Citation Nr: 18150490 Decision Date: 11/15/18 Archive Date: 11/15/18 DOCKET NO. 16-46 744 DATE: November 15, 2018 REMANDED Entitlement to an initial compensable rating for left knee tendonitis with Osgood-Schlatter disease is remanded. Entitlement to an initial compensable rating for right knee tendonitis with Osgood-Schlatter disease is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Marine Corps from May 1998 to May 2002. 1. Entitlement to an initial compensable rating for left knee tendonitis with Osgood-Schlatter disease is remanded. 2. Entitlement to an initial compensable rating for right knee tendonitis with Osgood-Schlatter disease is remanded. The current level of disability is most important in claims for an increased rating. Where the evidence of record does not reflect the current state of the Veteran’s disability, a VA examination must be conducted. Schafrath v. Derwinski, 1 Vet. App. 589 (1991); 38 C.F.R. § 3.327 (a). Here, the most recent examination of the Veteran’s knees was 3 years ago. Although age of an examination is not, in itself, an automatic reason for remand, a current examination is necessary in determining the overall disability picture. Here, the Veteran asserts in his Notice of Disagreement that the examination was focused on range of motion, but that the severe pain he has when he is on his knees, or has any pressure on his knees, was not considered. In his Substantive Appeal, the Veteran further contended that the pain in his knees “becomes so intense that even wearing clothing that comes in contact is difficult to tolerate.” He also stated that, “The doctors who were examining me for the disability continued to concentrate on the area between the tibia and femur…The problem/pain is not where the bones of the femur and the tibia connect. The problem as noted in my military medical file is at the tibia where the patella tendon connects to the bone, this is the bottom part of the knee, not the area that bends.” In addition, the Board observes that the Veteran’s credible lay evidence of pain has not been addressed in the November 2015 VA examination, other than to note that he has flare-ups and is unable to get on his knees or have pressure on his knees. See Mitchell v. Shinseki, 25 Vet. App. 32, 38 (2011). Moreover, since the Veteran’s last examination, the U.S. Court of Appeal for Veteran’s Claims (Court) issued a decision in Corriea v. McDonald, 28 Vet. App. 158 (2016). In Correia, the Court found that under 38 C.F.R. § 4.59, a VA examination must include joint testing for pain on both active and passive motion, in weight-bearing and nonweight-bearing (as appropriate), and, if possible, with rating of motion measurements of the opposite undamaged joint. To date, the Veteran has not been afforded a VA examination that includes such testing. As such, per Corriea, the examinations are inadequate and a remand is necessary to afford the Veteran an adequate examination. See Bowling v. Principi, 15 Vet. App. 1, 12 (2001). Thus, the Board requires a new VA examination report that adequately addresses the Veteran’s current bilateral knee symptomology, including his pain. The matters are REMANDED for the following action: 1. Schedule the Veteran for an examination to determine the current severity of his bilateral knee disability. The examiner must test the Veteran’s active motion, passive motion, and pain with weight-bearing and without weight-bearing. The examiner must also attempt to elicit information regarding the severity, frequency, and duration of any flare-ups, and the degree of functional loss during flare-ups, to include his credible statements regarding his severe pain. The examiner must address the Veteran’s statement that his disability is due to where the patella tendon connects to the bone at the tibia, as noted in his STR, and not the area of the tibia and femur. To the extent possible, the examiner should identify any symptoms and functional impairments due to the Veteran’s bilateral knee disability alone and discuss the effect of the Veteran’s service-connected knees on any occupational functioning and activities of daily living. If it is not possible to provide a specific measurement, or an opinion regarding flare-ups, symptoms, or functional impairment without speculation, the examiner must state whether the need to speculate is due to a deficiency in the state of general medical knowledge (no one could respond given medical science and the known facts), a deficiency in the record (additional facts are required), or the examiner (does not have the knowledge or training). (Continued on the next page)   2. Then, the record should again be reviewed. If any benefit sought on appeal remains denied, the Veteran and his representative should be furnished with a supplemental statement of the case and be given the opportunity to respond. T. REYNOLDS Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD L. Nelson, Associate Counsel