Citation Nr: 18154064
Decision Date: 11/29/18	Archive Date: 11/28/18

DOCKET NO. 12-19 607
DATE:	November 29, 2018
REMANDED
An initial rating in excess of 10 percent for tendonobursitis and arthritis of the right knee is remanded.
A rating in excess of 10 percent for instability of the right knee is remanded.
 
REASONS FOR REMAND
The Veteran served on active duty from October 1991 to September 1999, from November 2001 to April 2003 and from July 2009 to April 2010.
The case is on appeal from an August 2011 rating decision.
In March 2014, the Veteran testified at a Board hearing.
The claims most recently came before the Board in May 2017 and were remanded for further development.
1. An initial rating in excess of 10 percent for tendonobursitis and arthritis of the right knee.
2. A rating in excess of 10 percent for instability of the right knee.
In May 2017, the Board remanded the claims for further development, including a VA examination to assess the severity of the Veteran’s right knee disabilities.  The Veteran was afforded an August 2017 VA examination in which the examiner indicated the Veteran’s right knee flexion was limited to 90 degrees.  He stated there was no evidence of pain on passive range of motion testing, as well as no evidence of pain in weight bearing or non-weight bearing settings.  The examiner also indicated the Veteran has slight instability of the right knee.
The August 2017 VA examination is adequate with regard to testing for pain on both active and passive motion, and in weight-bearing and nonweight-bearing.  See Correia v. McDonald, 28 Vet. App. 158 (2016).  However, the Veteran also reported flare-ups of the right knee, including daily intermittent pain with prolonged standing and walking lasting for a few hours.  The examiner indicated he was unable to report whether pain, weakness, fatigability, or incoordination significantly limit the Veteran’s functional ability during flare-ups, without resorting to speculation.
The Board finds that despite the August 2017 VA examination, a remand is warranted for a new VA examination to fully evaluate the severity of the Veteran’s service-connected right knee arthritis disability.  The examiner should provide an adequate rationale with regard to the Veteran’s reported flare-ups.  He or she should fully discuss the Veteran’s reported flares and symptoms from such, as well as the impact they have on any additional functional loss caused.  See Sharp v. Shulkin, 29 Vet. App. 26, 33 (2017).
The Board finds the claim for an increased rating for right knee instability is inextricably intertwined with the claim for an increased rating for arthritis of the right knee.  See Harris v. Derwinski, 1 Vet. App. 180, 183 (1991).  Thus, this claim will also be remanded.
The matters are REMANDED for the following action:
Schedule the Veteran for a VA examination by an appropriate medical professional to determine the nature and severity of the right knee disability.
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The examiner should estimate the functional loss of the disorder that would occur during flare-ups.  If the examination is not conducted during a flare-up, the functional impact of a flare-up should be estimated based on the Veteran’s reports.  If this cannot be done, it should be explained why this is so.
 
RYAN T. KESSEL
Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD	B. Isaacs, Associate Counsel