Citation Nr: 18139855 Decision Date: 10/01/18 Archive Date: 10/01/18 DOCKET NO. 14-12 989 DATE: October 1, 2018 ORDER An initial 10 percent rating for left knee osteoarthritis is granted, subject to the laws and regulations governing the payment of monetary benefits. An initial 10 percent rating for right wrist strain is granted, subject to the laws and regulations governing the payment of monetary benefits. An initial 10 percent rating for left wrist strain is granted, subject to the laws and regulations governing the payment of monetary benefits. REMANDED An initial rating in excess of 10 percent for lumbar spine strain with left lower extremity radiculopathy is remanded. An initial rating in excess of 10 percent for left knee osteoarthritis is remanded. An initial rating in excess of 10 percent for right wrist strain is remanded. An initial rating in excess of 10 percent for left wrist strain is remanded. An initial rating in excess of 10 percent for status post right retinal detachment surgery with vitreous floaters and retina scar is remanded. FINDING OF FACT During the entire period on appeal, the Veteran’s left knee disorder, as well as right and left wrist disorders, have caused painful motion. CONCLUSIONS OF LAW 1. The criteria for at least an initial 10 percent rating for left knee osteoarthritis have been met. 38 U.S.C. § 1155; 38 C.F.R. §§ 4.59, 4.71a, Diagnostic Code (DC) 5260. 2. The criteria for at least an initial 10 percent rating for right wrist strain have been met. 38 U.S.C. § 1155; 38 C.F.R. §§ 4.59, 4.71a, DC 5215. 3. The criteria for at least an initial 10 percent rating for left wrist strain have been met. 38 U.S.C. § 1155; 38 C.F.R. §§ 4.59, 4.71a, DC 5215. REASONS AND BASES FOR FINDING AND CONCLUSIONS The Veteran served on active duty from January 2007 to January 2011. The case is on appeal from a July 2011 rating decision. In June 2016, the Board granted service connection for bilateral testicular epididymitis. At that time, the Board also remanded the remaining claims on appeal for further development. Entitlement to initial compensable ratings for left knee, and right and left wrist disorders. Ratings are based on a schedule of reductions in earning capacity from specific injuries or combination of injuries. The ratings shall be based, as far as practicable, upon the average impairments of earning capacity resulting from such injuries in civil occupations. 38 U.S.C. § 1155. Generally, the degrees of disability specified are considered adequate to compensate for considerable loss of working time from exacerbations or illnesses proportionate to the severity of the several grades of disability. 38 C.F.R. § 4.1. During the entire period on appeal the Veteran’s service-connected left knee, right wrist and left wrist disabilities are currently rated as noncompensable. The Veteran was afforded a January 2011 VA examination in which he was diagnosed with bilateral knee patellofemoral pain syndrome. The Veteran reported knee symptoms of weakness, stiffness, swelling, giving way, lack of endurance, locking and pain. The Veteran was also diagnosed with bilateral wrist disorders. He reported weakness, stiffness, giving way, tenderness and pain. Additionally, in a May 2012 statement, the Veteran reported ongoing painful motion in his bilateral wrists and left knee. On further consideration, the Board finds that there is sufficient evidence showing painful motion in the Veteran’s left knee and bilateral wrists throughout the period on appeal. Painful motion is entitled to at least the minimum compensable rating for a joint. See 38 C.F.R. § 4.59; Burton v. Shinseki, 25 Vet. App. 1, 3-5 (2011). A 10 percent rating is the minimum compensable rating for limitation of motion of the knee and wrists. See 38 C.F.R. § 4.71a, DCs 5215, 5260. Therefore, the Board concludes that at least 10 percent ratings are warranted for left knee and bilateral wrist disorders. Thus, the issues on appeal become entitlement to initial ratings in excess of 10 percent for left knee and bilateral wrists disabilities, as well as the other issues pertaining to initial ratings in excess of 10 percent for low back and right eye disabilities. The Veteran is not prejudiced by this action as it is a grant of benefits without any denial of greater benefits. These issues will be addressed further in the remand section below. REASONS FOR REMAND 1. Ratings in excess of 10 percent for the low back, left knee and right and left wrist disabilities. The Veteran contends that increased ratings are warranted for his four service-connected musculoskeletal disorders on appeal. His most recent VA examination to assess the severity of his disabilities was in January 2011, more than seven years ago. In a May 2012 statement, the Veteran reported worsening back symptoms, including sharp pain. He stated his bilateral wrist grip is weak and causes him to