Citation Nr: 18152294 Decision Date: 11/21/18 Archive Date: 11/21/18 DOCKET NO. 16-49 861 DATE: November 21, 2018 REMANDED Entitlement to a compensable disability rating for a service-connected right knee strain is remanded. REASONS FOR REMAND The Veteran served on active duty from March 2010 to August 2013. This matter is before the Board of Veterans’ Appeals (Board) on appeal from a March 2016 rating decision issued by a Department of Veterans Affairs (VA) Regional Office (RO). In that decision, the RO denied a compensable rating for a right knee disability. Specifically, the RO granted the Veteran’s service connection claim for a right knee strain, and provided the Veteran with a noncompensable rating under Diagnostic Code 5257. Entitlement to a compensable disability rating for a service-connected right knee strain is remanded. A remand is required before the Board is able to make a determination with regard to the increased rating claim of the Veteran’s right knee strain. Specifically, the Court has held that, in order to be adequate, a VA examination of the joints must, wherever possible, include joint testing for pain on both active and passive motion, in weight-bearing and non-weightbearing and, if possible, with range of motion measurements of the opposite undamaged joint. Correia v. McDonald, 28 Vet. App. 158 (2016). Thus, the Court’s holding in Correia establishes additional requirements that must be met prior to finding that a VA examination is adequate. In addition, as relevant to the present case, the Court stated in Correia that knees were “undoubtedly weight-bearing.” Id. A review of the claims file reveals that neither the January 2016 VA examiner nor any VA treatment records presently associated with the Veteran’s claims file demonstrate range of motion testing for the right knee in passive and active motion, and non-weight-bearing situations. In short, at present, none of the medical evidence of record fully satisfies the requirements of Correia and 38 C.F.R. § 4.59. As such, a new VA knee examination is necessary for the purpose of ascertaining the current severity and manifestations of the Veteran’s service-connected right knee strain. In order to comply with the holding in Correia, a new VA examination must be conducted and the VA examiner must test the range of motion for both knees in active motion, passive motion, weight-bearing, and non-weight-bearing situations. If such testing cannot be performed, the examiner must explain why such testing could not be performed. Additionally, the VA examiner should record the results of range of motion testing for pain on both active and passive range of motion, and in weight-bearing and non-weight bearing. 38 C.F.R. § 4.59, DeLuca v. Brown, 6 Vet. App. 321 (1993). While the Veteran did not report fare-ups of his right knee strain during the January 2016 VA examination, if there is evidence of flare-ups at the new VA examination, a VA examiner must elicit information regarding the severity, frequency, duration, or functional loss during flare-ups, and if the examiner is unable to provide an estimate for functional loss, a rationale for such, based on lack of medical knowledge within the medical community, must be provided. Sharp v. Shulkin, 29 Vet. App. 26 (2017). In addition, the Court has recently a precedential panel decision in English v. Wilkie, 17-2083, which discussed how to consider lay testimony of knee instability when considering whether to assign a rating under Diagnostic Code (Code) 5257 regarding the presence of knee lateral instability. As such, the VA examiner should not only assess any right knee lateral instability found, but should illicit from the Veteran a complete description of the instability experienced, and provide an opinion as to whether such reported instability is consistent with the objective manifestations of such found on examination, and provide a rationale for any such assessment. The matter is REMANDED for the following action: 1. Obtain any outstanding VA treatment records not presently associated with the Veteran’s claims file 2. Schedule the Veteran for an examination of the current severity of his right knee strain. The electronic claims file, to include the Veteran’s service treatment records, lay statements and testimonies, and treatment records, must be reviewed by the examiner, and a note that it was reviewed should be included in the report. 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 the extent possible, the examiner should identify any symptoms and functional impairments due to the Veteran’s right knee strain alone and discuss the effect of the Veteran’s right knee strain 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). In addition, the VA examiner should not only assess the degree of any right knee lateral instability found on examination, but should also illicit from the Veteran a complete description of the instability experienced in daily life; thereafter, the examiner should provide an opinion as to whether such reported instability is consistent with the objective manifestations of such found on examination, and provide a rationale for any distinction in the objective assessment from the reported symptoms. All findings, conclusions, and opinions must be supported by a clear rationale. (Continued on the next page)   3. Then, after conducting any other development deemed necessary, readjudicate the Veteran’s claim. If any benefits sought on appeal remain denied, provide the Veteran and his representative with a supplemental statement of the case (SSOC) and allow an appropriate period of time for response. Thereafter, the claims folder should be returned to the Board. Michael Pappas Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD A. White, Associate Counsel