Citation Nr: 18152962 Decision Date: 11/26/18 Archive Date: 11/26/18 DOCKET NO. 16-50 307 DATE: November 26, 2018 REMANDED Entitlement to a rating in excess of 10 percent for left knee disability is remanded. Entitlement to a total disability based on individual unemployability (TDIU) is remanded. REASONS FOR REMAND The Veteran served on active duty from May 1976 to May 1979. This matter is before the Board of Veterans’ Appeals (Board) on appeal from an August 2013 rating decision by a Department of Veterans Affairs (VA) Regional Office (RO). The Board notes that in a May 2017 appellate brief, the Veteran, through his representative highlighted the Veteran’s reports during the October 2010 VA examination that he was unable to work as a laborer due to his service-connected left knee disability. The Veteran, through his representative, asserted that TDIU has been raised in the record as related to the left knee disability. A review of the record confirms such contention and additional records from Social Security Administration (SSA) have also noted the Veteran was found disabled in part due to his left knee disability. See May 2016 Medical Treatment Records – Furnished by SSA. Accordingly, the Board finds that a claim for a TDIU has been raised by the record and is part of the current appeal. See Rice v. Shinseki, 22 Vet. App. 447 (2009). Entitlement to a rating in excess of 10 percent for left knee disability is remanded. Entitlement to a TDIU is remanded. The Veteran was last provided a VA examination in January 2012. During examination, the examiner noted the Veteran’s complaints of left knee plain. The examiner noted the Veteran’s gait was balanced and coordinated and that he could walk or stand no longer than one hour. The examiner noted the Veteran remained independent in his activities of daily living and that the Veteran was able to wash, dress, toilet himself, and take care of his personal needs without interference of his left knee pain. The examiner noted there was no atrophy of the left lower extremity. The examiner highlighted a 2005 MRI that showed the Veteran’s quadriceps tendon and patella tendons were intact and that there was no diffuse increased signal in the posterior horn of the medial meniscus. However, since the January 2012 VA examination, the Veteran has reported and the evidence of record has shown worsening symptoms in his left knee. A March 2015 VA treatment record noted the Veteran’s reports that his knee gave out. See March 2015 CAPRI. A February 2016 treatment record from Family Care Partners noted an assessment of functional gait abnormality. See June 2016 Medical Treatment Record – Non-Government Facility. A September 2016 treatment record from Brooks Rehabilitation noted the Veteran’s increased difficulty with bending down and squatting to pick things up from the floor and the Veteran’s decreased walking capability. The record also noted left quad atrophy. See October 2016 Medical Treatment Record – Non-Government Facility. A September 2016 x-ray report of the left knee from Elite Imaging also noted a large enthesophyte at the superior pole of the patella at the attachment point of the quadriceps tendon. An earlier January 2014 x-ray report from a VA clinic noted only small quadriceps tendon enthesophyte. See January 2014 Medical Treatment Record – Government Facility. Evidence of a change in the condition or allegation of worsening of the condition renders an examination inadequate for rating purposes. Palczewski v. Nicholson, 21 Vet. App. 174, 182 (2007); see also Proscelle v. Derwinski, 2 Vet. App. 629 (1992). Given the Veteran’s assertion that his left knee disability had worsened since his last VA examination, a remand is warranted for a new VA examination. Lastly, entitlement to a TDIU is inextricably intertwined with the Veteran’s claim on appeal. The matters are REMANDED for the following action: 1. With any necessary identification of sources by the Veteran, request all VA treatment records not already associated with the file from the Veteran’s VA treatment facilities, and all private treatment records from the Veteran not already associated with the file. 2. Develop the raised claim for TDIU. 3. After the development in #1 has been completed, schedule a VA examination with an appropriate examiner to determine the current severity of his left knee disability. The evidentiary record, including a copy of this remand, must be made available to, and reviewed by, the examiner. A complete history should be elicited from the Veteran, and the examiner should conduct any tests and studies deemed necessary. All findings should be reported in detail. The examiner should provide the following: (a) The examiner is asked to test the range of motion in active motion, passive motion, weight-bearing, and non-weight-bearing for the Veteran’s left knee and non-service connected right knee. If the examiner is unable to conduct the required testing, or concludes that the required testing is not necessary in this case, he or she should clearly explain why that is so. (b) The examiner must consider functional loss due to flare-ups, repetitive use, painful motion, weakness, excessive fatigability, lack of endurance, and/or incoordination. To the extent possible, any such determination should be expressed in terms of the estimated loss of range of motion. 4. Thereafter, readjudicate the increased rating claim and the claim for TDIU. S. HENEKS Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD J. Cheng, Associate Counsel