Case A26040543

Summary

The veteran, who served in the Marine Corps from January 2003 to September 2011, appeals the denial of service connection for a lower back condition, right knee condition, and an increased rating for his left ankle disability. The Board found no evidence of a current lower back condition, noting the Veteran's own statements were conclusory and contradicted by VA treatment records showing no back pain. Therefore, service connection for the lower back was denied. For the right knee, the Board acknowledged a current diagnosis of osteoarthritis and an in-service complaint, but found the VA examiner's opinion of less likely than not service connection to be more probative than the Veteran's lay assertions. The right knee claim was denied. Regarding the left ankle, the Board reviewed the current rating under DC 5003-5271 and found the evidence did not support a higher rating than the 10 percent assigned, as the VA examination did not indicate marked symptomatology. The Veteran's lay opinion regarding the ankle was outweighed by the VA examiner's findings. However, the Board remanded the left knee condition, finding the VA examination inadequate because it failed to address the claimed left knee condition, labeling it an "unclaimed joint" despite it being part of the claim. The case was remanded for a new VA examination to determine the nature and etiology of the left knee condition and its relationship to service.

Rationale

No current lower back disability found; Veteran's statements conclusory and contradicted by treatment records; Evidence persuasively weighs against claim

Full Decision Text

Citation Nr: A26040543
Decision Date: 04/30/26	Archive Date: 04/30/26

DOCKET NO. 250604-552061
DATE: April 30, 2026

ORDER

Entitlement to service connection for lower back condition is denied.

Entitlement to service connection for right knee condition is denied.

Entitlement to an initial evaluation in excess of 10 percent for degenerative joint disease, left ankle ("left ankle disability") is denied.

REMANDED

Entitlement to service connection for left knee condition is remanded.

FINDINGS OF FACT

1. The evidence persuasively weighs against finding that the Veteran has had a diagnosis of a low back disorder or functional impairment of the low back at any time during or approximate to the pendency of the claim.

2. A chronic disorder of the right knee was not shown in service or within a year of service discharge; and, evidence persuasively weighs against finding the Veteran's current right knee osteoarthritis was caused by, or otherwise related to, his active duty service.

3. The Veteran's left ankle disability has not more nearly approximated marked limitation of motion at any point during the period on appeal.

CONCLUSIONS OF LAW

1. The criteria for service connection for lower back condition have not been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.304.

2. The criteria for service connection for right knee condition have not been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.304.

3. The criteria for an initial rating in excess of 10 percent for a left ankle disability have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.3, 4.7, 4.71a, DC 5003-5271.

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Veteran served on active duty in the Marine Corps from January 2003 to September 2011.

This matter comes before the Board of Veterans' Appeals (Board) on appeal from an April 7, 2025 higher-level review (HLR) rating decision by the Department of Veterans Affairs (VA) Regional Office (RO), also known as the Agency of Original Jurisdiction (AOJ), which adjudicated the Veteran's request for higher-level review of a prior December 2024 rating decision.  The Veteran appealed the April 2025 HLR decision by filing a VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement) in June 2025. He elected the Direct Review docket.

Therefore, the Board may only consider the evidence of record at the time of the December 2024 AOJ decision on appeal, which was subsequently subject to higher-level review. 38 C.F.R. § 20.301. Any evidence submitted after the AOJ decision on appeal cannot be considered by the Board. 38 C.F.R. §§ 20.300, 20.301, 20.801. 

If the Veteran would like VA to consider any evidence that was submitted that the Board could not consider, the Veteran may file a Supplemental Claim (VA Form 20-0995) and submit or identify this evidence. 38 C.F.R. § 3.2501. If the evidence is new and relevant, VA will issue another decision on the claim[s], considering the new evidence in addition to the evidence previously considered. Id. Specific instructions for filing a Supplemental Claim are included with this decision.

Service Connection

Service connection may be granted for disability resulting from disease or injury incurred in or aggravated by active service.  38 U.S.C. §§ 1110, 5107; 38 C.F.R. § 3.303.  The three-element test for service-connection requires evidence of: (1) a current disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the current disability and the in-service disease or injury.  See Shedden v. Principi, 381 F.3d 1163, 1166-67 (Fed. Cir. 2004). 

