Citation Nr: 22012281 Decision Date: 03/03/22 Archive Date: 03/03/22 DOCKET NO. 15-31 301 DATE: March 3, 2022 REMANDED Entitlement to service connection for a right knee condition to include chronic pain is remanded REASONS FOR REMAND The Veteran served on active duty in the United States Marine Corps from November 1973 to December 1977. This matter is on appeal from a July 2013 rating decision. In June 2019, the Veteran testified at a Travel Board hearing before the undersigned Veterans Law Judge of the Board. A transcript of the hearing is associated with the record. In September 2019, the Board reopened and remanded the issue on appeal for further development. Regrettably additional development is still necessary. Entitlement to service connection for right knee condition to include chronic pain is remanded. As noted above, in September 2019, the Board remanded the appeal for an examination and opinion as to the etiology of the Veteran's claimed right knee disability. In December 2019, the Veteran was afforded an examination and the examiner concluded that it was less likely than not that the Veteran's right knee disorder was related to service. In so finding, the examiner stated that the Veteran's service treatment records did not note complaint, treatment or diagnosis of a right knee condition. However, the examiner failed to discuss the Veteran's assertion during his examination that his knee symptoms began just before he separated from service when he twisted his right knee and had pain on and off since that time. The Board notes that "symptoms, not treatment, are the essence of any evidence of continuity of symptomatology" and that a lack of treatment records should not automatically lead to a conclusion that the Veteran did not experience headaches since service. Wilson v. Derwinski, 2 Vet. App. 16, 19 (1991). Accordingly, the December 2019 medical opinion is found to be inadequate. Further, since the September 2019 remand, service connection for the Veteran's right ankle sprain disability was granted in a July 2020 rating. The Veteran asserts, in part, that his right knee disability may be secondary to his now-service connected right ankle disability. Thus, a new examination is in order, so that the Veteran's lay statements, and secondary service connection, may be considered. The Board by this remand makes no determination, expressed or implied, concerning the credibility of any statements on file. The matters are REMANDED for the following action: 1. Schedule the Veteran for a VA examination with an appropriate medical professional to determine the nature and etiology of his claimed right knee condition to include chronic pain. The Veteran's electronic claims file must be made accessible to the examiner in conjunction with the examination along with any other information the medical professional deems pertinent. Following review of the record, including treatment records, and examination of the Veteran, the examiner should provide an opinion as to the following: a) Is it at least as likely as not (a 50 percent or greater probability) that the Veteran's right knee condition to include chronic pain is etiologically related to his active-duty service? b) Is at least as likely as not (50 percent or greater probability) that the Veteran's right knee condition to include chronic pain manifested within one year of his service discharge in December 1977 and, if so, describe the manifestations. c) If no, is the Veteran's right knee disability is at least as likely as not related to/proximately due to service-connected disability/aggravated by his service-connected right ankle disability? (Continued on the next page) The provided opinion must reflect consideration of the medical and lay evidence of record setting forth a complete rationale for all findings and conclusions. 2. Upon completion of the requested development and any additional development deemed appropriate, adjudicate the claims on appeal. If the determination remains unfavorable, the Veteran and his representative should be furnished a supplemental statement of the case which addresses all relevant evidence. The Veteran and his representative should be afforded the applicable time period in which to respond. Then, return the case to the Board. KELLI A. KORDICH Veterans Law Judge Board of Veterans' Appeals Attorney for the Board G. Slovick, 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.