating decision by a Department of Veterans Affairs (VA) Regional Office (RO). In April 2018, the Veteran testified at a hearing before a Veterans Law Judge who is no longer at the Board. A transcript of the hearing is of record. In January 2020, the Board denied the Veteran's claim for service connection for a left knee disability, which the Veteran appealed to the United States Court of Appeals for Veterans Claims (Court). Per a December 2020 Joint Motion for Remand (JMR) and December 2020 Court Order, the Court vacated the Board's decision denying the Veteran's claim for service connection for a left knee disability, finding the Board erred by relying on an April 2019 VA examination and medical opinion that did not adequately address whether the Veteran's left knee degenerative joint disease is proximately due to or aggravated by his service-connected right knee disability, and remanded the claim for readjudication consistent with the JMR. Notably, the Veteran is advised he has a right to another hearing before another Veteran's Law Judge, as the Veterans Law Judge who presided over his April 2018 hearing is no longer at the Board. However, given the Veteran's appeal status as Advanced on Docket, his age and health impairments, and that the relevant evidence is medical and not lay evidence, the Board finds the Veteran would be better served by first providing him a VA examination as indicated by the Court's December 2020 JMR. It may result in the benefit sought on appeal being granted in full sooner and will not disturb his right to be scheduled for another Board hearing following the development ordered herein, should the benefit sought not be granted. Entitlement to service connection for left knee degenerative joint disease, to include as secondary to his service-connected right knee disability, is remanded. In the December 2020 JMR, the parties agreed that the Board relied on an inadequate April 2019 VA examination. Specifically, the April 2019 examiner provided a conclusory opinion that did not sufficiently inform the Board as to whether the Veteran's left knee disability is proximately due to or aggravated by his service-connected right knee disability. Stefl v. Nicholson, 21 Vet. App. 120, 124-25 (2007); Bailey v. O'Rourke, 30 Vet. App. 54, 60 (2018). Moreover, the examiner provided the same rationale for both causation and aggravation, when they are rather independent concepts that require separate findings and rationales. Atencio v. O'Rourke, 30 Vet. App. 74 (2018). As such, a remand is warranted to provide the Veteran another VA examination on whether his left knee disability is associated with his right knee disability. The matter is REMANDED for the following actions: 1. Obtain an addendum opinion from an appropriate clinician on whether there is a causal nexus between the Veteran's left knee disability and his service-connected right knee disability. The need for an in-person examination is left to the examiner's discretion. The examiner is asked to opine on whether the Veteran's left knee degenerative joint disease is at least as likely as not: (1) proximately due to; or, (2) aggravated (i.e., worsened beyond its natural progression) by his service-connected right knee disability. The examiner is advised that causation and aggravation are independent concepts. As such, the examiner must provide separate opinions and rationales for proximate causation and aggravation for each disability. The examiner is also advised that aggravation under 38 C.F.R. § 3.310 (b) does not require that there be "permanent" worsening of the nonservice-connected disability. A complete rationale for any opinion must be provided. A complete rationale is one that contains clear conclusions with supporting data and a reasoned medical explanation connecting the two. 2. Readjudicate the claim. L. Chu Veterans Law Judge Board of Veterans' Appeals Attorney for the Board P.A. Infante, 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.