Citation Nr: 22012005 Decision Date: 03/02/22 Archive Date: 03/02/22 DOCKET NO. 13-31 852 DATE: March 2, 2022 REMANDED Entitlement to service connection for left knee disability is remanded. REASONS FOR REMAND The Veteran served on active duty from March 1978 to March 1981. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a July 2012 rating decision. In February 2018 and July 2020, the Board remanded this matter for additional development. Unfortunately, another remand is necessary. 1. Entitlement to service connection for left knee disability is remanded. The Veteran seeks service connection for left knee disability, asserting his left knee disability is from an injury in service or related to his service-connected right knee disability. In July 2020, the Board remanded this matter to obtain VA medical opinion regarding whether the Veteran's left knee disability was caused by or aggravated by his right knee disability. In October 2020, a VA examiner opined that the Veteran's left knee disability is less likely than not caused by or aggravated by his right knee disability. The examiner explained that medical records are silent for complaints or diagnosis of a left knee disability and that the December 2019 VA examination showed a normal left knee examination. The examiner concluded that there was no objective medical evidence of a causal relationship or aggravation of left knee pain by the right knee disability. However, while the examiner said medical records were silent for a diagnosis, the July 2012, April 2018, and November 2019 VA examiners noted a diagnosis of left knee degenerative arthritis. Accordingly, the opinion appears to be based on an inaccurate factual premise. See Reonal v. Brown, 5 Vet. App. 458, 461(1993). In addition, the examiner did not address the Veteran's reports that his left knee pain had increased in severity due to compensating for his right knee disability. See Miller v. Wilkie, 32 Vet. App. 249 (2020) (holding when an examiner fails to address the Veteran's lay evidence, and the Board does not find the Veteran not credible or not competent to offer that lay evidence, a new exam is needed). In addition, while the October 2020 VA examiner noted the December 2019 VA left knee examination was normal, a later VA examination obtained in December 2020 shows limited movement of the left knee. For these reasons, remand is warranted to obtain additional VA medical opinion regarding whether the Veteran's left knee disability is secondary to his service-connected right knee disability. While this matter is on remand, any additional outstanding treatment records should be obtained. The matters are REMANDED for the following action: 1. Obtain any additional VA treatment records, to include VA treatment records from December 2021 to the present. Associate with the claims file all potentially relevant documents scanned into Vista Imaging or CPRS but not associated with the Veteran's claims file. 2. After the above records are obtained to the extent possible, ask the appropriate examiner to review the Veteran's file. The necessity of an in-person examination is left to the discretion of the examiner. - The examiner should identify any left knee disability the Veteran has experienced during the claim period, even if resolved. If there is no diagnosed disability, the examiner should opine whether there is a left knee disability causing functional impairment of earning capacity. In so opining, the examiner should specifically address the July 2012, April 2018, and November 2019 VA examiners' diagnosis of left knee degenerative arthritis. - For each such disability (including any functional impairment of earning capacity), the examiner should opine regarding whether it is at least as likely as not that the disability is caused by or aggravated by his service-connected right knee disability. Note that aggravation means any incremental increase in disability in non-service-connected disabilities (i.e., any additional impairment of earning capacity) resulting from service-connected condition. The examiner should consider all medical and lay evidence of record. The examiner must specifically address the Veteran's reports that his left knee pain had increased in severity due to compensating for his right knee disability. If the Veteran's reports are discounted, the examiner should provide a rationale for doing so (e.g., whether there is any medical reason to accept or reject his contentions). The examiner is asked to explain the reasons behind any opinions expressed. 3. After the above development, and any additionally indicated development, has been completed, readjudicate the issue on appeal. SHEREEN M. MARCUS Veterans Law Judge Board of Veterans' Appeals Attorney for the Board A. Purcell, 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.