Citation Nr: 19155698 Decision Date: 07/18/19 Archive Date: 07/18/19 DOCKET NO. 16-41 217 DATE: July 18, 2019 REMANDED Entitlement to a rating in excess of 10 percent prior to February 17, 2015, and 30 percent from February 17, 2015, for left knee meniscectomy with degenerative changes is remanded. Entitlement to a rating in excess 20 percent for left knee instability is remanded. REASONS FOR REMAND The Veteran served on active duty from October 1999 to April 2000 and from October 2003 to April 2005. These matters come before the Board of Veterans’ Appeals (Board) on appeal from a September 2014 rating decision. These matters were previously remanded by the Board in November 2018. A May 2018 VA examination of the Veteran’s right knee also provided examination of the Veteran’s left knee. The Board finds, however, that the May 2018 VA examination of the Veteran’s right knee does not provide adequate information for adjudication purposes regarding the Veteran’s left knee. The Veteran’s last left knee examination was in October 2015. Therefore, the Board finds that a more contemporaneous examination of the Veteran’s left knee is warranted.   The matters are REMANDED for the following actions: 1. Associate with the record any VA clinical documentation pertaining to treatment of the Veteran. 2. Schedule the Veteran for a VA examination to determine the current severity of his service-connected left knee disability. The VA examiner must review the claims file and must note that review in the report. All necessary tests and studies should be accomplished, and all clinical findings reported in detail. The examination should clearly set out all manifestations indicating the extent and severity of the Veteran’s service-connected left knee disability. The examiner is asked to: (a.) Conduct range of motion testing of the Veteran’s left knee, expressed in degrees in active motion, passive motion, weight-bearing, and non-weight-bearing. 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. (b.) Render specific findings as to whether, during the examination, there is objective evidence of pain on motion, weakness, excess fatigability, or incoordination associated with the left knee. If pain on motion is observed, the VA examiner should indicate the point at which pain begins. In addition, the VA examiner should indicate whether, and to what extent, the Veteran experiences functional loss of his left knee due to pain or any of the other symptoms during flare-ups or with repeated use. To the extent possible, the VA examiner should express any additional functional loss in terms of additional degrees of limited motion. (c.) State whether the examination is taking place during a period of flare-up. If not, the examiner should ask the Veteran to describe the flare-ups he experiences, including: frequency, duration, characteristics, precipitating and alleviating factors, severity and/or extent of functional impairment he experiences during a flare-up of his left knee symptoms and/or after repeated use over time. Based on the Veteran’s lay statements and the other evidence of record, the examiner should provide an opinion estimating any additional degrees of limited motion caused by functional loss during a flare-up or after repeated use over time. If the examiner cannot estimate the degrees of additional range of motion loss during flare-ups or after repetitive use without resorting to speculation, the examiner should state whether the need to speculate is caused by a deficiency in the state of general medical knowledge (i.e. no one could respond given medical science and the known facts). (d.) Indicate, if possible, any specific symptomology associated with the Veteran’s left knee arthritis, any specific symptomology associated with his left knee meniscectomies, and any specific symptomology associated with left knee instability, and note any overlapping symptomology. The examiner should set forth the complete rationale for all conclusions reached. 3. After ensuring compliance with the development requested above, readjudicate the claims, specifically determining if separate compensable ratings are warranted for the Veteran’s left knee disabilities pursuant to 38 C.F.R. § 4.71a, Diagnostic Codes 5257-5261. If any decision is adverse to the Veteran, issue a supplemental statement of the case and allow the appropriate time for response. Then, return the case to the Board. JOHN Z. JONES Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD A. Parrish, Associate Counsel The Board’s decision in this case is binding only with respect to the instant matter decided. This decision is not precedential, and does not establish VA policies or interpretations of general applicability. 38 C.F.R. § 20.1303.