Citation Nr: 18159000
Decision Date: 12/18/18	Archive Date: 12/18/18

DOCKET NO. 15-42 480A
DATE:	December 18, 2018
REMANDED
1. Entitlement to a rating in excess of 40 percent for left thigh quadriceps atrophy with nerve impairment and multiple scars, is remanded.
2. Entitlement to a rating in excess of 10 percent for residuals of left knee anterior cruciate ligament tear with osteoarthritis associated with postoperative arthrotomy of the left knee is remanded.
REASONS FOR REMAND
The Veteran served on active duty in the United States Navy from July 1964 to August 1964 and in the United States Army from January 1976 to June 1976. This matter come to the Board of Veterans Appeals’ on appeal from a Department of Veterans Affairs (VA) Regional Office (RO) rating decision.
The Veteran’s disabilities of the left lower extremities are both rated, at least in part, on range of motion testing.  The Veteran was last examined in August 2015.  Subsequently, the United States Court of Appeals for Veterans Claims (Court) issued directives regarding VA examinations in Correia v. McDonald, 28 Vet. App. 158 (2016) indicating that the examiner should specifically test the range of motion in active motion, passive motion, weight-bearing, and nonweight-bearing, and that the opposite joint should also be tested.  
The Board further notes that in Sharp v. Shulkin, 29 Vet. App. 26 (2017), the Court explained that “the VA Clinician’s Guide instructs examiners when evaluating certain musculoskeletal conditions to obtain information about the severity, frequency, duration, precipitating and alleviating factors, and extent of functional impairment of flares from a veteran, including during flare-ups.  The examiners should elicit relevant information as to a veteran’s flares with a description of the additional functional loss, if any, a veteran suffers during flares.  The examiner should estimate a veteran’s functional loss due to flare-ups based on all the evidence of record-including the lay information or sufficiently explain why the examiner cannot do so.  
In light of the foregoing and the Veteran’s assertions that his left lower extremity disabilities are of greater severity than shown on the 2015 VA examination, the Veteran must be afforded another VA examination which fully complies with Correia and Sharp.  
The matters are REMANDED for the following action:
1. Schedule the Veteran for a VA examination to determine the nature and extent of his service-connected left thigh quadriceps atrophy nerve impairment and left knee disabilities.  The examiner should review the record prior to examination.  
The examiner must test the Veteran’s active motion, passive motion, and pain with weight-bearing and without weight-bearing.  The examiner must also 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 the left thigh and the left knee separately and discuss the effect of each of these disabilities (left thigh and left knee) 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).
Any opinions expressed by the examiner must be accompanied by a complete rationale.
 
S. L. Kennedy
Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD	J. Connolly, Counsel