Citation Nr: 18131227
Decision Date: 08/31/18	Archive Date: 08/31/18

DOCKET NO. 15-08 723
DATE:	August 31, 2018
REMANDED
Entitlement to an increased evaluation for right knee sprain/strain associated with right ankle strain, rated as noncompensable, is remanded.
Entitlement to an increased evaluation for left ankle strain, rated as 10 percent disabling is remanded.
Entitlement to an increased evaluation for right ankle strain, rated as 10 percent disabling is remanded.
REASONS FOR REMAND
The Veteran served on active duty from March 1983 to September 1992. This matter comes before the Board on appeal from a December 2013 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO) in St. Louis, Missouri. A videoconference hearing was held in May 2018 before the undersigned Veterans Law Judge. 
Entitlement to an increased evaluation for right knee sprain/strain associated with right ankle strain, and bilateral ankle strain are remanded.
VA examined the Veteran in December 2013. He was diagnosed with right knee sprain/strain and bilateral ankle sprain. 
In a November 2013 Statement in Support of Claim, the Veteran contended that he was diagnosed with patellofemoral syndrome in October 2013 and prescribed a knee brace and braces/wraps for his ankles. In the January 2014 NOD, the Veteran asserted that the “lateral instability in the right knee was never identified.” In the March 2015 substantive appeal (VA Form 9), the Veteran asserted that he had limited range of motion of the ankles due to pain and was unable to drive because of painful ankles. 
During the May 2018 hearing, the Veteran testified that his right knee “locked-up” and that he fell and injured his elbow, which required surgery. The Veteran testified that his right knee sprain/strain exacerbated the right ankle strain; his right ankle locked-up and popped. The Veteran testified that VA wanted to “cut [him] open and stick him with needled...in 2014”; however, he was too afraid to seek treatment for his right knee sprain/strain. The Veteran testified that his left ankle was “worse than the right” and that he elevated it with a pillow at night. The Veteran testified that his left ankle “pops more frequently.” The Veteran testified that his doctor informed him that he had a tear in his left ankle, which required surgical repair.  The Veteran testified that he experienced bilateral ankle swelling. H. C., the Veteran’s associate, testified that the Veteran had “neuropathy. . . just above the ankle tendons [that] extends all the way down into the feet.”
In addition, the Court of Appeals for Veterans Claims (Court) held in Correia, that the final sentence of 38 C.F.R. § 4.59 requires that VA examinations include joint testing for pain on both active and passive motion, in weight-bearing and nonweight-bearing and, if possible, with range of motion measurements of the opposite undamaged joint. Thus, the Court’s holding in Correia establishes additional requirements that must be met prior to finding that a VA examination is adequate. In addition, as relevant to the present case, the Court stated in Correia that knees were “undoubtedly weight-bearing.” Id.  A review of the claims file reveals that the prior VA examination report includes only active range of motion findings and does not include range of motion findings for passive range of motion. It also does not specify whether the results are weight-bearing or nonweight-bearing. As the previous examination report does not fully satisfy the requirements of Correia and 38 C.F.R. § 4.59, a new examination is necessary to decide the claim. An additional relevant opinion pertaining to flare-ups was also issued by the Court in Sharp v. Shulkin, 29 Vet. App. 26 (2017).
The matters are REMANDED for the following action:
1. Schedule the Veteran for an appropriate VA examination to evaluate the service-connected right knee sprain/strain and bilateral ankle strain disorders. The Veteran’s claims folder must be reviewed by the examiner.
(a) In reporting the results of range of motion testing, the examiner should identify any objective evidence of pain, and the degree at which pain begins.
(b)  Pursuant to Correia v. McDonald, the examination should record the results of range of motion testing for pain on BOTH active and passive motion AND in weight-bearing and nonweight-bearing. If the knees or ankles cannot be tested on “weight-bearing,” then the examiner must specifically indicate that such testing cannot be done.
(c) The examiner should also express an opinion concerning whether there would be additional functional impairment on repeated use or during flare-ups assessed in terms of the degree of additional range of motion loss.  In regard to flare-ups (pursuant to Sharp v. Shulkin) if the Veteran is not currently experiencing a flare-up, based on relevant information elicited from the Veteran, review of the file, and the current examination results regarding the frequency, duration, characteristics, severity, and functional loss regarding his flares, the examiner is requested to provide an estimate of the Veteran’s functional loss due to flares expressed in terms of the degree of additional range of motion lost, or explain why the examiner cannot do so.  [The Board recognizes the difficulty in making such determinations but requests that the examiner provide his or her best estimate based on the examination findings and statements of the Veteran.]
 
TANYA SMITH
Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD	C. Taylor, Associate Counsel

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