Thank you for the response, here's a bit of history on my right knee. The right knee claim was initially denied as service connected. Therefore, I submitted an NOD and was seen at QTC for the condition in September 2015. At the end of August 2016, the VA review officer called and told me that the QTC doctor did not make a finding on the knee, therefore they had no medical basis to make a positive finding for my right knee. He suggested that I obtain a medical opinion letter from a doctor and submit that to support my case. He said the letter needed to state the medical opinion, rational for the opinion, and that the doctor reviewed my entire case file.
I tried my HMO doctor but he does not provide medical opinion letters. I then tried the VA but my primary care said VA doctors would not provide medical opinion letters. I then began to search for civilian medical orthopedic doctors who could prepare independent medical opinions.
What's throwing me off is that the VA review officer is looking for the three elements in the medical opinion letter in order to make a decision. Would the VA orthopedic doctor's medical opinion in their progress notes be sufficient for the VA review officer to make a decision?
Side note: I only started in the VA healthcare system about 2 years ago, but appears I should have built up a case history with my knees at the VA rather than my HMO.