When there is an approximate balance of positive and negative evidence regarding the merits of an issue material to the determination of the matter, the benefit of the doubt in resolving each such issue shall be given to the claimant. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102.
 service-connection requires evidence of: (1) a current disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the current disability and the in-service disease or injury.  See Shedden v. Principi, 381 F.3d 1163, 1166-67 (Fed. Cir. 2004). 

When there is an approximate balance of positive and negative evidence regarding the merits of an issue material to the determination of the matter, the benefit of the doubt in resolving each such issue shall be given to the claimant. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102. When all the evidence is assembled, VA is responsible for determining whether the evidence supports the claim or is in relative equipoise, with the Veteran prevailing in either event, or whether the evidence is persuasively against the claim, in which case the claim is denied. Id.

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1. Entitlement to service connection for lower back condition.

The Veteran contends that he suffers from a lower back condition as a result of his military service.  See June 2025 NOD.

The threshold requirement for the granting of service connection is evidence of a current disability. In the absence of evidence of a current disability there can be no valid claim. Brammer v. Derwinski, 3 Vet. App. 223, 225 (1992). The requirement in a claim of service connection of current disability "is satisfied when a claimant has a disability at the time a claim for VA disability compensation is filed or during the pendency of that claim and that a claimant may be granted service connection even though the disability resolves prior to the Secretary's adjudication of the claim." See McClain v. Nicholson, 21 Vet. App. 319 (2007).

After carefully reviewing the evidence of record, the Board concludes that the Veteran does not have a current disability of a lower back condition and has not had one at any time during the pendency of the claim or recent to the filing of the claim. Romanowsky v. Shinseki, 26 Vet. App. 289, 294 (2013); McClain v. Nicholson, 21 Vet. App. 319, 321 (2007).  The relevant VA and private treatment records do not contain any reference to a back injury or any other back condition, nor has the Veteran identified any evidence in support of a current disability for this condition.

The Board has also considered Saunders v. Wilkie, 886 F.3d 1356 (Fed. Cir. 2018), in which the Federal Circuit held that "pain alone, without an accompanying diagnosis of a present disease, can qualify as a disability" if it "reaches the level of a functional impairment of earning capacity." Id. at 1367-69. However, the Veteran has not made any statements regarding pain or functional impairment related to a back injury beyond the bare assertion of filing a claim for entitlement to service connection for this condition.  Indeed, the Veteran's medical records appear to indicate that the opposite.  See May 2014 VAMC treatment records (Veteran has no neck or back pain).

The Board recognizes that the Veteran believes he suffers from a lower back condition and further believes that this condition is related to his time in service.  The Board notes that there are instances in which a layperson may be competent to offer testimony on medical matters, such as describing symptoms observable to the naked eye or even diagnosing simple conditions. See Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007).  The Board finds, however, that the questions posed by this claim are of such complexity as to require that individuals who provide competent medical evidence on this matter possess a level of expertise that a layperson simply does not possess. There is no definitive statement of continuous symptoms since service. The only evidence of record relating the Veteran's claimed disability to service or a service-connected disability are the Veteran's own general conclusory statements, which do not meet the low threshold of an indication that the claimed disability is due to service. See Waters v. Shinseki, 601 F.3d 1274, 1278-79 (Fed. Cir. 2010) (distinguishing cases where only a conclusory generalized statement is provided by the veteran and rejecting the theory that medical examinations are to be routinely and virtually automatically provided to all veterans in disability cases involving nexus issues). 

The Board further notes that the Veteran has not been afforded a VA examination in relation to his back conditions.  Pursuant to McLendon v. Nicholson, 20 Vet. App. 79 (2006), an examination is required when there is: (1) evidence of a current
 not meet the low threshold of an indication that the claimed disability is due to service. See Waters v. Shinseki, 601 F.3d 1274, 1278-79 (Fed. Cir. 2010) (distinguishing cases where only a conclusory generalized statement is provided by the veteran and rejecting the theory that medical examinations are to be routinely and virtually automatically provided to all veterans in disability cases involving nexus issues). 

