Citation Nr: 18154361 Decision Date: 11/29/18 Archive Date: 11/29/18 DOCKET NO. 16-23 533 DATE: November 29, 2018 REMANDED Entitlement to an evaluation in excess of 10 percent for service-connected genua valga with chondropathia of the left knee is remanded. Entitlement to an evaluation in excess of 10 percent for service-connected genua valga with chondropathia of the right knee is remanded. Entitlement to a compensable evaluation for service-connected muscle compartment syndrome of the left knee is remanded. Entitlement to a compensable evaluation for service-connected muscle compartment syndrome of the right knee is remanded. REASONS FOR REMAND The Veteran served on active duty with the United States Army from April 2002 to June 2004. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from an August 2014 rating decision issued by a Department of Veterans Affairs (VA) Regional Office (RO). 1. The issues of entitlement to an evaluation in excess of 10 percent for service-connected genua valga with chondropathia of the left and right knees are remanded. The Veteran was afforded a VA examination in March 2016, at which he reported progressive worsening of symptoms including pain under the kneecaps on walking up stairs or squatting, and after prolonged walking. He also reported feelings of weakness in his knees after a long day at work. The examiner declined to estimate any functional loss during these described flare-ups, stating that he was not observing the Veteran during a flare-up and it would be mere speculation. This failure to address any functional limitation during flare-ups, when the Veteran offered descriptions of what occurs during flare-ups, renders the examination inadequate to determine the current severity of the Veteran’s service-connected knee disabilities. See Sharp v. Shulkin, 29 Vet. App. 26, 34-35 (2017) (an examination is inadequate where examiner fails to estimate functional loss due to flare-ups based on all evidence, including lay statements). 2. The issues of entitlement to a compensable evaluation for service-connected muscle compartment syndrome of the right and left knees are remanded. The muscle compartment syndrome issues are intertwined with the above remanded issues and are also remanded at this time. See Henderson v. West, 12 Vet. App. 11, 20 (1998); Harris v. Derwinski, 1 Vet. App. 180, 183 (1991). The matters are REMANDED for the following action: Schedule the Veteran for an examination with an appropriate clinician to determine the current severity of the Veteran’s service-connected knee disabilities. The claims file should be made available to and reviewed by the examiner and all necessary tests should be performed. All findings should be reported in detail. The joints involved should be tested in both active and passive motion, in weight-bearing and non weight-bearing. 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 this is so. The examiner should describe any pain, weakened movement, excess fatigability, instability of station and incoordination present. The examiner should also state whether the examination is taking place during a period of flare-up. If not, the examiner should ask the Veteran to describe the flare-ups he experiences, including: frequency, duration, characteristics, precipitating and alleviating factors, severity and/or extent of functional impairment he experiences during a flare-up of symptoms and/or after repeated use over time. Based on the Veteran’s lay statements and the other evidence of record, the examiner should provide an opinion estimating any additional degrees of limited motion caused by functional loss during a flare-up or after repeated use over time. If the examiner cannot estimate the degrees of additional range of motion loss during flare-ups or after repetitive use without resorting to speculation, the examiner should state whether the need to speculate is caused by a deficiency in the state of general medical knowledge (i.e. no one could respond given medical science and the known facts) or by a deficiency in the record or the examiner (i.e. additional facts are required, or the examiner does not have the needed knowledge or training). The examiner should also describe whether the reported symptoms of pain, swelling, and weakness, as well as any other symptoms reported by the Veteran, are attributable to the musculoskeletal disability of genua valga with chondropathia or to the muscular disability of muscle compartment syndrome. If the examiner finds the symptoms are attributable to both, the examiner should attempt to estimate the extent to which each disability manifests in the reported symptoms. M. HYLAND Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD K. Josey, Associate Counsel