Citation Nr: 21041225 Decision Date: 07/08/21 Archive Date: 07/08/21 DOCKET NO. 15-20 910 DATE: July 8, 2021 REMANDED The issue of entitlement to service connection for residuals of a left knee injury is remanded. The issue of entitlement to service connection for residuals of a right knee injury is remanded. REASONS FOR REMAND The Veteran served on active duty from April 1969 to November 1971. In February 2019, the Veteran and his spouse testified before the undersigned Veterans Law Judge at a videoconference hearing. A transcript of the hearing is of record. In February 2019, the Board remanded the appeal for additional development. For the reasons outlined below, the Board finds that remand is again needed in this matter. Service connection left and right knee injury. The Board finds that additional development is needed before final adjudication of the issues on appeal. First, the Board finds that a new VA opinion is needed. In the December 2019 VA opinion, the examiner indicates that "[t]he claimed condition, which clearly and unmistakably existed prior to service, was clearly and unmistakably not aggravated beyond its natural progression by an in-service injury, event, or illness." (Emphasis added). However, in the rationale for the opinion, the examiner states that "[t]here was no documentation of knee complaints, diagnoses, or treatments prior to or during service for the knees found in the records." The finding that the Veteran's claimed condition "clearly and unmistakably existed prior to service" and that "[t]here was no documentation of knee complaints, diagnoses, or treatments prior to . . . service" appears to be contradictory. Indeed, further on in the rationale, the examiner states: "the condition was not clearly and unmistakably present prior to service . . ." Accordingly, the Board seeks clarification upon remand. In addition, the Veteran submitted correspondence in July 2020, noting that he had submitted statements from individuals who knew him prior to and after service. He asks that these statements be considered. The Board notes a March 2018 letter from the Veteran's spouse, a March 2018 letter from D.M., and an April 2018 letter from Dr. W.J.H. The Board asks that these statements be considered upon remand. Finally, as was noted in the February 2019 remand, the Veteran contends that there may be missing service treatment records. See, e.g., VA Form 646, June 2015. Upon remand, any outstanding service treatment records should be obtained. The matters are REMANDED for the following action: 1. After securing any necessary consent forms from the Veteran, obtain any outstanding treatment records, to include any service, VA and/or private treatment records, pertaining to the issues on appeal. The Veteran has indicated treatment at W. F. and N. T. C. See VA Form 646, June 2015. All efforts should be documented in the claim file. If any records could not be obtained, this should be noted in the claim file. 2. Upon completion of the above, obtain a VA opinion to address the following regarding the Veteran's claimed left and right knee disabilities. If necessary, schedule the Veteran for a new VA examination. (a) Whether it is at least as likely as not that the disability(ies) clearly and unmistakably pre-existed service. (b) If there is clear and unmistakable evidence that the claimed disability(ies) preexisted service, then the examiner should address whether there is clear and unmistakable evidence that the claimed disability was not permanently aggravated by service. If not, the examiner should then address whether it is at least as likely as not that it was caused by the Veteran's active duty service. The Board notes that a preexisting injury or disease will be considered to have been aggravated by active service, where there is an increase in disability during such service, unless there is a specific finding that the increase in disability is due to the natural progress of the disease. See 38 C.F.R. § 3.306 (a). (c) If it is determined that the disability(ies) did not clearly and unmistakably preexist service, then the examiner should address whether it is at least as likely as not that it was caused by the Veteran's active duty service. In rendering an opinion, the examiner is asked to address specifically the Veteran's descriptions of in-service injury, to include: (a) jumping off a porch on the barracks; (b) running a makeshift obstacle course; (c) jumping off aircraft wings; and (d) going up and down ladders; and (e) walking and marching on concrete and asphalt. In addition, the examiner is asked to address a March 2018 letter from the Veteran's spouse, a March 2018 letter from D.M., and an April 2018 letter from Dr. W.J.H. In particular, the Board asks that the examiner address the Veteran's spouse's contention that the Veteran reported to her, during a period of active duty, that "he injured his left knee, and since that time he has had knee problems." See Statement, March 2018. The VA examiner should be given access to the claim file. The examiner should state that a review of the claim file was completed. The examiner must provide a comprehensive report including complete rationales for all opinions and conclusions reached, citing the objective medical findings leading to the conclusions. A detailed rationale is requested for all opinions provided. 3. If upon completion of the above action the issues are denied, the case should be returned to the Board after compliance with appellate procedures. E. I. VELEZ Veterans Law Judge Board of Veterans' Appeals Attorney for the Board K. Foster, 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.