Citation Nr: 18156788 Decision Date: 12/11/18 Archive Date: 12/10/18 DOCKET NO. 16-51 523 DATE: December 11, 2018 REMANDED Entitlement to higher ratings for bilateral knee disabilities is remanded. REASONS FOR REMAND The Veteran served on active duty from September 1985 to January 1989. He served honorably in the United States Navy. The Board thanks the Veteran for his service to our country. This matter comes to the Board of Veterans’ Appeals (Board) on appeal from a January 2016 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO) in St. Petersburg, Florida. The January 2016 decision denied ratings in excess of 10 percent for degenerative joint disease with Baker’s cyst of each knee and a rating in excess of 20 percent associated with a right knee anterior cruciate ligament tear, status post arthroscopy with partial meniscectomy. In January 2017, the RO has adjusted the Veteran’s knee ratings to grant a 100 percent rating from September 6, 2016, and a 30 percent rating from November 1, 2017, under Diagnostic Code 5055 for right total knee replacement and to grant a 100 percent rating from January 10, 2017, and a 30 percent rating from March 1, 2018 for left knee total knee replacement. In September 2018, the Veteran withdrew his request for a Board hearing. He also indicated that he planned to remove his current representative but that he would do so in a subsequent writing to VA that has not yet been received. Accordingly, pursuant to the Veteran’s September 2018 instructions, his current representative will remain in place pending receipt of the forthcoming writing. Entitlement to a higher rating for bilateral knee disabilities is remanded. In Correia v. McDonald, 28 Vet. App. 158 (2016), the Court of Appeals for Veterans Claims held that the final sentence of 38 C.F.R. § 4.59 requires certain range of motion testing be conducted for claims involving joints, such as the knees. The final sentence of § 4.59 provides that “[t]he joints involved should be tested for pain on both active and passive motion, in weight-bearing and nonweight-bearing and, if possible, with the range of the opposite undamaged joint.” The Court held that an adequate VA examination of the joints must, wherever possible, include the results of the range of motion testing described in the final sentence of § 4.59. VA examiners should also convey any additional or increased symptoms and functional loss experienced during flare-ups, as well as information pertaining to frequency, duration, characteristics, and severity. See Sharp v. Shulkin, 29 Vet. App. 26 (2017). Here, the Veteran underwent a VA examination for his knees in January 2016 prior to his bilateral knee replacement surgeries. A review of the examination report shows that it does not comply with the above requirements and therefore a remand for a compliant examination (and to obtain a retrospective medical opinion) is warranted so that the severity of the Veteran’s knee disabilities may be fully evaluated. The Board notes that in the Veteran’s January 2016 notice of disagreement and August 2018 IHP he contended that the VA examination was inadequate, to include lack of consideration of later reported flare-ups; accordingly, an updated examination is also responsive to duty to assist issues raised by the Veteran. The matter is REMANDED for the following action: 1. Please associate with the claims file all outstanding VA and non-VA medical records for the Veteran’s service-connected bilateral knee disabilities. 2. After the record is determined to be complete, please schedule the Veteran for a VA examination to determine the current extent of his service-connected bilateral knee disabilities, status post total knee replacements, and to provide a retrospective medical opinion, to the extent feasible. In particular, the examiner should: (a.) Conduct range of motion testing, specifically noting the ranges of motion in degrees on active and passive motion, weight-bearing and nonweight-bearing, including with comparison to the opposite undamaged joint. If any indicated testing cannot be completed, then the examiner should specifically indicate why such testing cannot be done. (b.) The examiner should also render, if possible to do so without resorting to mere speculation, a retrospective opinion that identifies active motion, passive motion, pain with weight-bearing and without weight-bearing (to the extent medically appropriate) at the time of the January 2016 VA examination report or any time between April 2014 and his knee replacement surgeries in September 2016 (right) and January 2017 (left). (c.) Consider the Veteran’s reports of flare-ups and portray any related functional impairment in terms of additional range of motion loss. The frequency, duration, characteristics, and severity should also be noted. If any indicated testing cannot be completed, then the examiner should specifically indicate why such testing cannot be done. (d.) The examiner should also render, if possible to do so without resorting to mere speculation, a retrospective opinion that identifies the frequency, duration, characteristics, and severity of flare-ups and portray any related functional impairment in terms of additional range of motion loss at the time of the January 2016 VA examination report or any time between April 2014 and his knee replacement surgeries in September 2016 (right) and January 2017 (left). M. C. GRAHAM Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD T. Fales, Associate Counsel