Citation Nr: 22014205 Decision Date: 03/11/22 Archive Date: 03/11/22 DOCKET NO. 17-20 801 DATE: March 11, 2022 REMANDED Entitlement to service connection for a right knee disability is remanded. Entitlement to service connection for a left knee disability is remanded. REASONS FOR REMAND The Veteran served on active duty from August 1973 to June 1977, and from February 1979 to July 1987. These matters come before the Board of Veterans' Appeals (Board) on appeal from a May 2014 Rating Decision of a Department of Veterans Affairs (VA) Regional Office (RO). The Veteran testified at a Board virtual hearing before the undersigned Veterans Law Judge (VLJ) in October 2021. A transcript of that hearing has been associated with the claims file. The Veteran seeks entitlement to service connection for a right knee disability and a left knee disability. Unfortunately, the Board finds that additional development must be undertaken before these claims can be adjudicated on the merits. The Veteran testified at his October 2021 Board virtual hearing that he initially sustained a right knee injury due to a hard landing while parachute jumping during his training as an airborne paratrooper at Fort Benning, Georgia. The Veteran further testified that he gradually incurred chronic bilateral knee pain during his second period of active-duty service over time as a result of running everyday through the desert sand and rocks of the Sinai Peninsula while wearing combat boots in his capacity as a dog handler. The Veteran indicated that he experienced continuous bilateral knee pain since that time, but that he self-medicated with pain relief medication because he did not want his complaints of knee pain to interfere with his military career. A review of the Veteran's service records confirms that he completed one week of the Airborne Course at Fort Benning Georgia, in 1974, and that he earned the Parachute Badge. His service personnel records also confirm that his principal duty was Military Police Patrol / Narcotic Dog Handler while stationed in Sinai, Egypt, from October 1984 to October 1985. VA treatment records have diagnosed the Veteran as having bilateral knee pain, degenerative joint disease of the bilateral knees, and left knee effusion. However, post-service treatment records do not include an etiological opinion linking these disabilities to his periods of active-duty service. To date, the Veteran has not been provided with a medical examination regarding the probable nature, onset, and etiology of his bilateral knee symptomatology. Based on the above evidence, the Board finds that VA's duty to obtain a medical opinion relevant to this issue has been triggered under McLendon v. Nicholson, 20 Vet. App. 79 (2006) (VA must provide a VA examination or obtain a medical opinion where there is a current disability, and an indication the disability may be related to the veteran's service, but there is insufficient medical evidence to decide the claim). Lay testimony as to continuity of symptomatology can satisfy the requirement for evidence that the claimed disability may be related to service, and the threshold for finding that the disability (or symptoms of a disability) may be associated with service is low. Id. at 83. Furthermore, the Veteran is competent to testify to in-service injuries, symptoms, and events. Jandreau v. Nicholson, 492 F.3d 1372, 1376-77 (2007). The matters are REMANDED for the following action: 1. Obtain updated VA treatment records. 2. Schedule the Veteran for an examination to determine the likely nature and etiology of any diagnosed disabilities of the right knee and left knee. The examiner should review the claims file and indicate such on the examination report. Any testing deemed necessary should be conducted, and the results thereof should be noted in the examination report. All relevant knee pathology shown on examination should be annotated in the examination report. Following a review of the claims file, as well as an interview with, and examination of, the Veteran, the examiner is asked to answer the following: a. List any knee disability by either (1) diagnosis or (2) functional impairment that presently exists or that has existed during the appeal period. b. For each knee disability identified, opine as to whether it is at least as likely as not (50 percent or greater probability) that any such diagnosed knee disability was incurred during the Veteran's active service or within one year thereafter, or is otherwise causally related to his active service or to an incident therein. In answering these questions, the examiner should consider and address the Veteran's testimony that he initially sustained a right knee injury due to a hard landing while parachute jumping during his training as an airborne paratrooper at Fort Benning, Georgia, and that he gradually incurred chronic bilateral knee pain during his second period of active duty service over time as a result of running everyday through the desert sand and rocks of the Sinai Peninsula while wearing combat boots in his capacity as a dog handler. The examiner must also consider and discuss the Veteran's testimony that he experienced continuous bilateral knee pain since service. The examiner is advised that the Veteran is competent to report that he has had symptoms such as bilateral knee pain since active service. If the examiner has reason (based on other evidence of record or medical knowledge) to question the Veteran's self-reported history, then the examiner should so state and provide a complete explanation why this is so. (Continued on the next page) A complete rationale for all opinions expressed must be provided. An examiner's report that he or she cannot provide an opinion without resort to speculation is inadequate unless the examiner provides a rationale for that statement. As such, if the examiner is unable to offer an opinion, then it is essential that the examiner provide a rationale for the conclusion that an opinion could not be provided without resort to speculation, together with a statement as to whether there is additional evidence that could enable an opinion to be provided or whether the inability to provide the opinion is based on the limits of medical knowledge. Tiffany Dawson Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Anthony M. Flamini 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.