The Board further notes that the Veteran has not been afforded a VA examination in relation to his back conditions.  Pursuant to McLendon v. Nicholson, 20 Vet. App. 79 (2006), an examination is required when there is: (1) evidence of a current disability, (2) evidence establishing an "in-service event, injury or disease," or that a disease, manifested in accordance with presumptive service connection regulations, occurred which would support incurrence or aggravation, (3) an indication that the current disability may be related to the in-service event, and (4) insufficient evidence to decide the case.  The Board finds that a VA examination in this instance is unnecessary.  Although McLendon sets a low bar, that bar has not been met here.  The only evidence of a possible connection between the Veteran's back condition and the Veteran's service are the Veteran's generalized, conclusory statements that this condition is a result of his time in service.  These statements alone are not sufficient to obtain an examination or opinion, particularly in light of the lack of any VA or private treatment notes supporting the existence of this condition.  See Waters v. Shinseki, 601 F.3d 1274, 1278-79 (Fed. Cir. 2010) (holding that conclusory lay assertions of nexus are insufficient to entitlement a claimant to a VA medical examination). 

In short, after considering the competent evidence of record, the Board finds that the evidence persuasively weighs against a finding that the Veteran had a lower back condition at any time relevant to the appeal.  Brammer v. Derwinski, 3 Vet. App. 223, 225 (1992); McClain v. Nicholson, 21 Vet. App. 319, 321 (2007).  As such, the Board must find that entitlement to service connection for a lower back condition is not warranted.

The Board has considered the benefit-of-the-doubt doctrine. However, as the evidence persuasively weighs against the claims, the claims are not in approximate balance. See 38 U.S.C. § 5107(b); 38 C.F.R. §§ 3.102, 4.3; Gilbert v. Derwinski, 1 Vet. App. 49, 53-56 (1990); Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021).  Accordingly, the claim for service connection for a lower back condition is denied.

2. Entitlement to service connection for right knee condition.

The Veteran contends that he suffers from a right knee condition as a result of his military service.  See June 2025 NOD.

The Veteran underwent a VA examination for his knee and lower leg conditions in January 2025, where the Veteran was diagnosed with right knee joint osteoarthritis.  Moreover, in its April 2025 rating decision, the AOJ made a favorable finding of a current diagnosis of right knee osteoarthritis.  The Board is bound by favorable findings by the AOJ in the absence of evidence of clear and unmistakable error. 38 C.F.R. § 3.104 (c).  The Board finds, therefore, that the first element of service connection has been met.  38 U.S.C. §§ 1131, 5107(b); Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009); 38 C.F.R. § 3.303(a).

As to the second requirement of an in-service injury or event, the Veteran's service treatment records (STRs) indicate that the Veteran complained of right knee pain.  See June 2003 STRs.  In its April 2025 rating decision, the AOJ made a favorable finding of a qualifying event, injury, or disease.  The Board is bound by favorable findings by the AOJ in the absence of evidence of clear and unmistakable error. 38 C.F.R. § 3.104 (c).  The Board finds, therefore, that the second element of service connection has been met.

Turning to the third element of a nexus, the Veteran was afforded a contemporaneous VA medical opinion with his January 2025 VA examination for knee and lower leg conditions.  The VA examiner op
 Veteran's service treatment records (STRs) indicate that the Veteran complained of right knee pain.  See June 2003 STRs.  In its April 2025 rating decision, the AOJ made a favorable finding of a qualifying event, injury, or disease.  The Board is bound by favorable findings by the AOJ in the absence of evidence of clear and unmistakable error. 38 C.F.R. § 3.104 (c).  The Board finds, therefore, that the second element of service connection has been met.

Turning to the third element of a nexus, the Veteran was afforded a contemporaneous VA medical opinion with his January 2025 VA examination for knee and lower leg conditions.  The VA examiner opined that it was less likely than not that the Veteran's right knee osteoarthritis is a result of his military service.  The VA examiner reasoned that although the Veteran reported a bruised right knee in 2003, there were no additional STRs or any additional medical records of any kind documenting a right knee condition until 19 years later, where an x-ray showed age-appropriate osteoarthritis.  As such, the examiner opined a negative nexus for his right knee condition.

The Board finds that the most recent VA medical opinion provides a sufficiently thorough rationale, which the Board finds probative and persuasive. No probative medical opinions refuting the January 2025 VA medical opinion have been rendered and the relevant VA and private treatment notes of record do not contradict the VA examiner's medical opinion. The Veteran has not identified any other evidence that would contradict the conclusions of the VA examiner, much less submitted contradictory opinions from another medical professional opining a supportive nexus between his current diagnosis and his military service.

