13-06 960, 13-06 960

Veteran served on active duty from Nov. 1954 to Nov. 1958 and appealed VA denials for service connection for right and left knee disabilities.
Initial RO decision in July 2011; appeal before the Board of Veterans' Appeals (BVA) with prior remands in Dec. 2014, May 2015, and Dec. 2015.
December 2015 BVA remand ordered a nexus VA examination addressing etiology of bilateral knee conditions and instructed the examiner to consider the Veteran’s report that knee pain began in 1959 but he did not seek treatment until decades later.
VA provided a January 2016 knee examination concluding osteoarthritis was more likely due to age, occupation, genetics, and life, and stating no complaints or injury from service to 2011; the examiner did not reconcile this with the Veteran’s report of pain onset in 1959.
The Board found the January 2016 opinion inadequate because it failed to address the Veteran’s competent lay report of symptom onset and therefore lacked probative value; remand ordered for a new, fully-rationalized examination and updated VA treatment records (post-Nov. 2014).

Issue	Plaintiff's Argument	Defendant's Argument	Held
Entitlement to service connection for right knee disability	Veteran reports knee pain beginning in 1959 and continuing; seeks nexus to service	January 2016 VA examiner: osteoarthritis due to age/occupation/genetics; no service-related complaints from 1954–2011	BVA remanded: January 2016 opinion inadequate for failing to reconcile examiner’s conclusion with Veteran’s report; new exam and rationale required
Entitlement to service connection for left knee disability	Same as right knee — lay report of 1959 onset and continuous symptoms	Same as right knee — examiner attributed condition to non-service factors and noted no treatment until 2011	BVA remanded: same inadequacy; ordered new exam addressing lay statements and providing complete rationale

Stegall v. West, 11 Vet. App. 268 (1998) (Board remand confers the right to compliance with remand orders)
Layno v. Brown, 6 Vet. App. 465 (1994) (veteran competent to report observable symptoms)
Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007) (standard for lay evidence competence regarding medical symptoms)
Nieves-Rodriguez v. Peake, 22 Vet. App. 295 (2008) (VA medical opinions must account for claimant-provided history)
Barr v. Nicholson, 21 Vet. App. 303 (2007) (medical opinions must be adequate to be probative)
Bell v. Derwinski, 2 Vet. App. 611 (1992) (VA in constructive possession of VA-generated treatment records)
Kutscherousky v. West, 12 Vet. App. 369 (1999) (veteran may submit additional evidence after remand)