Citation Nr: 18123712 Decision Date: 08/02/18 Archive Date: 08/02/18 DOCKET NO. 15-22 097 DATE: August 2, 2018 ORDER Entitlement to a compensable evaluation for right knee scar is denied. REMANDED Entitlement to an evaluation in excess of 10 percent for right knee limitation of flexion is remanded. Entitlement to an evaluation in excess of 10 percent for left knee limitation of flexion is remanded. Entitlement to an evaluation in excess of 10 percent for right knee instability is remanded. Entitlement to an evaluation in excess of 10 percent for left knee instability is remanded. FINDING OF FACT The Veteran’s scar of the right knee, status post right knee arthroplasty, is manifested by a scar that is not painful or unstable; the scar measures less than 39 square centimeters, without objective evidence of other functional impairment. CONCLUSION OF LAW The criteria for a compensable rating for scar of the right knee, status post arthroplasty are not met. 38 U.S.C. §§ 1155, 5107 (2012); 38 C.F.R. §§ 3.159, 3.321, 4.1, 4.2, 4.7, 4.10, 4.118, Diagnostic Codes 7801, 7804 (2017). REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from June 1984 to July 1994. 1. Entitlement to a compensable evaluation for right knee scar is denied. The Veteran contends he is entitled to a compensable disability rating for his service-connected scar of the right knee. Disability evaluations are determined by evaluating the extent to which a Veteran’s service-connected disability adversely affects his ability to function under the ordinary conditions of daily life, including employment, by comparing his symptomatology with the criteria set forth in the Schedule for Rating Disabilities (Rating Schedule). 38 U.S.C. § 1155; 38 C.F.R. §§ 4.1, 4.2, 4.10. If two evaluations are potentially applicable, the higher evaluation will be assigned if the disability picture more nearly approximates the criteria required for that evaluation; otherwise, the lower evaluation will be assigned. 38 C.F.R. § 4.7. As explained below, a uniform evaluation is warranted. Hart v. Mansfield, 21 Vet. App. 505 (2007). The Veteran’s service-connected scar of the right knee, status post arthroplasty is rated as 0 percent disabling pursuant to the criteria of 38 C.F.R. § 4.118, Diagnostic Code 7804. The applicable rating criteria include Diagnostic Code 7801, which provides ratings for scars, other than the head, face, or neck. Scars that are painful or unstable or in an area or areas exceeding 6 square inches (39 sq. cm.) are rated 10 percent disabling. Note (1) to Diagnostic Code 7801 provides that a deep scar is one associated with underlying soft tissue damage. 38 C.F.R. § 4.118, Diagnostic Codes 7801, 7804. A January 2013 VA examination report reflects that the examiner noted a scar of the right knee from the Veteran’s history of right knee meniscectomy and arthroplasty and that the scar was not unstable or painful, and was linear and not deep. See January 2013 VA Examination. There was no edema, or erythema, and no other disabling effects. On VA examination in May 2015, the examiner noted that the Veteran did not manifest a visible scar of the right knee. See May 2015 VA Examination. The Board interprets this examination report to indicate the Veteran’s right knee scar was not unstable or painful. Here, the Board finds that a compensable evaluation is not warranted. Neither the lay nor medical evidence of record shows that the knee scar is unstable or painful, or in area or areas exceeding 6 square inches (39 sq. cm.). 38 C.F.R. § 4.118, Diagnostic Codes 7801; 7804. Further, the Board notes the Veteran’s briefs since the May 2015 VA examination do not indicate his disability has worsened. See October 2015 Brief; see also May 2018 Brief. Accordingly, the Board finds that a compensable evaluation for scar of the right knee, status post arthroplasty, is not warranted. In reaching this decision, the Board has considered the benefit-of-the-doubt doctrine. See 38 U.S.C. § 5107(b); 38 C.F.R. §§ 3.102, 4.3; Gilbert v. Derwinski, 1 Vet. App. 49, 55-56 (1990). The Veteran has not raised any other issues, nor have any other issues been reasonably raised by the record. See Doucette v. Shulkin, 28 Vet. App. 366, 369-70 (2017) (confirming that the Board is not required to address issues unless they are specifically raised by the claimant or reasonably raised by the evidence of record). The Board is grateful for the Veteran’s honorable service. This decision denying an increased rating is in no way meant to diminish that service. Unfortunately, however, as the preponderance of the evidence is against the claim, the claim cannot be granted. REASONS FOR REMAND Although the Board regrets the additional delay, a remand is necessary to ensure that there is a complete record upon which to decide the Veteran’s claims. 