Citation Nr: 18151466 Decision Date: 11/19/18 Archive Date: 11/19/18 DOCKET NO. 18-09 900 DATE: November 19, 2018 REMANDED A higher (compensable) initial disability rating for right hip limitation of abduction and rotation is remanded. A higher (compensable) initial disability rating for right hip limitation of flexion is remanded. An initial disability rating higher than 10 percent for left hip trochanteric pain syndrome is remanded. A higher (compensable) initial disability rating for left knee strain is remanded. The appeal of whether reduction of the disability rating from 30 percent to 10 percent for the left ankle post-operative arthroscopic ligament repair and bone debridement effective from May 1, 2016 was proper is remanded. An increased disability rating higher than 30 percent for left ankle post-operative arthroscopic ligament repair and bone debridement from August 27, 2015 to May 1, 2016, and higher than 10 percent thereafter, is remanded. A higher (compensable) initial disability rating for right knee strain is remanded. An increased disability rating higher than 10 percent for chronic right ankle sprain is remanded. REASONS FOR REMAND The Veteran, who is the appellant, had active service in the U.S. Air Force from April 1989 to September 1994. This matter is on appeal from a February 2016 rating decision. 1. Higher Ratings for Bilateral Hip, Knee, and Ankle Disabilities The bilateral hip, knee, and ankle disabilities were last examined by VA in February 2016. At that time, the Veteran reported intermittent bilateral knee and hip pain, as well as ankle pain with prolonged weight-bearing and intermittent swelling. On the January 2018 VA Form 9, the Veteran wrote that the knees and hips had worsened so that he now experienced constant pain in the knees and hips. He also reported additional stress on the right ankle and knees affecting his walking and limited his work and daily activities due to increased left ankle symptoms. May 2018 VA treatment records show worsening left knee pain possibly related to some meniscal damage and right ankle surgery to reconstruct the site of a past fracture. In consideration of the foregoing, the Board finds that a remand for a VA examination and updated VA treatment records to ascertain the current severity and manifestations of the bilateral hip, knee, and ankle disabilities is warranted. 2. Propriety of the Rating Reduction for Left Ankle Disability Because the ordered development for the left ankle disability would be relevant to the question of whether the left ankle disability has improved under the ordinary conditions of life and work, the VA examination results could potentially impact a decision on the issue of whether reduction of the rating for the left ankle disability from 30 percent to 10 percent effective from May 1, 2016 was proper, so the issues are inextricably intertwined; therefore, a remand is required. The matters are REMANDED for the following action: 1. Obtain VA treatment records for the period from May 2018 to the present. 2. Schedule an examination of the bilateral knee, hip, and ankle disabilities. The examiner should attempt to elicit information regarding the severity, frequency, and duration of any flare-ups, and the degree of functional loss during flare-ups. The examinations should contain passive range of motion measurements and pain on weight-bearing testing. To the extent possible, the examiner should identify any symptoms and functional impairments due to each of the knee, hip, and ankle disabilities alone and discuss their individual effects 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)   (CONTINUED ON NEXT PAGE) J. PARKER Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD C. Ferguson, Counsel