Citation Nr: 22010100
Decision Date: 02/22/22	Archive Date: 02/22/22

DOCKET NO. 14-37 468
DATE: February 22, 2022

REMANDED

Entitlement to service connection for a right knee disability, to include as secondary to service-connected disability, is remanded.

REASONS FOR REMAND

The Veteran served on active duty from December 1971 to December 1974. Unfortunately, he died during the pendency of the appeal and his daughter has been substituted as the appellant.

This matter comes before the Board of Veterans' Appeals (Board) on appeal from a February 2012 rating decision by a Department of Veterans Affairs (VA) regional office. Most recently, the Board remanded the matter in a July 2021 Decision.

While further delay is regrettable, the Board finds remand is again necessary before a decision may be rendered. Pursuant to the July 2021 remand, a VA opinion was obtained in November 2021 with respect to whether the Veteran's right knee disability was caused or aggravated by his service-connected pes planus. Upon review, however, the Board finds this opinion is insufficient for purposes of determining entitlement to service connection. In that regard, the examiner opined that the right knee disability was not caused or aggravated by pes planus because the service treatment records and medical records did not sufficiently demonstrate a relationship between the conditions, and because the Veteran's gait was not always noted to be abnormal. Id. However, a lack of documented causation is not, alone, a sufficient rationale for a negative opinion. Further, the examiner did not explain the significance of the Veteran's gait being abnormal at times and normal at others. When asked to explain why the Veteran's service-connected left knee disability was found to be secondary to pes planus but the right knee was not, the examiner simply stated that the right and left knee disabilities are different "for obvious reasons." Id. As the examiner did not provide an adequate rationale for the opinions stated, the Board finds remand is again warranted so that a new opinion may be obtained from a VA different examiner. 

The matter is REMANDED for the following action:

The claims file should be sent to an appropriate examiner, other than the one who provided the November 2021 VA opinion, to offer an opinion as to whether the Veteran's right knee disability had onset during service or is otherwise related to an in-service injury, event, or disease.  

The examiner should also address whether the right knee disability was (a) caused by, or (b) aggravated by (worsened beyond natural progression) the Veteran's service-connected pes planus and/or left knee disability, to include as a result of an altered gait.

If the examiner finds that the right knee disability was not caused or aggravated by the Veteran's service-connected disabilities, an explanation should be provided as to how the Veteran's altered gait caused his left knee disability, but not his right knee disability. The examiner is reminded that a lack of documented treatment or causation in the service treatment records is not a sufficient basis for a negative opinion. 

A rationale for all opinions offered is requested as adjudicators are precluded from making any medical findings. 

 

 

M. Mills

Acting Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	M. D. Bruce, 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.