Citation Nr: 18124040
Decision Date: 08/03/18	Archive Date: 08/03/18

DOCKET NO. 15-06 893
DATE:	August 3, 2018
REMANDED
Entitlement to service connection for a right knee disability is remanded.
Entitlement to an initial rating in excess of 10 percent for a service-connected left knee disability is remanded.
REASONS FOR REMAND
The Veteran has active service from November 14, 1967 to September 3, 1969, December 15, 1970 to December 14, 1973, and November 7, 1980 to November 8, 1980.  The Veteran testified before the undersigned Veterans Law Judge during a March 2018 Board hearing.  This matter is on appeal from an October 2013 rating decision.
1. Entitlement to service connection for a right knee disability is remanded.
A remand is needed to obtain an additional medical opinion regarding the nature and etiology of the Veteran’s right knee condition.  In September 2013, a VA examiner opined it was not likely that the Veteran’s claimed right knee condition was related to service.  In support of this opinion, the examiner indicated, in part, there was no evidence demonstrating an ongoing problem with the right knee since discharge.  However, a subsequent September 2014 VA examination report noted the Veteran underwent a 2000 right knee surgical procedure and currently had documented right knee degenerative/traumatic arthritis.  The September 2014 VA examiner did not provide an opinion as to the etiology of the Veteran’s right knee condition.  Since these examinations, the Veteran has provided testimony that his right knee symptoms began in service due to injuries suffered from parachute-jump-related injuries and continued after service.  See March 2018 Hearing Testimony.  An additional opinion is needed that includes a review of the relevant medical records and addresses the Veteran’s testimony regarding symptomatology.
2. Entitlement to an initial rating in excess of 10 percent for a service-connected left knee disability is remanded.
In addition, recent court decisions have established examination standards that must be complied with before assigning an adequate disability rating.  Indeed, in Correia v. McDonald, 28 Vet. App. 158 (2016), the Court held “that the final sentence of § 4.59 creates a requirement that certain range of motion testing be conducted whenever possible in cases of joint disabilities.”  Id, at 8.  Specifically, range of motion studies must be performed that test active and passive range of motion as well as in weight-bearing and nonweight-bearing.
The Board finds that the September 2014 examination of record is inadequate in light of the holdings in Correia and Sharp v. Shulkin, 29 Vet. App. 26 (2017), so that this matter must be remanded for a new examination.
The matters are REMANDED for the following action:
1. Obtain and associate with the claims folder any outstanding VA treatment records.
2. Schedule the Veteran for an additional VA examination to determine the nature and etiology of any diagnosed right knee condition.  Access to the electronic claims file must be made available to the examiner for review.  All necessary tests should be conducted and the results reported.  Following review of the claims file and examination of the Veteran, the examiner must render an opinion as to the following question:
Whether it is at least as likely as not (50 percent probability or more) that any diagnosed right knee condition, is related to events in service.  In providing this opinion, the examiner’s attention is directed toward the following:
•	1980 service treatment records reflecting treatment for a bilateral knee injury; 
•	September 2013 and September 2014 VA examination reports containing findings concerning the Veteran’s right knee condition; and
•	March 2018 Veteran hearing testimony concerning his claimed right knee condition.
A complete rationale for all stated opinions is required.  If the examiner feels that the requested opinion cannot be rendered without resorting to speculation, he or she should state whether the need to speculate is caused by a deficiency in the state of general medical knowledge (i.e., no one could respond given medical science and the known facts), by a deficiency in the record (i.e., additional facts are required), or by the examiner himself or herself (because he or she does not have the needed knowledge or training).
3. Schedule the Veteran for a VA examination to determine the severity of his service-connected left knee disability.  The Veteran’s electronic claims file must be made available for review. 
In order to comply with Sharp v. Shulkin, 29 Vet. App. 26, 33 (2017), the examiner is asked to describe whether pain, weakness, fatigue and/or incoordination significantly limits functional ability during flares or repetitive use, and if so, the examiner must estimate range of motion during flares or repetitive use.  If the examination does not take place during a flare, the examiner should have the Veteran describe and/or demonstrate the extent of motion loss during flares or repetitive use and provide the extent of motion loss described in terms of degrees.  If there is no pain and/or no limitation of function, such facts must be noted in the report.  The examiner should comment as to whether there is any medical reason to accept or reject the Veteran’s description of reduced range of motion during flares or repetitive use.
Also, in order to comply with the Court’s decision in Correia, the VA examination must include range of motion testing in the following areas:
•	Active motion;
•	Passive motion;
•	Weight-bearing; and
•	Nonweight-bearing.
If the examiner is unable to conduct the required testing or concludes that the required testing is not necessary in this case, he or she should clearly explain why that is so.  The VA examiner should provide a complete rationale for any opinions provided.
4. After completing the above actions, and conducting any additional development deemed necessary, readjudicate the issues on appeal in light of all additional evidence received.  If any of the benefits sought on appeal are not granted in full, the Veteran should be furnished with a supplemental statement of the case and afforded an opportunity to respond before the file is returned to the Board for further appellate consideration.
 
T. MAINELLI
Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD	N. Rasool

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