Citation Nr: 23014232 Decision Date: 03/09/23 Archive Date: 03/09/23 DOCKET NO. 17-53 205 DATE: March 9, 2023 REMANDED Entitlement to service connection for right knee disability, to include degenerative arthritis and right knee strain, is remanded. Entitlement to service connection for degenerative arthritis of the lumbar spine with stenosis and radiculopathy is remanded. Entitlement to service connection for diabetes as secondary to degenerative arthritis of the lumbar spine with stenosis and radiculopathy is remanded. INTRODUCTION The Veteran served on active duty from June 1972 to June 1992. This matter comes to the Board of Veterans' Appeals (Board) from an October 2015 rating decision from the Department of Veterans Affairs (VA) Regional Office (RO), which denied service connection for the Veteran's degenerative arthritis of the lumbar spine with stenosis and radiculopathy, right knee disability and diabetes. The Board remanded the claims in April 2019 for additional development. In April 2022, the Board denied the Veteran's appeal of the denials of service connection for degenerative arthritis of the lumbar spine with stenosis and radiculopathy, right knee disability and diabetes. April 2022 Board Decision. The Veteran appealed the denial to the United States Court of Appeals for Veterans Claims (Court). In January 2023, the Court granted a joint motion for remand (JMR), vacating the April 2022 Board decision, and remanding the matter to the Board for actions consistent with the terms of the JMR. January 2023 CAVC Decision. REASONS FOR REMAND I. RIGHT KNEE AND LUMBAR SPINE DISABILITIES The parties agree remand is warranted because the Board failed to ensure compliance with prior remand orders. Stegall v. West, 11 Vet. App. 268, 271 (1998). In April 2019, the Board remanded the case for additional medical opinions for the Veteran's right knee and back disabilities. The examiners were required to specifically acknowledge and consider Veteran's lay reports, and if they rejected the reports, to provide their reasoning. The Veteran was afforded a VA examination in November 2019. The VA examiner provided an opinion that the Veteran's right knee disability as not related to service. This opinion was inadequate as the examiner, while noting that service treatment records reflected a football injury to the left knee, did not address the Veteran's contentions that he also injured his right knee while playing football in service, and that he attributed his right knee condition to "the tackles, and abuse my right knee was involved in while playing in semi-pro football games when I was in the Air Force." In addition, the parties agreed that a VA opinion regarding the Veteran's claim for service connection for a back disability was inadequate because the examiner failed to provide an adequate rationale for the opinion. Specifically, the examiner stated that "medical literature supports that almost 99% of strains resolve over time after conservative measures" but failed to explain the assumption that Veteran had in fact been diagnosed with merely a back strain in service and there was no further discussion as to whether his in-service back injuries resolved. The examiner also failed to address Veteran's lay opinion, concluding that "documented continuity or chronicity does not exist." However, the Veteran reported in his October 2017 statement that "[t]he disease degenerative arthritis of the spine with stenosis and lumbar radiculopathy never went away but instead kept on progressing while intensifying the pain, the length of the pain, controlling how I walk, controlling how far I could bend over and get up and down." On remand, adequate medical opinions must be obtained addressing whether the Veteran's right knee and lumbar spine conditions are related to service. II. DIABETES AS SECONDARY TO DEGENERATIVE ARTHRITIS OF THE LUMBAR SPINE WITH STENOSIS AND RADICULOPATHY As noted in the JMR, the claim for service connection for diabetes is inextricably intertwined with the claim for service connection for degenerative arthritis of the lumbar spine with stenosis and radiculopathy. As such, the issue is remanded. The matters are REMANDED for the following action: 1. Schedule the Veteran for a VA examination for his right knee disability and lumbar spine disability. The examiner must review the claims file. The examiner is asked to provide an opinion as to whether either the Veteran's current right knee disability or his degenerative arthritis of the lumbar spine (with stenosis and radiculopathy) had its onset during, or is otherwise related to, his active duty. 2. Provide a rationale to support the opinions. In providing the requested opinion, the examiner must address the Veteran's description of his in-service injury and symptoms, to include the tackles, and stress the Veteran's right knee was involved in while playing in semi-pro football games when he was in the Air Force, as well as his post-service symptoms. The examiner must also address the Veteran's description of his in-service injury and symptoms, to include his October 2017 statement that "[t]he disease degenerative arthritis of the spine with stenosis and lumbar radiculopathy never went away but instead kept on progressing while intensifying the pain, the length of the pain, controlling how I walk, controlling how far I could bend over and get up and down." If there is any medical reason to accept or reject the proposition that the Veteran's reported injury and symptoms in service and thereafter represented the onset of his current disability, this should be noted. Stated another way, do the Veteran's reports about his symptoms align with how the currently diagnosed disability is known to develop or are the Veteran's reports generally inconsistent with medical knowledge or implausible? J. B. FREEMAN Veterans Law Judge Board of Veterans' Appeals Attorney for the Board M. Harrigan Smith 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.