Citation Nr: 18153452 Decision Date: 11/27/18 Archive Date: 11/27/18 DOCKET NO. 12-29 512 DATE: November 27, 2018 REMANDED Entitlement to a rating in excess of 10 percent prior to January 11, 2016, for residuals of left knee injury, status post surgery with degenerative changes; in excess of 40 percent from January 11, 2016, to February 15, 2017, for limitation of extension of the left knee; and in excess of 30 percent beginning May 1, 2018, for left knee total replacement is remanded. REASONS FOR REMAND The Veteran served on active duty from August 1989 to October 1992, with a period of inactive duty for training from February 1988 to June 1988. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a March 2011 rating decision issued by a Department of Veterans Affairs (VA) Regional Office (RO), which, as relevant, continued the Veteran’s 10 percent rating for residuals of left knee injury, status post surgery with degenerative changes, under 38 C.F.R. § 4.71a, Diagnostic Code 5257-5010. In June 2015, the Veteran testified at a Board hearing before the undersigned Veterans Law Judge. A transcript of the hearing has been associated with the record. In August 2015, the Board remanded the case for additional development. While on remand, a January 2016 rating decision discontinued the 10 percent rating for left knee injury, status post surgery with degenerative changes, and recharacterized the Veteran’s left knee disability as limitation of extension of the left knee, and assigned a 40 percent rating pursuant to Diagnostic Code 5003-5261, effective January 11, 2016. Thereafter, a March 2017 rating decision again recharacterized the Veteran’s left knee disability as left knee total replacement, and assigned a 100 percent rating, effective February 15, 2017, and a 30 percent rating, effective May 1, 2018. Consequently, the issue on appeal has been characterized as shown on the title page. In October 2017, the Board remanded the issue on appeal for additional development and the case now returns for further appellate review. Entitlement to a rating in excess of 10 percent prior to January 11, 2016, for residuals of left knee injury, status post surgery with degenerative changes; in excess of 40 percent from January 11, 2016, to February 15, 2017, for limitation of extension of the left knee; and in excess of 30 percent beginning May 1, 2018, for left knee total replacement. As noted above, this matter was remanded by the Board in October 2017. Unfortunately, there has not been substantial compliance with the Board’s previous remand directives and, as such, another remand is required. See Stegall v. West, 11 Vet. App. 268 (1998). In this regard, the Board remanded this matter in October 2017 in order to obtain a retrospective medical opinion addressing the findings rendered in prior VA examinations conducted during the appeal period pursuant to the United States Court of Appeals Veterans’ Claims’ holdings in Correia v. McDonald, 28 Vet. App. 158 (2016), and Sharp v. Shulkin, 29 Vet. App. 26 (2017). Specifically, the remand directed the examiner to review the VA examinations containing range of motion findings pertinent to the Veteran’s left knee disability conducted during the course of the appeal in January 2011, April 2013 (conducted in connection with an examination of his right knee), November 2015 (conducted in connection with an examination of his back), and January 2016, and to offer a retrospective medical opinion with respect to each examination. Upon remand, a November 2017 medical opinion was obtained, with an addendum in February 2018. As relevant, in November 2017, the examiner included a comparison diagram and corresponding discussion of findings between the VA examinations conducted in January 2011, April 2013, and January 2016, to include range of motion testing of the left and right knee, pain on weight-bearing, tenderness on palpitation, crepitus, repetitive testing, flare-ups, muscle testing, muscle atrophy, ankylosis, joint effusion, and joint instability. However, the opinions obtained on remand did not address the findings rendered at the November 2015 VA examination as directed by the October 2017 remand. Consequently, another remand is necessary in order to obtain an addendum opinion addressing such matter. The matter is REMANDED for the following action: Forward the record to an appropriate medical professional for a retrospective opinion addressing the findings referable to the Veteran’s left knee disability rendered at a November 2015 VA examination. The record and a copy of this Remand must be made available to the examiner. The need for an additional examination of the Veteran is left to the discretion of the clinician selected to write the addendum opinion. The examiner is requested to review the VA examination containing range of motion findings pertinent to the Veteran’s left knee disability conducted in November 2015 (which was conducted in connection with an examination of his back). With regard to such examination, the examiner is requested to offer an opinion as to the range of motion findings for pain on both active and passive motion, on weight-bearing and nonweight-bearing and, if possible, with range of motion measurements of the opposite undamaged joint. If the examiner is unable to do so, he or she should explain why. Additionally, if the Veteran endorsed flare-ups at the above referenced VA examination, the examiner should offer an opinion as to whether additional loss of range of motion was present during a flare-up. If the examiner is unable to do so, the examiner must make clear that s/he has considered all procurable data (i.e., the information regarding frequency, duration, characteristics, severity, and/or functional loss related to such flare-ups elicited from the Veteran), but any member of the medical community at large could not provide such an opinion without resorting to speculation. All opinions expressed should be accompanied by supporting rationale. A. JAEGER Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD Koria B. Stanton, Associate Counsel