Citation Nr: 21042281 Decision Date: 07/12/21 Archive Date: 07/12/21 DOCKET NO. 17-13 924 DATE: July 12, 2021 REMANDED The issue of service connection for a lumbar spine disability is remanded. The issue of service connection for a right knee disability is remanded. The issue of service connection for tinea pedis of the left foot, claimed as a left foot rash, is remanded. The issue of service connection for tinea pedis of the right foot, claimed as a right foot rash, is remanded. REASONS FOR REMAND The Veteran served on active duty in the Army from September 1987 to December 1998. The record shows he had active honorable service from September 1987 to July 1991. Thereafter, his service has been determined to be dishonorable for VA purposes. These matters come before the Board of Veterans' Appeals (Board) from an August 2016 rating decision. The Veteran testified before the Board at a hearing in April 2021. A transcript of the hearing has been associated with the claims file. Lumbar Spine Disability The Veteran was afforded a VA examination regarding his lumbar spine disability in July 2016, which noted a brief description of some of the Veteran's in-service injuries as well as a discussion of service treatment records (STRs) relating to some of the injuries. Since then, the Veteran provided descriptions of some of these in-service incidents in statements submitted in September 2016, December 2019, and November 2020. In addition, at the April 2021 hearing before the Board, the Veteran provided a detailed account of multiple in-service incidents, including experiencing back strain from physical training throughout service; falling off a tank and landing on his back in 1988; injuring his back while operating the gunner seat of a tank during a field exercise in 1990; and, experiencing recurrent back pain from sleeping on a steel tank throughout service. Although the findings of July 2016 VA examination note a brief description of the Veteran's in-service injuries relating to his lumbar spine disability, because more detailed descriptions have since been provided, an addendum opinion is needed that contemplates this additional information. Right Knee Disability At the April 2021 hearing before the Board, the Veteran provided testimony regarding his right knee disability. He stated that he experienced an in-service injury to his right knee when a crowbar struck his kneecap while working in the motor pool. Further, he stated that his physicians have told him that his knee problem is related to his spine disability because it is causing radicular symptoms in his bilateral legs as well as stiffness and locking of the knees. The Board notes that the Veteran's STRs do not indicate an in-service right knee injury; however, the December 1988 and March 1989 STRs document a left knee injury with a patellar contusion and tenderness, for which he was put on a limited profile and given physical therapy exercises to perform. The Board finds that as the evidence of record demonstrates that the Veteran experienced an in-service injury of the left knee and does not demonstrate an in-service injury of the right knee, for which his is presently claiming service connection, the probative evidence of record therefore does not indicate that the Veteran's current right knee disability may be associated with service. Thus, a VA examination regarding service connection for a right knee disability is not warranted. McLendon v. Nicholson, 20 Vet. App. 79 (2006); 38 U.S.C. § 5103A(d); 38 C.F.R. § 3.159(c)(4). Nonetheless, the Board is unable to adjudicate the claim of service connection for a right knee disability, as the Veteran asserts that it may be secondary to his lumbar spine disability. Therefore, as the claim of service connection for a right knee disability is inextricably intertwined with the Veteran's claim of service connection for a lumbar spine disability, a remand is necessary at this time. Harris v. Derwinski, 1 Vet. App. 180, 183 (1991). Bilateral Foot Disability At the April 2021 hearing before the Board, the Veteran stated that although his bilateral foot disability has been treated by VA for many years as a rash, tinea pedis, he was recently seen by a VA specialist, who stated that the diagnosis of tinea pedis was incorrect and provided a new diagnosis for the bilateral foot disability. A review of the claims file indicates that in November 2020 and December 2020 the Veteran was referred to schedule appointments with dermatology and podiatry regarding his bilateral foot disability; however, the most recent medical records are dated December 2, 2020, and the claims file does not contain any medical records regarding dermatology or podiatry care. Therefore, as the evidence indicates that there are outstanding VA treatment records relevant to the Veteran's claim of service connection for a bilateral foot disability, claimed as a bilateral foot rash, a remand is warranted at this time to obtain updated VA treatment records. 38 C.F.R. § 3.159(c)(3); Sullivan v. McDonald, 815 F.3d 786 (Fed. Cir. 2016). The matters are REMANDED for the following action: 1. Obtain all treatment records that are not already of record from any VA facility from which the Veteran has received treatment and associate the records with the claims file, specifically including dermatology and podiatry records regarding the Veteran's bilateral foot disability. (At his hearing the Veteran made reference to appointments dated after December 2020.) 2. Following the completion of the above, if the obtained VA treatment records indicate a newly diagnosed foot disability or if the agency of original jurisdiction otherwise determines that additional development is warranted, schedule the Veteran for an examination to determine the nature and etiology of his bilateral foot disability. The claims folder must be made available to and be reviewed by the examiner. The examiner should address the following: a. Is it at least as likely as not (50 percent or greater probability) that the Veteran's bilateral foot disability, claimed as a bilateral foot rash, had its onset during service or is otherwise related to service? In providing the requested opinion, the examiner should consider and discuss all pertinent medical and lay evidence of record, to include the Veteran's assertions as to the nature, onset, and continuity of such problems since service. Notably, the absence of documented evidence of a diagnosis or associated symptoms during and shortly after service should not, alone, serve as the sole basis for a negative opinion. 3. Obtain an addendum VA opinion regarding the nature and etiology of the Veteran's lumbar spine disability. The claims folder must be made available to and be reviewed by the examiner. The examiner should address the following: a. Is it at least as likely as not (50 percent or greater probability) that the Veteran's lumbar spine disability had its onset during service or is otherwise related to service? The examiner should consider the Veteran's lay statements, including as provided in the April 2021 Board hearing and in statements submitted in September 2016, December 2019, and November 2020. In providing the requested opinion, the examiner should consider and discuss all pertinent medical and lay evidence of record, to include the Veteran's assertions as to the nature, onset, and continuity of such problems since service. Notably, the absence of documented evidence of a diagnosis or associated symptoms during and shortly after service should not, alone, serve as the sole basis for a negative opinion. A rationale for all opinions is to be provided. If the examiner cannot provide any of the requested opinions without resorting to speculation, he or she should provide an explanation stating why this is so. In so doing, the examiner should explain whether the inability to provide a more definitive opinion is the result of a need for additional information or that he or she has exhausted the limits of current medical knowledge in providing an answer to that particular question(s). 4. After undertaking any additional development as may become indicated, re-adjudicate the issues on appeal, including service connection for right knee disability. MICHAEL E. KILCOYNE Veterans Law Judge Board of Veterans' Appeals Attorney for the Board A. Page-Nelson, 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.