The Board recognizes that the Veteran believes his right knee condition is related to his military service. The Board notes that there are instances in which a layperson may be competent to offer testimony on medical matters, such as describing symptoms observable to the naked eye or even diagnosing simple conditions. See Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007). The Board finds, however, that the questions posed by this claim are of such complexity as to require that individuals who provide competent medical evidence on this matter possess a level of expertise that a layperson simply does not possess. There is no definitive statement of continuous symptoms since service. The only evidence of record relating the Veteran's claimed disabilities to service are the Veteran's own general conclusory statements, which do not meet the low threshold of an indication that the claimed disability is due to service. See Waters v. Shinseki, 601 F.3d 1274, 1278-79 (Fed. Cir. 2010) (distinguishing cases where only a conclusory generalized statement is provided by the veteran and rejecting the theory that medical examinations are to be routinely and virtually automatically provided to all veterans in disability cases involving nexus issues). Thus, the Veteran's lay assertions, alone, do not constitute evidence upon which service connection can be granted. The Board finds, therefore, that the foregoing VA medical opinion outweighs the Veteran's contentions in these circumstances.

As the foregoing evidence is persuasively against the Veteran's claim for service connection, there is no reasonable doubt to resolve in the Veteran's favor. Lynch v. McDonough, 21 F.4th 776, 781-82 (2021). Accordingly, the claim for entitlement to service connection for a right knee condition is denied.

Increased Ratings

Disability evaluations are determined by the application of the VA Schedule for Ratings Disabilities (Rating Schedule).  38. C.F.R. Part 4.  The percentage ratings contained in the Rating Schedule represent, as far as can be practicably determined, the average impairment in earning capacity resulting from diseases and injuries incurred or aggravated during military service and their residual conditions in civil occupations.  38 U.S.C. § 1155; 38 C.F.R. § 4.1.  Any reasonable doubt regarding the degree of disability will be resolved in favor of the claimant.  38 C.F.R. § 4.3.  If two evaluations are potentially applicable, the higher evaluation will be assigned if the disability picture more nearly approximates the criteria required for that evaluation; otherwise, the lower rating will be assigned.  38 C.F.R. § 4.7.  A disability may require re-evaluation in accordance with changes in a veteran's condition.  It is thus essential, in determining the level of current impairment, that the disability be considered in the context of the entire recorded history.  38 C.F.R. § 4.1.

The intent of the Rating Schedule is to recognize actually painful, unstable or malaligned joints, due to healed injury, as entitled to at least the minimum compens
.F.R. § 4.3.  If two evaluations are potentially applicable, the higher evaluation will be assigned if the disability picture more nearly approximates the criteria required for that evaluation; otherwise, the lower rating will be assigned.  38 C.F.R. § 4.7.  A disability may require re-evaluation in accordance with changes in a veteran's condition.  It is thus essential, in determining the level of current impairment, that the disability be considered in the context of the entire recorded history.  38 C.F.R. § 4.1.

The intent of the Rating Schedule is to recognize actually painful, unstable or malaligned joints, due to healed injury, as entitled to at least the minimum compensable rating for the joint, even in the absence of arthritis. 38 C.F.R. § 4.59; Burton v. Shinseki, 25 Vet. App. 1, 5 (2011). In this regard, 38 C.F.R. § 4.59 requires that "[t]he joints involved should be tested for pain on both active and passive motion, in weight-bearing and nonweight-bearing and, if possible, with the range of the opposite undamaged joint." Correia v. McDonald, 28 Vet. App. 158 (2016). Further, 38 C.F.R. § 4.59 is applicable to the evaluation of musculoskeletal disabilities involving actually painful, unstable or malaligned joints or periarticular regions, regardless of whether the Diagnostic Code under which the disability is evaluated is predicated on range of motion measurements. Southall-Norman v. McDonald, 28 Vet. App. 346 (2016).