drop things and his left knee disorder causes continuous pain and occasionally gives out when he walks. The claims came before the Board and were remanded in June 2016 for further development, including VA examinations to assess the current severity of the disabilities. The RO scheduled VA examinations for December 2016; however, the Veteran did not attend such. The RO issued a January 2017 letter which indicated it was notified by a VA Medical Center that the Veteran declined to undergo the scheduled examinations, as he was already receiving compensation for the service-connected disabilities on appeal. Thereafter, in a July 2018 correspondence, the Veteran’s representative indicated the Veteran had not withdrawn his appeal and VA should proceed with adjudication of the claims. In light of the representative’s statement and as no further evidence has been submitted by the Veteran in this regard, the Board will remand the claims for further development, including a VA examination. As noted, the Veteran has not undergone a VA examination for the musculoskeletal disorders since January 2011 and new VA examinations are necessary to assess the severity of the service-connected disabilities. The examination should reflect detailed range of motion findings and findings regarding functional loss, per the recent precedential decisions of Correia v. McDonald, 28 Vet. App. 158 (2016) (instructing that VA orthopedic examinations should include tested for pain on both active and passive motion, in weight-bearing and nonweight-bearing (if applicable) and, if possible, with the range of the opposite undamaged joint), and Sharp v. Shulkin, 29 Vet. App. 26, 33 (2017) (outlining VA examiners’ obligation to elicit information regarding flare-ups of a musculoskeletal disability if the examination is not conducted during such a flare-up, and to use this information to characterize additional functional loss during flare-ups). As noted above, the Veteran failed to attend the December 2016 VA examination. The Board notes when a Veteran fails to report for a scheduled examination, his claims may be rated based on the evidence of record. 38 C.F.R. § 3.655; see also Wood v. Derwinski, 1 Vet. App. 190, 193 (1991) (finding that the duty to assist is not a one-way street). 2. A rating in excess of 10 percent for the right eye disability. The Veteran contends a rating in excess of 10 percent is warranted for his right eye disorder. He was afforded a January 2011 VA examination in which he reported symptoms of pain, sensitivity to light, distorted vision, halo, floaters, and blurred vision. However, the examiner found his vision to be normal. The Veteran then submitted a May 2012 statement in which he indicated he continues to suffer right eye pain which causes headaches. As worsening eye symptoms were alleged, the Board remanded the claim in June 2016 for a VA examination. As noted, the Veteran failed to attend the examination; however, the claim is remanded for another VA examination to determine the nature and severity of his right eye disability. Ongoing VA treatment records should also be requested in light of the remand. The matters are REMANDED for the following action: 1. Request updated VA treatment records since November 2016. 2. Thereafter, schedule the Veteran for a VA examination by an appropriate medical professional to assess the current severity of his service-connected back, left knee and bilateral wrist disabilities, to include specific findings regarding pain on range of motion testing and an estimation of functional loss, per Correia and Sharp. After reviewing the Veteran’s claims file and eliciting the history of his symptoms, to specifically include any symptoms and functional impact that he experiences during flare-ups of such disabilities, the examiner should conduct a relevant clinical examination. Specifically, the disorders should be tested for pain in both weight-bearing and nonweight-bearing positions, on both active and passive motion, and, if applicable, with the range of the opposite undamaged joint. If this cannot be performed, the examiner should explain why. The examiner should also estimate the functional loss that would occur during flares. If the examination is not conducted during a flare-up, the functional impact of a flare-up should be estimated based on the Veteran’s reports. Any left knee instability/subluxation should be discussed and described in terms of severe, moderate or slight. 3. Schedule the Veteran for a VA examination by an appropriate medical professional to assess the current severity of his service-connected right eye disability. (Continued on the next page)   4. If the Veteran does not attend the examinations, ensure that the examination notification letters are included in the claims file. RYAN T. KESSEL Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD B. Isaacs, Associate Counsel