Citation Nr: 22015102 Decision Date: 03/16/22 Archive Date: 03/16/22 DOCKET NO. 18-15 734 DATE: March 16, 2022 REMANDED Service connection for a left knee disability is remanded. REASONS FOR REMAND The Veteran had service with the Army National Guard from November 1965 to January 1972 and active duty service from January 1967 to May 1967. This matter came to the Board of Veterans' Appeals (Board) from a July 2017 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO). This matter was remanded in June 2019 for further development. Specifically, the Veteran reported treatment for his knee in March 1967 at the Ft. Polk Base Hospital. As service treatment records do not typically include inpatient records (clinical records) from military treatment facilities, the matter was remanded to attempt to obtain these records. See Sullivan v. McDonald, 815 F.3d 786, 79092 (Fed. Cir. 2016). Attempts to obtain additional treatment records from the National Personnel Records Center (NPRC) were unsuccessful. See 01/07/2022 Final Attempt Letter. The Board finds, however, that an attempt should be made to obtain the Veteran's treatment records directly from Bayne-Jones Army Community Hospital at Fort Polk, Louisiana. It is also acknowledged that a March 28, 1969 VA Form 07-3101 Request for Information reflects that medical records were requested for a left knee injury that occurred in February 1967 during active duty. In May 1969, health records were forwarded; however, such records do not contain any reports pertaining to the left knee injury. See 05/23/2017 Military Personnel Record at 7. The VA Form 07-3101 generated in 1969 is in a 2017 entry pertaining to military personnel records. The RO should ensure that there are no prior claims for compensation or outstanding VA records pertaining to this Veteran. In February 2020, the Veteran was afforded a C&P examination wherein the examiner proffered a negative etiological opinion with regard to the left knee. The examiner noted review of the claims folder and based on examination of the Veteran, found a lapse in treatment. It was determined that an unexplained long period of time between medical care does not support the claimed condition is directly related to service. In addition, there is lacking evidence to support the Veteran had any knee complaints and/or issues while in-service from January to May 1967. The examiner referenced a June 1971 orthopedic examination, which revealed no effusion of left knee joint, no instability of ligaments; good muscular strength left quad; squats well; negative cartilage tests. cleared for duty. Therefore, the examiner opined that the claimed condition (current left knee disability) was less likely than not related to, or had its onset, during the Veteran's period of active service. It is not clear whether the examiner considered the March 1969 VA request for information pertaining to a left knee injury in February 1967 when making the conclusion that "there is lacking evidence to support the Veteran had any knee complaints and/or issues while in service." Thus, after attempts are made to obtain the Veteran's records from Bayne-Jones Army Community Hospital, an addendum opinion should be sought from the examiner. The matter is REMANDED for the following actions: 1. Request the Veteran's treatment records from Bayne-Jones Army Community Hospital at Fort Polk for the period from February to March 1967. If such efforts prove unsuccessful, documentation to that effect should be added to the claims folder. 2. In light of the March 28, 1969 VA Form 07-3101 Request for Information contained in the Military Personnel Records, determine whether there are any outstanding VA documents or claims for compensation for any period prior to 2017, and associate any outstanding documents with the claims folder. If such efforts prove unsuccessful, documentation to that effect should be added to the claims folder. 3. Request that the February 2020 C&P examiner (or another qualified examiner if the February 2020 examiner is unavailable) review the claims folder and provide an opinion as to whether it is at least as likely as not that his left knee disability is due to service or any incident therein? Consideration should be given to the medical and lay evidence, to include the March 28, 1969 VA Form 07-3101 Request for Information pertaining to a February 1967 left knee injury. See 05/23/2017 Military Personnel Record at 7. The examiner is advised that the Veteran is competent to report his symptoms and history, and such reports must be acknowledged and considered in formulating any provided opinions. (Continued on the next page) A clear explanation for all opinions would be helpful, and a discussion of the facts and medical principles involved would be of considerable assistance to the Board. If the examiner is unable to provide an opinion he or she should explain why. Eric S. Leboff Veterans Law Judge Board of Veterans' Appeals Attorney for the Board M.W. Kreindler, 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.