When evaluating musculoskeletal disabilities based on limitation of motion, 38 C.F.R. § 4.40 requires consideration of functional loss caused by pain or other factors listed in that section that could occur during flare-ups or after repeated use and, therefore, not be reflected on range-of-motion testing. 38 C.F.R. § 4.45 requires consideration also be given to less movement than normal, more movement than normal, weakened movement, excess fatigability, incoordination, and pain on movement. See DeLuca v. Brown, 8 Vet. App. 202 (1995); see also Mitchell v. Shinseki, 25 Vet. App. 32, 44 (2011). Nonetheless, even when the background factors listed in § 4.40 or 4.45 are relevant when evaluating a disability, the rating is assigned based on the extent to which motion is limited, pursuant to 38 C.F.R. § 4.71a (musculoskeletal system) or § 4.73 (muscle injury); a separate or higher rating under § 4.40 or 4.45 itself is not appropriate. See Thompson v. McDonald, 815 F.3d 781, 785 (Fed. Cir. 2016) ("[I]t is clear that the guidance of § 4.40 is intended to be used in understanding the nature of the veteran's disability, after which a rating is determined based on the § 4.71a [or 4.73] criteria.").

3. Entitlement to an evaluation in excess of 10 percent for degenerative joint disease, left ankle ("left ankle disability").

The Veteran contends that his left ankle disability warrants a higher rating than that which is currently assigned.  See June 2025 NOD.

The Veteran's left ankle disability is rated under 38 C.F.R. § 4.71a, DC 5003-5271.  Hyphenated diagnostic codes are used when a rating under one code requires use of an additional diagnostic code to identify the basis for the evaluation assigned; the additional code is shown after the hyphen. 38 C.F.R. § 4.27.

Under DC 5271, a 10 percent rating is warranted for moderate limitation of motion, defined as less than 15 degrees dorsiflexion or less than 30 degrees plantar flexion.  A 20 percent rating is warranted for marked limitation of motion, defined as less than 5 degrees dorsiflexion or less than 10 degrees plantar flexion.

Normal ranges of motion of the ankle are dorsiflexion from 0 degrees to 20 degrees, and plantar flexion from 0 degrees to 45 degrees. 38 C.F.R. § 4.71, Plate II.

The words "moderate" or "severe" are not defined in the VA Schedule. Rather than applying a mechanical formula, the Board must evaluate all of the evidence to the end that its decisions are equitable and just. 38 C.F.R. § 4.6. It should also be noted
ion.  A 20 percent rating is warranted for marked limitation of motion, defined as less than 5 degrees dorsiflexion or less than 10 degrees plantar flexion.

Normal ranges of motion of the ankle are dorsiflexion from 0 degrees to 20 degrees, and plantar flexion from 0 degrees to 45 degrees. 38 C.F.R. § 4.71, Plate II.

The words "moderate" or "severe" are not defined in the VA Schedule. Rather than applying a mechanical formula, the Board must evaluate all of the evidence to the end that its decisions are equitable and just. 38 C.F.R. § 4.6. It should also be noted that use of terminology such as "moderate" or "severe" by VA examiners and others, although an element of evidence to be considered by the Board, is not dispositive of an issue. All evidence must be evaluated in arriving at a decision regarding an increased rating. 38 C.F.R. §§ 4.2, 4.6.

Turning to the evidence of record, the Veteran was afforded a VA examination for his ankle conditions in September 2024, where he was diagnosed with degenerative joint disease, left ankle.  He reported current symptoms of daily left ankle pain, tension, and popping; he reported that it interferes with prolonged standing and walking, which he treats with over-the-counter pain medication.  He indicated that he does not experience flare-ups of the left ankle.  

On physical examination, range of motion (ROM) testing measured 20 degrees plantar flexion and 10 degrees dorsiflexion, with pain on plantar flexion and dorsiflexion, as well as weight-bearing, nonweight-bearing, active motion, and passive motion, which causes functional loss.  The examiner did not test the Veteran's left ankle after repeated use over time or estimated flare-ups.  The examiner found that the Veteran had interference with standing, disturbance of locomotion, less movement than normal, and would have difficulty standing and walking for prolonged periods.  The examiner found that the Veteran had no muscle atrophy, ankylosis, or joint instability.  The examiner found that the Veteran does not require the use of an assistive device, but would have functional impact in a workplace setting in that he would have difficulty with occupations requiring standing and walking for prolonged periods.

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The Board has also carefully reviewed the Veteran's VA and private treatment records and finds that they are generally silent for any information pertinent to the Veteran's left ankle disability, other than affirming his diagnosis.  In any event, these records do not document more severe ROM than that which was assessed in the September 2024 VA examination for ankle conditions.

