Citation Nr: A26041015 Decision Date: 04/30/26 Archive Date: 04/30/26 DOCKET NO. 250828-581368 DATE: April 30, 2026 REMANDED Entitlement to service connection for a left ankle disability is remanded. Entitlement to service connection for a right ankle disability is remanded. Entitlement to service connection for left shin splints is remanded. Entitlement to service connection for right shin splints is remanded. Entitlement to service connection for a left knee disability is remanded. Entitlement to service connection for a right knee disability is remanded. Entitlement to service connection for left hip disability is remanded. Entitlement to service connection for right hip disability is remanded. Entitlement to service connection for an acquired psychiatric disorder is remanded. REASONS FOR REMAND The Veteran served on active duty for training (ACDUTRA) from February 2020 to July 2020. She appeals a January 2025 rating decision by the Agency of Original Jurisdiction (AOJ). In her August 2025 notice of disagreement (NOD), the Veteran appealed the decision directly to the Board and chose the Direct Review docket. See August 2025 VA Form 10182. Therefore, the Board may only consider the evidence of record at the time of the AOJ decision on appeal. 38 C.F.R. § 20.301. Evidence was added to the claims file during a period of time when new evidence was not allowed. As the Board is remanding all claims contained in the instant appeal as listed above for further development, this additional evidence will be considered by the AOJ in the adjudication of those claims. 1. Left Ankle 2. Right Ankle 3. Left Hip 4. Right Hip 5. Left Knee 6. Right Knee 7. Left Shin Splints 8. Right Shin Splints The Veteran was afforded VA examinations in October 2023 addressing her claimed bilateral ankle, bilateral hip, bilateral knee, and bilateral shin splint disabilities. See October 2023 VA examination reports. The examinations confirm current diagnoses. Id. However, the AOJ did not obtain medical nexus opinions addressing whether these disabilities are related to the Veteran's reported onset during basic training and continued symptomatology since service. The Veteran contends that she injured her knees, hips, shins, and ankles during basic training, and that her pain has continued to date. See October 2023 VA examination reports; see also September 2024 Veteran statement. The Veteran is competent to report that she experienced said pain since her time in service. See Jandreau v. Nicholson, 492 F.3d 1372, 1377 (Fed. Cir. 2007). Notably, the Veteran has consistently maintained this argument since the outset of her claim. See June 2023 VA Form 21-526EZ. Once VA undertakes to provide an examination, it must ensure that the examination is adequate. See Barr v. Nicholson, 21 Vet. App. 303 (2007). Because the examinations of record do not include nexus opinions, they are inadequate for adjudication purposes. The Board finds that the AOJ's failure to obtain nexus opinions in connection with the October 2023 VA examinations is a predecisional duty to assist error; therefore, remand is warranted. See 38 C.F.R. § 20.802(a). 9. Acquired Psychiatric Disorder The Veteran contends that her acquired psychiatric disorder is secondary to her musculoskeletal disabilities. See December 2024 Higher-Level Review (HLR) Informal Conference Worksheet. Critically, the January 2025 rating decision contains the favorable finding that the Veteran's psychiatric disorder is secondary to her right knee disability, subject to remand herein. See January 2025 rating decision. Thus, this issue is inextricably intertwined with the remanded issues above. Accordingly, the Board will defer adjudication on the matter. See Harris v. Derwinski, 1 Vet. App. 180 (1991). The duty to assist errors identified above regarding the Veteran's claims extend to this intertwined claim as well and remand is appropriate. 38 C.F.R. § 20.802(a). The matters are REMANDED for the following action: 1. Obtain an opinion from an appropriately qualified clinician to determine the nature and etiology of the Veteran's (1) left ankle, (2) right ankle, (3) left hip, (4) right hip, (5) left shin splints, (6) right shin splints, (7) left knee, and (8) right knee disabilities. The evidentiary record, including a copy of this remand, must be made available and reviewed by the clinician. The opinion should include a notation that this record review took place. It is up to the discretion of the reviewing clinician as to whether a new examination is necessary to provide an adequate opinion. After the record review, and examination if deemed necessary, the reviewing clinician is asked to respond to the following: (a.) Is it at least as likely as not (likelihood is at least approximately balanced or nearly equal, if not higher) that the Veteran's left ankle disability is related to a disease or injury incurred during her period of ACDUTRA? (b.) Is it at least as likely as not (likelihood is at least approximately balanced or nearly equal, if not higher) that the Veteran's right ankle disability is related to a disease or injury incurred during her period of ACDUTRA? (c.) Is it at least as likely as not (likelihood is at least approximately balanced or nearly equal, if not higher) that the Veteran's left hip is related to a disease or injury incurred during her period of ACDUTRA? (d.) Is it at least as likely as not (likelihood is at least approximately balanced or nearly equal, if not higher) that the Veteran's right hip disability is related to a disease or injury incurred during her period of ACDUTRA? (e.) Is it at least as likely as not (likelihood is at least approximately balanced or nearly equal, if not higher) that the Veteran's left shin splints are related to a disease or injury incurred during her period of ACDUTRA? (f.) Is it at least as likely as not (likelihood is at least approximately balanced or nearly equal, if not higher) that the Veteran's right shin splints are related to a disease or injury incurred during her period of ACDUTRA? (g.) Is it at least as likely as not (likelihood is at least approximately balanced or nearly equal, if not higher) that the Veteran's left knee disability is related to a disease or injury incurred during her period of ACDUTRA? (h.) Is it at least as likely as not (likelihood is at least approximately balanced or nearly equal, if not higher) that the Veteran's right knee disability is related to a disease or injury incurred during her period of ACDUTRA? In rendering these opinions, the reviewing clinician is advised that the Veteran is competent to report her symptoms and history. Such reports must be acknowledged and considered in formulating any opinion. If the reviewing clinician rejects the Veteran's reports, he or she must provide an explanation for such rejection. The reviewing clinician is not to improperly discount the Veteran's lay statements or mistakenly rely on an absence of medical evidence in the record to support his or her conclusions. The complete rationale for all opinions should be set forth and a discussion of the facts and medical principles involved would be of considerable assistance to the Board. If an opinion cannot be provided without resorting to mere speculation, the reviewing clinician must provide a complete explanation for why an opinion cannot be rendered. In so doing, the reviewing clinician must explain whether the inability to provide a more definitive opinion is the result of a need for additional information, or that he or she has exhausted the limits of current medical knowledge in providing an answer to that particular question. DONNIE R. HACHEY Veterans Law Judge Board of Veterans' Appeals Attorney for the Board K. Poe, 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.