Citation Nr: 18160384
Decision Date: 12/27/18	Archive Date: 12/26/18

DOCKET NO. 14-11 999
DATE:	December 27, 2018
Entitlement to service connection for left knee osteoarthritis (claimed as left knee) secondary to service-connected right knee anterior cruciate ligament (ACL) tear, status post-reconstruction and medial meniscal tear, status post-debridement is remanded.
The Veteran served on active duty from December 1998 to December 2003. This matter is before the Board of Veterans’ Appeals (Board) on appeal from a May 2011 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO). 
In January 2018, the Board remanded the case for further development.  The Board finds that the remand directives were not substantially complied with, which will be discussed further below.  As such, another remand is warranted to comply with the Board directives.  Stegall v. West, 11 Vet. App. 268, 271 (1998).  
Entitlement to service connection for left knee osteoarthritis (claimed as left knee) secondary to service-connected right knee ACL tear, status post-reconstruction and medial meniscal tear, status post-debridement is remanded.
The January 2018 Board remand directed the Agency of Original Jurisdiction (AOJ) to schedule the Veteran another VA examination because the prior May 2011 VA examination did not address diagnoses of record regarding his left knee.  The 2011 examination determined there was no current left knee disability even though there were several left knee diagnoses in the evidence of record.  Subsequently, he was scheduled for a VA examination in March 2018 that evaluated his current symptomatology.  In addition, a VA medical opinion was also provided by an examiner in March 2018.  The examiner did not address the left knee diagnoses that the Board identified on remand or answer fully answer the question posed by the January 2018 remand directives.  Specifically, an April 2011 clinician diagnosis of derangement of the left knee.  A May 2011, diagnosis a left knee sprain and a September 2011 diagnosis of pes anserine bursitis of the left knee were not addressed.  Instead, the examiner stated that the right knee conditions have nothing to do with actual degenerative joint disease affecting left and right knee conditions – condition is due to aging process and not due to right knee conditions.  As the Board finds that there has not been substantial compliance with its prior directives, it finds that another remand is warranted.  
Additionally, updated VA treatment records should be associated with the record on remand.  See Sullivan v. McDonald, 815 F.3d 786, 792 (Fed. Cir. 2016) (finding that because § 3.159(c)(3) expanded the VA’s duty to assist to include obtaining VA medical records without consideration of their relevance.)
The matter is REMANDED for the following actions:
1. Update/Obtain VA treatment records from July 2013 to the present.  Document all requests for information as well as responses in the claims file.
2. After completion of step #1, schedule the Veteran for an examination by an appropriate clinician to determine the nature and etiology of his left knee disability.  The examiner is to provide an opinion whether it at least likely as not related to an in-service injury, event, or disease. A comprehensive rationale is to accompany the opinion.  The examiner is to specifically discuss:
(a.) Diagnoses in treatment records which include:  
(1) an April 7, 2011, diagnosis derangement of left knee (at March 2011 VA examination);
(2) a May 10, 2011, diagnosis of left knee sprain, and;
(3) a September 20, 2011 diagnosis of Left side pes anserine bursitis as they relate to either a direct service connection claim or as secondary to his service-connected right knee ACL surgery.
(b.) The examiner should discuss whether it is at least likely as not that the Veteran’s statements regarding his favoring/compensating on his left knee to avoid placing additional pressure on his service-connected right knee while performing his job as a postman is the proximate cause of his left knee condition.
The examiner is advised that the Veteran is competent to report his symptoms and history, and such reports must be specifically acknowledged and considered in formulating any opinions.  
Paul Sorisio
Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD	A. M. Williams, Associate Counsel

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