After carefully considering the foregoing evidence, the Board finds that the Veteran's left ankle disability does not warrant a higher rating.  The Board finds that the September 2024 VA examination is the most probative evidence of record, and this examination does not indicate that the Veteran has marked symptomatology of the left ankle under DC 5271.  The Veteran does not assert that the VA examiner's findings with respect to his left ankle were inaccurate. He has not identified any other evidence that would support a higher rating for his service-connected left ankle disability. The Board finds no such evidence in the record, including in prior VA examinations or medical records for the period on appeal.

The Board has also considered whether higher ratings can be assigned under any alternative diagnostic code for conditions of the ankle; however, the Board finds that no other potentially applicable diagnostic codes warrant a higher rating and a rating under DC 5271 is most favorable to the Veteran.  38 C.F.R. § 4.124a.

The Board has considered the Veteran's statements regarding the severity of his disability.  However, as a lay person, the Veteran does not have the training or expertise to render a competent opinion which is more probative than the VA examiners' opinions on this issue, as this is a medical determination that is complex. See Jandreau v. Nicholson, 492 F.3d 1372, 1376-77 (Fed. Cir. 2007); Barr v. Nicholson, 21 Vet. App. 303, 309 (2007); Layno v. Brown, 6 Vet. App. 465, 469-71 (1994)). Thus, the lay opinions by themselves are outweighed by the VA examiners' findings. See id.; see also King v. Shinseki, 700 F.3d 1339, 1345 (Fed. Cir. 2012) (affirming the Court's conclusion that the Board did not improperly discount the weight of a lay opinion in finding a medical expert's opinion more probative on the issue of medical causation).

Accordingly
 1376-77 (Fed. Cir. 2007); Barr v. Nicholson, 21 Vet. App. 303, 309 (2007); Layno v. Brown, 6 Vet. App. 465, 469-71 (1994)). Thus, the lay opinions by themselves are outweighed by the VA examiners' findings. See id.; see also King v. Shinseki, 700 F.3d 1339, 1345 (Fed. Cir. 2012) (affirming the Court's conclusion that the Board did not improperly discount the weight of a lay opinion in finding a medical expert's opinion more probative on the issue of medical causation).

Accordingly, the Veteran's claim for entitlement to an initial evaluation in excess of 10 percent for left ankle disability is denied.

REASONS FOR REMAND

The Veteran contends that he suffers from a bilateral knee condition.  See June 2025 NOD.

The Veteran underwent a VA examination for knee and lower leg conditions in January 2025, where he was diagnosed with right knee joint osteoarthritis.  The Veteran reported pain in both knees.  The Board notes, however, that the January 2025 VA examiner indicated that the left knee was an "unclaimed joint", but this appears to be incorrect as the left knee was a claimed condition alongside the right knee.  As such, the Board finds that this examination to be inadequate as it pertains to the left knee, and that the Veteran has met the low threshold for obtaining a VA examination for his left knee.  See McLendon v. Nicholson, 20 Vet. App. 79 (2006); Barr v. Nicholson, 21 Vet. App. 303, 312 (2007) (Once VA undertakes the effort to provide a medical examination or opinion, it must provide an adequate one).

Under the AMA, the Board's remand authority is generally limited to correcting predecisional duty to assist errors or to correct any other error in satisfying a regulatory or statutory duty.  Here, the Board finds that the AOJ committed a predecisional duty-to-assist error by not affording the Veteran a VA examination for his left knee condition, in addition to his right knee condition, and that the January 2025 VA examination for inadequate for the reasons set forth above.  See McLendon, Barr.

This matter is REMANDED for the following action:

Schedule the Veteran for a VA examination to determine the nature and etiology of the Veteran's left knee condition.  The clinician must review the entire claims file, including a copy of this Remand. 

Following a review of the Veteran's claims file, the clinician must provide an opinion as to whether it is at least as likely as not (likelihood is at least approximately balanced or nearly equal, if not higher) that the Veteran's diagnosed left knee condition is related to his active duty service.

A complete rationale for all opinions must be provided.  If the clinician cannot provide a requested opinion without resorting to speculation, it must be so stated, and the clinician must provide the reasons why an opinion would require speculation.  The clinician must indicate whether there was any further need for information or testing necessary to make a determination.  Additionally, the clinician must indicate whether any opinion could not be rendered due to limitations of knowledge in the medical community at large and not those of the particular examiner.

 

 

MICHAEL A. HERMAN

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	B. Hillman, 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.