Citation Nr: 22013433 Decision Date: 03/09/22 Archive Date: 03/09/22 DOCKET NO. 14-34 821A DATE: March 9, 2022 REMANDED Entitlement to service connection for a right knee condition, to include as secondary to service-connected disabilities is remanded. REASONS FOR REMAND The Veteran served on active duty from August 1976 to March 1979. These matters come before the Board of Veterans' Appeals (Board) on appeal from rating decisions of a Department of Veterans Affairs (VA) Regional Office (RO). The matter was most recently before the Board in August 2021, at which time it was remanded for development. It returns now for appellate review. 1. Entitlement to service connection for a right knee condition, to include as secondary to service-connected disabilities is remanded. The inadequacy of VA examiners' medical opinions of record necessitates a remand of this matter. The Veteran has not as yet been afforded an adequate VA medical examination and opinion as to etiology, and while the Board cannot substitute its medical judgment for that of a qualified medical professional, neither can it adjudicate this matter absent a reasoned medical opinion that considers the Veteran's proposed theories of entitlement to the benefit sought. Specifically, the Veteran has argued that (1) his service-connected lumbar and left knee disabilities have affected his gait which has, in turn, caused or aggravated his right knee disability; and that, in the alternative, (2) his service-connected lumbar and left knee disabilities have caused or aggravated his obesity by causing him to limit activity levels, and that obesity has, in turn, caused or aggravated his right knee disability. The VA examiner with whom the Veteran met in October 2021, pursuant to a prior Board remand, dismissed these contentions in conclusory terms without furnishing adequate reasoning for his conclusions. On remand, a new VA examination must be conducted and adequate medical opinions obtained which afford due consideration to the Veteran's theories of entitlement. The matters are REMANDED for the following action: 1. After obtaining the necessary authorization, update the file with any VA or private treatment records relevant to the Veteran's claim. If any requested records are unavailable, the Veteran should be notified to that effect. 2. Then, schedule the Veteran for a VA examination with a qualified examiner who has not yet participated in this matter, to explore the etiology of his right knee disorder, to include as secondary to obesity, and to other service-connected disabilities, including in combination. All indicated tests and studies should be conducted and all clinical findings reported in detail. The entire claims file should be made available to and be reviewed by the examiner in conjunction with this request. The examiner should state whether a current right knee disorder is at least as likely as not (e.g. at least a 50 percent probability or greater) related to service and explain why or why not. If direct service connection is not warranted, the examiner is directed to state whether, on an at least as likely as not basis, the Veteran's service-connected disabilities caused or aggravated the Veteran's obesity, and if so, if the Veteran's right knee disorder has been caused or aggravated beyond its normal course of progression by the Veteran's obesity, or by any other service-connected disability, or combination of service-connected disabilities. The examiner should explain why or why not. The examiner is directed to afford due consideration to the Veteran's lay statements, including those advanced at the VA examination. All opinions expressed must be accompanied by thorough rationale. 3. Review the opinion and any examination report to ensure that it is in complete compliance with the directives of this remand. If the opinion or report is deficient in any manner, the AOJ must implement corrective procedures. Stegall v. West, 11 Vet. App. 268, 271 (1998). GAYLE STROMMEN Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Z. Sahraie, 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.