Entitlement to service connection for a left knee disorder is remanded.

Citation Nr: A26069938 Decision Date: 07/30/26 Archive Date: 07/30/26 DOCKET NO. 260403-662459 DATE: July 30, 2026 REMANDED Entitlement to service connection for a left knee disorder is remanded. Entitlement to service connection for a right knee disorder is remanded. Entitlement to service connection for a back disorder is remanded. Entitlement to service connection for lower back scar is remanded. Entitlement to service connection for right knee scar is remanded. REASONS FOR REMAND The Veteran served on active duty from January 1976 to January 1980. These matters come before the Board of Veterans' Appeals (Board) on appeal from a January 2026 rating decision, which was a higher-level review of a July 2025 rating decision. The Veteran submitted a VA Form 10182 in April 2026 and elected the direct review docket. Therefore, the Board may only consider the evidence of record at the time of the July 2025 agency of original jurisdiction (AOJ) decision, which was subsequently subject to higher-level review. 38 C.F.R. § 20.301. If evidence was submitted during the period after the AOJ issued the decision, which was subsequently subject to higher-level review the Board did not consider it in its decision. 38 C.F.R. §§ 20.300, 20.301, 20.801. However, because the Board is remanding the case, any evidence that the Board could not consider will be considered by the AOJ in the adjudication of the claims. 38 C.F.R. § 3.103 (c)(2)(ii). In the April 2026 VA Form 10182, the Veteran waived his right to switch dockets under 38 C.F.R. § 20.202(c)(2). Therefore, the Board may proceed with adjudication at this time. See Williams v. McDonough, 37 Vet. App. 305 (2024). Upon review, the Board finds that a remand is needed to correct pre-decisional duty to assist errors. The Veteran has contended that he developed right and left knee disorders due to a fall he sustained during his active service. See January 2024 VA Form 21-526EZ. A March 2024 VA examiner opined that the Veteran's left and right knee disorders were less likely than not incurred in or caused by the claimed in-service injury, event, or illness. She found that there was a lack of substantiating evidence supporting a nexus between the current diagnoses and his military service. She stated that, without chronicity during service or after service, a post-service event, illness, or injury is considered to be a more likely etiology. However, the examiner did not address the service treatment records documenting trauma to both knees or explain why the subsequent development of a current disorder, such as arthritis, could not be related to an injury in service even if did not manifest therein. Indeed, she did not discuss how the current disorders generally present or develop. A May 2025 VA examiner also opined that the Veteran's right and left knee disorders were less likely than not incurred in or caused by the claimed in-service injury, event, or illness. She noted that the Veteran's 1977 in-service injury was an abrasion to both knees without a recorded strain, structural, or musculoskeletal issue. She also indicated that there were no follow-up records demonstrating chronicity of symptomatology until 2017 with the appearance of arthritis. Thus, she concluded that a post-service event, illness, or injury was a more likely etiology. Nevertheless, the Board notes that the examiner did address the Veteran's lay statements, including his reports that he pushed through the pain and did not seek treatment until 2016 because he could not afford it or take time off. See June 2024 correspondence; March 2025 VA Form 21-10210. Moreover, the Board notes that the Veteran submitted several articles regarding osteoarthritis that were not addressed. See March 2025 correspondence. For these reasons, the Board finds that additional medical opinions were needed. The Board also finds that the issues of entitlement to service connection for a back disorder, a back scar, and a right knee scar are inextricably intertwined with the issues of entitlement to service connection for right and left knee disorder being remanded herein. See March 2025 VA Form 20-0995. Harris v. Derwinski, 1 Vet. App. 180 (1991); see also Gurley v. Peake, 528 F.3d 1322 (Fed. Cir. 2008) (remand of inextricably intertwined claims was warranted for reasons of judicial economy even in absence of administrative error). The matters are REMANDED for the following actions: The AOJ should obtain a medical opinion to determine the etiology of the Veteran's right and left knee disorders. A physical examination is only needed if one is deemed necessary by the individual providing the opinion. The examiner is requested to review all pertinent records associated with the claims file. The examiner should note that the Veteran is competent to attest to factual matters of which he has first-hand knowledge, including observable symptomatology. If there is a medical basis to support or doubt the history provided by the Veteran, the examiner should provide a fully reasoned explanation. The examiner should opine as to whether it is at least as likely as not that the Veteran's right and knee disorder are at least as likely as not causally or etiologically related to his military service, to include any injury or symptomatology therein. The examiner should specifically address the service treatment records documenting a knee injury in October 1977 and consider the Veteran's June 2024 and March 2025 lay statements in which he indicated that he continued to experience knee pain following his October 1977 injury, that he self-treated with ice and elevation until the 1990s when he began receiving regular cortisone shots for the pain, and that he pushed through his pain as it worsened and did not receive treatment until 2016 because he could not afford a doctor or take time off work. He or she should also address articles submitted by the Veteran in March 2025 addressing the avoidance of medical care, osteoarthritis, and links between knee pain and lower back pain. In rendering these opinions, the examiner should discuss how the Veteran's any current knee disorder generally presents or develops. If the examiner finds any gap in time between the Veteran's military service and the onset of his current knee disorders to be probative, he or she should provide an explanation of its medical significance. A complete rationale should be provided for all opinions. J.W. ZISSIMOS Veterans Law Judge Board of Veterans' Appeals Attorney for the Board R. Carrier, Attorney Advisor 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.