38 U.S.C. § 5103A (2012); 38 C.F.R. § 3.159 (2017). 2. Entitlement to an evaluation in excess of 10 percent for right knee limitation of flexion is remanded. The Veteran asserts his right knee disability is worse than reflected by a May 2015 VA examination. See May 2018 Brief (alleging that the Veteran’s “limitation of motion and instability is more disabling than the current evaluations reflect”). Further, the United States Court of Appeals for Veterans Claims, in Correia v. McDonald, 28 Vet. App. 158 (2016), held that the final sentence of 38 C.F.R. § 4.59 requires that VA examinations include joint testing for pain on both active and passive motion, in weight-bearing and nonweight-bearing and, if possible, with range of motion measurements of the opposite undamaged joint. The Board notes the May 2015 VA examination does not contain all of the required testing under 38 C.F.R. § 4.59. Given the Veteran’s assertion his right knee disability is not adequately reflected and the Court’s finding in Correia, the Board finds an additional examination is warranted to assess the current severity. See Green v. Derwinski, 1 Vet. App. 121 (1991) (VA has a duty to conduct a thorough and contemporaneous examination of the Veteran in an increased rating claim). 3. Entitlement to an evaluation in excess of 10 percent for left knee limitation of flexion is remanded. The Veteran asserts his left knee disability is worse than reflected by a May 2015 VA examination. See May 2018 Brief. For the reasons listed above, the Board finds an additional examination is warranted to assess the current severity of the Veteran’s left knee disability. Id. 4. Entitlement to an evaluation in excess of 10 percent for right knee instability is remanded. Given the Veteran’s assertion his right knee instability is not adequately reflected by the May 2015 VA examination and his statements that his disability has worsened since then, the Board finds an additional examination is warranted to assess the current severity. See May 2018 Brief; Green, 1 Vet. App. at 121. 5. Entitlement to an evaluation in excess of 10 percent for left knee limitation of flexion is remanded. Given the Veteran’s assertion his left knee instability is not adequately reflected by the May 2015 VA examination and his statements that his disability has worsened since then, the Board finds an additional examination is warranted to assess the current severity. See May 2018 Brief; Green, 1 Vet. App. at 121. The matters are REMANDED for the following action: 1. The AOJ should secure any outstanding, relevant VA medical records. 2. The Veteran should be afforded a VA examination to ascertain the current severity and manifestations of his service-connected bilateral knee disabilities. In particular, the examiner should be directed to perform range of motion testing to determine the extent of limitation of motion. Additionally, the examiner must include range of motion testing in the following areas: • Active motion; • Passive motion; • Weight-bearing; and • Nonweight-bearing. The examiner should indicate whether range of motion is additionally limited due to such factors as pain on motion, weakened movement, excess fatigability, diminished endurance, or incoordination. In doing so, the examiner should offer an opinion as to whether pain could significantly limit functional ability during flare-ups or when the left or right knee is used repeatedly over a period of time. Such determinations should, if feasible, be portrayed in terms of the degree of additional range-of-motion loss due to pain on use or during flare-ups. (Continued on the next page)   IF THE EXAMINATION DOES NOT TAKE PLACE DURING A FLARE, THE EXAMINER MUST GLEAN INFORMATION REGARDING THE FLARES’ SEVERITY, FREQUENCY, DURATION, AND FUNCTIONAL LOSS MANIFESTATIONS FROM THE VETERAN, MEDICAL RECORDS, AND OTHER AVAILABLE SOURCES. EFFORTS TO OBTAIN SUCH INFORMATION MUST BE DOCUMENTED. If there is no pain and/or no limitation of function, such facts must be noted in the report. The examiner should specifically indicate whether, and at what point during, the range of motion the Veteran experienced any limitation of motion that was specifically attributable to pain. If the examiner is unable to conduct the required testing or concludes that the required testing is not necessary in this case, he or she should clearly explain why that is so. A. S. CARACCIOLO Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD Trickey, Jonathan