Citation Nr: 18156988
Decision Date: 12/11/18	Archive Date: 12/11/18

DOCKET NO. 17-02 454
DATE:	December 11, 2018
REMANDED
Entitlement to an increased rating in excess of 10 percent for patellofemoral pain syndrome of the left knee with degenerative joint disease is remanded.
Entitlement to an increased rating in excess of 10 percent for patellofemoral pain syndrome of the right knee with degenerative joint disease is remanded.
REASONS FOR REMAND
The Veteran served on active duty in the United States Army from July 1981 to July 2007.
Bilateral Knee Conditions
Although the Board regrets further delay, additional development is required prior to adjudication of the Veteran’s claims. 
In January 2017, the Veteran filed his VA Form 9. The Veteran stated that he has overwhelmingly growing bilateral knee pain.  He further stated that the instability in his knees should be considered for separate rating purposes.  The Veteran further reported suffering from instability.  The Board notes that that the Veteran’s last examination was in May 2013, over 5 years ago.  Therefore, due the Veteran reporting worsening symptoms, the Board finds that a remand is required in order to obtain a new medical examination to determine the current severity of the Veteran’s bilateral knee conditions, to include consideration of any limitation of functional ability after repetitive use over time and during flare-ups, as well consideration of the severity of any lateral instability.  See Weggenmann v. Brown, 5 Vet. App. 281 (1993).
The matters are REMANDED for the following action:
1. Obtain and associate with the Veteran’s electronic claims file any outstanding VA treatment records and private medical records relevant to the Veteran’s claims.
2. After all outstanding records have been associated with the claims file, schedule the Veteran for a VA examination with an appropriate examiner to determine the current severity of his bilateral knee conditions.  The record and a copy of this Remand must be made available to the examiner.
Following a review of the entire record, to include the Veteran’s lay statements regarding his current symptoms, the examiner should identify any findings related to the Veteran’s bilateral knee conditions and fully describe the current extent and severity of those symptoms.  
The examiner should discuss all findings in terms of the Schedule of Ratings for Musculoskeletal System, specifically Diagnostic Codes 5256-5261.  The pertinent rating criteria must be provided to the examiner, and the findings reported must be sufficiently complete to allow for a rating under all alternate criteria.
The examiner should further determine whether any knee disability is manifested by weakened movement, excess fatigability, incoordination, flare-ups, or pain.  If feasible, the examiner must assess the additional functional impairment on repeated use or during flare-ups in terms of the degree of additional range of motion loss, using lay observations specifically elicited from the Veteran for each disability.  
If the examiner finds that recurrent subluxation or lateral instability is present, the examiner should describe whether such condition is slight, moderate, or severe. 
In offering any opinion, the examiner must consider the full record, to include the lay statements regarding symptoms and the opinion should note that consideration.  A clearly stated rationale must be provided for any opinion offered.
 
P.M. DILORENZO
Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD	J. Negron, Associate Counsel