Citation Nr: 18157143
Decision Date: 12/13/18	Archive Date: 12/11/18

DOCKET NO. 13-07 944
DATE:	December 13, 2018
REMANDED
1. Entitlement to an increased disability rating for partial left anterior cruciate ligament, status-post arthroscopic surgery with instability, currently rated as 10 percent disabling. is remanded.
2. Entitlement to an increased disability rating for partial left anterior cruciate ligament, status-post arthroscopic surgery with painful motion, currently evaluated as 10 percent disabling is remanded. 
REASONS FOR REMAND
The Veteran served on active duty from June to December 1999 in the United States Navy.
1. Entitlement to an increased disability rating for partial left anterior cruciate ligament tear, status-post arthroscopic surgery, currently rated as 10 percent disabling. is remanded.
2. Entitlement to an increased disability rating for partial left anterior cruciate ligament, status-post arthroscopic surgery with painful motion, currently evaluated as 10 percent disabling is remanded. 
In a January 2017 rating decision, the RO granted service connection and assigned a separate 10 percent rating for the left knee based on painful motion, effective January 5. 2102. Because the painful motion is a manifestation of the Veteran’s service-connected left knee disability, the appeal encompasses the rating for that disability as well. The issues before the Board are as shown on the title page.  
While the record contains a contemporaneous VA examination regarding the Veteran’s service-connected partial left anterior cruciate ligament tear, status-post arthroscopic surgery, the examination does not comply with the requirements in Sharp v. Shulkin, 29 Vet. App. 26 (2017).  The examiner did not attempt to elicit relevant information regarding the description of the Veteran’s flare-ups and any additional functional loss suffered during flare-ups.  Furthermore, while the examiner stated that an opinion could not be provided without resort to speculation, the examiner did not indicate that the speculation was due to lack of knowledge within the medical community.
The agency of original jurisdiction (AOJ), prior to returning the appeal to the Board, appears to have noted that the Veteran’s June 2016 was deficient.  The Veteran was contacted with regard to this deficiency and offered an additional examination.  The Veteran purportedly declined the examination because the Board had decided his claim.  The AOJ sent the Veteran an explanation that the Board’s decision had granted him a separate left knee rating for instability but did not increase his disability rating for his partial left anterior cruciate ligament tear, status-post arthroscopic surgery.  However, no additional VA examination or addendum opinion was obtained. As both aspects of the knee claim are before the Board, a remand is necessary to obtain a new examination.  
The matter is REMANDED for the following action:
1.  Schedule the Veteran for an examination of the current severity of his partial left anterior cruciate ligament tear, status-post arthroscopic surgery.  The examiner must address the extent and severity of any limited motion and instability.  The examiner must attempt to elicit information regarding the severity, frequency, and duration of any flare-ups, and the degree of functional loss during flare-ups.  To the extent possible, the examiner should identify any symptoms and functional impairments due to his partial left anterior cruciate ligament tear, status-post arthroscopic surgery alone and discuss the effect of the Veteran’s disability on any occupational functioning and activities of daily living.  If it is not possible to provide a specific measurement, or an opinion regarding flare-ups, symptoms, or functional impairment without speculation, the examiner must state whether the need to speculate is due to a deficiency in the state of general medical knowledge (no one could respond given medical science and the known facts), a deficiency in the record (additional facts are required), or the examiner (does not have the knowledge or training). 
2. After the above development, and any additionally indicated development, has been completed, readjudicate the issues, to include whether higher or separate ratings are warranted based on any limitation of knee motion or instability.  
 
ME LARKIN
Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD	P.S. McLeod