Citation Nr: 20000076 Decision Date: 01/02/20 Archive Date: 01/02/20 DOCKET NO. 13-18 324A DATE: January 2, 2020 REMANDED Entitlement to a rating in excess of 10 percent prior to October 31, 2017 for service-connected degenerative joint disease of the lumbosacral spine (“low back disability”) and 20 percent thereafter is remanded. Entitlement to a rating in excess of 10 percent for service-connected degenerative joint disease of the right knee (“right knee disability”) is remanded. Entitlement to a rating in excess of 10 percent for service-connected degenerative joint disease of the left knee (“left knee disability”) is remanded. REASONS FOR REMAND The Veteran had active military service from July 1975 to October 1978 and October 1979 to July 2002. This matter came before the Board of Veterans’ Appeals (Board) on appeal from an August 2011 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO). By way of background, in August 2017, the Board remanded the issues on appeal for further evidentiary development and adjudication. The matter has returned to the Board for appellate consideration. 1. Entitlement to a rating in excess of 10 percent prior to October 31, 2017 for service-connected low back disability and 20 percent thereafter is remanded. 2. Entitlement to a rating in excess of 10 percent for service-connected right knee disability is remanded. 3. Entitlement to a rating in excess of 10 percent for service-connected left knee disability is remanded. The Board’s review of the claims file reveals that further action on the claims of entitlement to an increased rating for service-connected low back disability and bilateral knee disability is needed. At the outset, the Board notes that there are several missing treatment records. For instance, the Veteran was noted to have had a left knee surgery in May 2013 by Dr. Fredrick Flandry at Columbus, Georgia. This record is not associated with the file. Further, there are no subsequent post-surgery physical therapy records. The records also show that an April 2019 magnetic resonance imaging (MRI) scan of the left knee is not associated with the file. See August 2019 CAPRI. Additionally, the Veteran stated that he receives treatment from a physician outside VA. See November 2017 CAPRI. The Board finds that a remand is needed to obtain updated records and possible missing records. As for the Veteran’s bilateral knee disability and low back disability, the records show that the Veteran was afforded VA examinations in July 2011 and October 2017 with an addendum opinion in September 2019. Since the October 2017 VA examination, the Board notes that the records reflect possible worsening as evidenced by the February 2019 treatment record wherein the Veteran complained of worsening left knee pain. See August 2019 CAPRI. The Board further notes that in May 2018 the Veteran sought stronger medication (i.e., Vicodin) for his low back and bilateral knee pain. As the treatment records show possible worsening since the October 2017 VA examination, the Board finds that a remand is warranted. The matters are REMANDED for the following action: 1. Contact the Veteran and with his assistance identify any outstanding records of pertinent medical treatment from VA or private health care providers, to include Tricare. In particular, obtain any outstanding treatment records from 2011 to the present, to include the April 2019 MRI scan of the left knee; May 2013 left knee surgery by Dr. Fredrick Flandry at Columbus, Georgia; and any subsequent post-surgery physical therapy records. 2. After the development in #1 has been completed, schedule the Veteran for a VA examination to evaluate the current severity of his low back and bilateral knee disability. The examiner should obtain a detailed clinical history from the Veteran. All pertinent pathology found on examination should be noted in the report of the evaluation. Any testing deemed necessary should be performed. (Continued on the next page)   With regard to the low back, any associated radiculopathy or other neurological impairment should be noted, to include the severity thereof. The examiner should discuss the impact, if any, as well as a full description of the effects, that the Veteran’s low back disability and bilateral knee disability have on his occupational functioning. S. HENEKS Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board P. Noh, 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.