Citation Nr: 18148804 Decision Date: 11/08/18 Archive Date: 11/08/18 DOCKET NO. 16-33 829 DATE: November 8, 2018 REMANDED Entitlement to a higher evaluation for osteoarthritis, residual of left knee injury, postoperative, currently evaluated as 10 percent disabling, is remanded. Entitlement to a higher evaluation for laxity of the left knee, currently evaluated as 10 percent disabling, is remanded. REASONS FOR REMAND The Veteran had active service from February 1980 to April 1984. This case comes before the Board of Veterans’ Appeals (Board) on appeal from a September 2014 rating decision by a Department of Veterans Affairs (VA) Regional Office (RO) in Waco, Texas. With respect to the Veteran’s left knee osteoarthritis, a new VA examination must be provided that complies with Sharp v. Shulkin, 29 Vet. App. 26 (2017). Sharp requires VA examiners to obtain information from the Veteran as to the severity, frequency, and duration of flare-ups, as well as precipitating and alleviating factors, and the extent of functional impairment. It also requires that VA examiners estimate the additional loss of range of motion (ROM) during a flare-up based on all procurable information from the record, as well as the Veteran’s own statements. If an estimate cannot be provided without resorting to speculation, it must be clear whether this is due to a lack of knowledge among the medical community at large, or insufficient knowledge of the specific examiner. On the January 2017 medical report, flare-ups were noted but there are no estimates for the additional loss of ROM during a flare-up. For repeated use and flare-ups, the examiner noted it would be speculative to provide estimates of additional ROM loss. It is unclear why the additional ROM loss could not be estimated based on, for example, the Veteran’s own statements. Accordingly, a remand is needed for an additional VA examination. As the VA examination report, i.e., Disability Benefits Questionnaire, will also provide findings pertinent to the Veteran’s claim for an increased rating for laxity of the left knee, that claim is deferred at this time. The matters are REMANDED for the following action: 1. Obtain the Veteran’s VA treatment records, dated from December 2016 forward. 2. Schedule the Veteran for an appropriate VA examination to assess the nature and current level of severity of his service-connected left knee disability. The Veteran’s claims file, including a copy of this REMAND, must be made available to and reviewed by the examiner in conjunction with the examination. The examiner must note in the examination report that the evidence in the claims file has been reviewed. The appropriate Disability Benefits Questionnaire should be filled out. (a) In the examination report, the examiner must include all the following: (i) Active ROM testing results. (ii) Passive ROM testing results. (iii) Weightbearing ROM testing results. (iv) Non-weightbearing ROM testing results. If the examiner is unable to conduct one or more of the above tests or finds that it is unnecessary, the examiner must provide an explanation. In any event, the type of test performed (i.e. active or passive, weightbearing or nonweightbearing), must be specified. (b) The examiner must elicit as much information as possible from the Veteran regarding the severity, frequency, and duration of flare-ups, their effect on functioning, and precipitating and alleviating factors. If the examination is not performed during a flare-up, the examiner must provide an estimate of additional loss of range of motion during a flare-up. If the examiner is unable to provide an estimate of additional loss of motion during a flare-up, the examiner must provide a specific explanation as to why the available information, including the Veteran’s own statements and any additional relevant evidence of record including the VA treatment records, is not sufficient to make such an estimate. (c) With respect to any complaints of laxity and/or instability of the knee, the examiner should state whether the Veteran’s reported symptoms are either consistent or inconsistent with clinical testing and provide an explanation as to why. The examiner must provide a comprehensive report including complete rationales for all opinions and conclusions reached. P. M. DILORENZO Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD Department of Veterans Affairs