Citation Nr: 18106920
Decision Date: 06/01/18	Archive Date: 05/31/18

DOCKET NO. 13-00 942
DATE:	June 1, 2018
REMANDED
Entitlement to an initial rating in excess of 20 percent for residuals of a left anterior cruciate ligament (ACL) repair is remanded.
REASONS FOR REMAND
The Veteran had active service from June 2006 to September 2010.  The Veteran originally requested a hearing before the Board of Veterans’ Appeals (Board) but subsequently withdrew her hearing request in June 2015.  This matter was previously before the Board in October 2016 when it was remanded for further development.
In June 2017 the Veteran requested additional time to submit evidence in support of her claim.  Although no response was provided to that request, the Veteran’s claim is being remanded and she will have the opportunity to submit additional evidence then. 
1. Entitlement to an initial rating in excess of 20 percent for residuals of a left ACL repair is remanded.
While the record contains contemporaneous VA examinations regarding the residuals of the Veteran’s left ACL repair, the examinations do not comply with the requirements in Correia v. McDonald, 28 Vet. App. 158, 168 (2016).  The examinations do not contain information documenting the Veteran’s passive range of motion, though the fact that she has pain on passive motion is documented in the January 2017 VA examination.  The most recent VA examination also contains other information that requires explanation.  It documents that the Veteran has both osteoarthritis of the left knee and has had a total knee replacement of the left knee. This total knee replacement does not appear to have been documented elsewhere in the record, and it is not clear from the record how the Veteran’s left knee could simultaneously be arthritic and have been totally replaced. 
The matter is REMANDED for the following actions:
1. Schedule the Veteran for an examination of the current severity of her residuals of a left ACL repair.  The examiner must test the Veteran’s active motion and passive motion, and provide the ranges of motion for each, 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 her residuals of a left ACL repair alone and discuss the effect of the Veteran’s residuals of a left ACL repair 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).  The clinician should also provide further description and context of the state of the Veteran’s knee replacement and arthritis.
 
A. ISHIZAWAR
Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD	Steven H. Johnston, Associate Counsel