Citation Nr: 18146885 Decision Date: 11/01/18 Archive Date: 11/01/18 DOCKET NO. 16-26 708 DATE: November 1, 2018 REMANDED Entitlement to an evaluation higher than 10 percent for service connected degenerative changes of the right knee, with scars, is remanded. REASONS FOR REMAND The Veteran served honorably in the Marine Corp from June 1995 to June 1999. Subsequently, the Veteran served honorably in the Army from September 1999 to July 2004. This case comes before the Board of Veterans’ Appeals (Board) on appeal from December 2015 rating decision of the Department of Veteran Affairs (VA) Regional Office (RO) in San Diego, California. Entitlement to an evaluation higher than 10 percent for service connected degenerative changes of the right knee, with scars is remanded. Remand is required to secure a current adequate VA examination. When a claimant asserts, or the evidence shows, that the severity of a disability has increased since the most recent rating examination, an additional examination is appropriate. VAOPGCPREC 11-95 (April 7, 1995); Snuffer v. Gober, 10 Vet. App. 400 (1997). The Veteran received a VA knee examination in July 2016. In August 2016, VA treatment records showed the Veteran reported increased pain in the right knee with swelling. The Veteran reported only being able to tolerate some weight, reported having trouble turning, and wearing a knee brace for support. Although the Veteran received a recent VA examination in January 2018, it is inadequate. Where VA provides the veteran with an examination, the examination must be adequate. Barr v. Nicholson, 21 Vet. App. 303, 311 (2007). The Veteran reported flare-ups in the right knee with pain, swelling, and decreased range of motion. The examiner stated pain, weakness, fatigability, or incoordination did not limit functional ability with flare-ups. Additionally, the examiner noted no meniscus conditions. A review of the record indicated the Veteran had several meniscus tears and undergone three surgeries for meniscus repair. Lastly, the examiner noted a surgical scar but did not provide the location and measurement of the scar. Accordingly, remand is required for an adequate VA examination to assess the current severity of the Veteran’s right knee symptoms. The matter is REMANDED for the following action: 1. Contact the appropriate VA Medical Center and obtain and associate with the claims file all outstanding records of treatment. If any requested records are not available, or the search for any such records otherwise yields negative results, that fact must clearly be documented in the claims file. Efforts to obtain these records must continue until it is determined that they do not exist or that further attempts to obtain them would be futile. The non-existence or unavailability of such records must be verified and this should be documented for the record. Required notice must be provided to the Veteran and his representative.   2. Contact the Veteran and afford him the opportunity to identify by name, address and dates of treatment or examination any relevant medical records. Subsequently, and after securing the proper authorizations where necessary, make arrangements to obtain all the records of treatment or examination from all the sources listed by the Veteran which are not already on file. All information obtained must be made part of the file. All attempts to secure this evidence must be documented in the claims file, and if, after making reasonable efforts to obtain named records, they are not able to be secured, provide the required notice and opportunity to respond to the Veteran and his representative. 3. After any additional records are associated with the claims file, provide the Veteran with an appropriate examination to determine the severity of the service-connected degenerative changes of the right knee, with scars. The entire claims file must be made available to and be reviewed by the examiner. Any indicated tests and studies must be accomplished and all clinical findings must be reported in detail and correlated to a specific diagnosis. An explanation for all opinions expressed must be provided. The relevant Disability Benefits Questionnaire must be utilized. The examiner is also asked to indicate the point during range of motion testing that motion is limited by pain. The examiner must test the range of motion and pain of the left knee in active motion, passive motion, weight-bearing, and non-weight-bearing. The examiner must also conduct the same testing on the right knee. If the examiner is unable to conduct the required testing or concludes that the required testing is not necessary, he or she should clearly explain why that is so. Describe any functional limitation due to pain, weakened movement, excess fatigability, pain with use, or incoordination. Additional limitation of motion during flare-ups and following repetitive use due to limited motion, excess motion, fatigability, weakened motion, incoordination, or painful motion must also be noted. If the Veteran describes flare-ups of pain, the examiner must offer an opinion as to whether there would be additional limits on functional ability during flare-ups. All losses of function due to problems such as pain should be equated to additional degrees of limitation of flexion and extension beyond that shown clinically. Should the examiner state that he or she is unable to offer such an opinion without resorting to speculation based on the fact that the examination was not performed during a flare, the examiner is directed to do all that reasonably can be done to become informed before such a conclusion, to include ascertaining adequate information-i.e. frequency, duration, characteristics, severity, or functional loss-regarding his flares by alternative means. 4. Notify the Veteran that it is his responsibility to report for any scheduled examination and to cooperate in the development of the claim, and that the consequences for failure to report for a VA examination without good cause may include denial of the claim. 38 C.F.R. §§ 3.158, 3.655 (2018). In the event that the Veteran does not report for any scheduled examination, documentation must be obtained which shows that notice scheduling the examination was sent to the last known address. It must also be indicated whether any notice that was sent was returned as undeliverable. K. MILLIKAN Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD C. Bruton, Associate Counsel