Citation Nr: 18154833 Decision Date: 11/30/18 Archive Date: 11/30/18 DOCKET NO. 16-53 663A DATE: November 30, 2018 REMANDED Entitlement to an increased rating in excess of 10 percent for chondromalacia, patella, left knee is remanded. Entitlement to an increased rating in excess of 10 percent for chondromalacia, patella, right knee is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Air Force from March 1985 to February 1993. The matter is on appeal from an April 2014 rating decision. 1. The claims for entitlement to increased ratings in excess of 10 percent for chondromalacia, patella, in the left and right knees, are remanded The Veteran’s chondromalacia, patella, in the left and right knees, have been rated under Diagnostic Code 5003-5260. Diagnostic Code 5003 provides that degenerative arthritis that is established by x-ray findings will be rated based on limitation of motion under the appropriate diagnostic codes for the specific joint or joints involved. Diagnostic Code 5260 is used to rate limitation of flexion and of extension of the knee. Upon review of the record, the Board finds that the claims for entitlement to increased ratings in excess of 10 percent for chondromalacia, patella, in the left and right knees must be remanded. The most recent VA examination for this claim, the September 2016 Knee and Lower Leg Conditions Disability Benefits Questionnaire and examination, do not comply with the requirements in Correia v. McDonald, 28 Vet. App. 158, 168 (2016). In light of Correia, the September 2016VA examination is insufficient, and the Veteran must be provided a new VA examination, which provides findings with regards to range of motion in active motion, passive motion, weight-bearing, and nonweight-bearing. The matters are REMANDED for the following action: 1. Schedule the Veteran for a VA examination to determine the severity of his chondromalacia, patella, in the left and right knees. The claims file must be made available to and reviewed by the examiner and all necessary tests should be performed. The examiner should report all signs and symptoms necessary for evaluating the Veteran’s disabilities under the rating criteria. The examiner should also provide the range of motion in degrees of the knees. In so doing, the examiner should test the Veteran’s range of motion in active motion, passive motion, weight-bearing, and nonweight-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 so in the report. It is also imperative that the examiner comment on the functional limitations caused by flare-ups and repetitive use of the knees. In this regard, the examiner must indicate whether, and to what extent, the Veteran’s range of motion is additionally limited during flare-ups or on repetitive use, expressed, if possible, in terms of degrees, or explain why such details cannot be feasibly provided. The examiner shall inquire as to periods of flare-ups, and note the frequency and duration of any such flare-ups. ANY ADDITIONAL IMPAIRMENT ON USE OR IN CONNECTION WITH FLARE-UPS SHOULD BE DESCRIBED IN TERMS OF THE DEGREE OF ADDITIONAL RANGE OF MOTION LOSS. THE EXAMINER SHOULD SPECIFICALLY DESCRIBE THE SEVERITY, FREQUENCY, AND DURATION OF FLARE-UPS; NAME THE PRECIPITATING AND ALLEVIATING FACTORS; AND ESTIMATE, PER THE VETERAN, TO WHAT EXTENT, IF ANY, SUCH FLARE-UPS AFFECT FUNCTIONAL IMPAIRMENT. 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. If the requested opinion cannot be rendered without resorting to speculation, the examiner must 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. Jones v. Shinseki, 23 Vet. App. 382, 389 (2010). (The Agency of Original Jurisdiction should ensure that any additional evidentiary development suggested by the examiner be undertaken so that a definite opinion can be obtained.) Any opinion expressed by the VA examiner must “contain not only clear conclusions with supporting data, but also a reasoned medical explanation connecting the two. See Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 301 (2008). For all opinions, the RO should ensure that a rationale is provided, to include specific discussion of the medical principles involved and the relevant facts. (Continued on the next page)   2. The Veteran is hereby notified that it is his responsibility to report for any examination, and to cooperate in the development of the claim. The consequences for failure to report for a VA examination without good cause may include denial of the claim. 38 C.F.R. §§ 3.158, 3.655. 3. THE AOJ MUST REVIEW THE CLAIMS FILE AND ENSURE THAT THE FOREGOING DEVELOPMENT ACTION HAS BEEN COMPLETED IN FULL. IF ANY DEVELOPMENT IS INCOMPLETE, APPROPRIATE CORRECTIVE ACTION MUST BE IMPLEMENTED. IF ANY REPORT DOES NOT INCLUDE ADEQUATE RESPONSES TO THE SPECIFIC OPINIONS REQUESTED, IT MUST BE RETURNED TO THE PROVIDING EXAMINER FOR CORRECTIVE ACTION. Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD C. J. Cho, Associate Counsel