Citation Nr: 21032113 Decision Date: 05/25/21 Archive Date: 05/25/21 DOCKET NO. 17-32 869 DATE: May 25, 2021 ORDER As new and material evidence was received, reopening the previously denied claim of service connection for a left knee condition is granted. REMANDED Service connection for a left knee condition. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from September 1973 to December 1977. The case is on appeal from an April 2016 rating decision. In December 2019, the Veteran testified at a Board hearing. During the hearing, the Veteran's representative requested the record held open for 90 days to submit additional evidence. No additional evidence was submitted. Whether new and material evidence was received to reopen the claim of service connection for a left knee condition. The Veteran's claim of service connection for a left knee condition was initially denied in a May 1979 rating decision on the basis that, at the time, there was no evidence of a knee disorder. The Veteran did not appeal. Subsequent claims to reopen were filed in May 2003 and September 2013, along with the issuance of September 2003 and September 2013 rating decisions, respectively, each denying reopening of the claim based on no new and material evidence. The notice for the September 2013 decision was mailed to the Veteran's correct mailing address later in September 2013. That decision is final. See 38 U.S.C. § 7105; 38 C.F.R. §§ 20.302, 20.1103. The present claim to reopen a claim of service connection for a left knee condition was received in February 2016 and forms the basis of the present appeal. The threshold to reopen a claim is low and does not require new and material evidence as to each previously unproven element of claim. Shade v. Shinseki, 24 Vet. App. 110, 118 (2010). Additionally, VA is required to presume the credibility of newly submitted evidence for the purposes of determining whether that evidence is material and sufficient to reopen a previously denied claim. Justus v. Principi, 3 Vet. App. 510, 513 (1992). The Board finds that new and material evidence has been submitted so that the previously denied claim of service connection is reopened. See 38 U.S.C. § 5108; 38 C.F.R. § 3.156(a); see also January 2016, December 2017, and August 2019 VA examinations; VA treatment records; and, private treatment records. REASONS FOR REMAND Service connection for a left knee condition. The Veteran contends he has a left knee condition that is caused or aggravated by his service-connected right knee. Specifically, he posits that he compensates for his right knee pain on his left knee, which causes an altered gait. Additionally, he provides that the left knee has become more painful. The Veteran testified at the December 2019 Board hearing that he has continued to compensate for his right knee pain and that both knees are getting worse. In reviewing the January 2016 VA examination in comparison to December 2017 VA examination, worsening of his left knee is demonstrated in the range of motion measurements for flexion and extension. In January 2016, flexion was from 15 to 105 degrees and extension was from 105 to 15 degrees; however, in December 2017, flexion was from 0 to 85 degrees and extension from 85 to zero degrees. Additionally, the Veteran reports being unable to climb stairs due to his left knee pain. In terms of treatment, the Veteran also testified at the December 2019 Board hearing that he has received injections every 6 months for the past 6 to 7 years in order to treat his left knee pain. The Board further notes that, while numerous VA examinations have been afforded the Veteran, the last examination which provided a medical opinion addressing the Veteran's left knee condition was conducted in January 2016. Due to additional medical evidence submitted since the January 2016 VA examination demonstrating worsening of the left knee condition, the Board finds that another VA examination is warranted. In light of the remand, updated VA treatment records should be obtained. The matters are REMANDED for the following action: 1. Obtain any additional VA treatment records dated since March 2019. 2. Schedule the Veteran for a VA examination (or telehealth interview, review of the record, etc. if an in-person examination is not feasible) by an appropriate medical professional to determine the nature and etiology of any left knee condition experienced by the Veteran. Any clinically indicated diagnostic testing should be performed. Based on the examination results and after review of the entire claims file, the examiner is asked to address each of the following: (a.) The examiner should first determine whether the Veteran has a current diagnosis manifested by left knee pain, which may include pain alone that rises to the level of functional impairment. In doing so, the examiner should comment on whether the symptoms of the claimed condition (left knee pain) are attributable to a known clinical diagnosis. If only pain is diagnosed, but there is no functional impairment present, it should be explained why this is so. (b.) The examiner should then provide an opinion as to whether it is at least as likely as not (probability of 50 percent or greater) that any identified disorder manifested by left knee pain had its onset during, or is otherwise related to, service. (c.) The examiner should also provide a medical opinion addressing whether it is at least as likely as not (probability of 50 percent or greater) that any identified left knee condition manifested by left knee pain is proximately caused (in whole or in part) or aggravated by the service-connected right knee. Aggravation is an increase in severity beyond the natural progress of the disease. A complete rationale should be provided for any opinion reached. RYAN T. KESSEL Veterans Law Judge Board of Veterans' Appeals Attorney for the Board S. Becton, 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.