Citation Nr: 20075083 Decision Date: 11/24/20 Archive Date: 11/24/20 DOCKET NO. 19-02 770A DATE: November 24, 2020 REMANDED Entitlement to an initial disability rating in excess of 10 percent for right knee patellofemoral syndrome with osteonecrosis and degenerative changes is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Navy from June 1985 to August 1990 and from November 1993 to March 2015. This matter comes to the Board of Veterans’ Appeals (Board) on appeal from an August 2015 rating decision issued by the Department of Veterans Affairs (VA) Regional Office in Winston-Salem, North Carolina. Entitlement to an initial disability rating in excess of 10 percent for right knee patellofemoral syndrome with osteonecrosis and degenerative changes is remanded. The Veteran was last provided a VA examination of his right knee in April 2015. He has since undergone three surgeries on that knee. A review of the record reflects that he underwent a right knee arthroscopic joint debridement with chondroplasty in April 2015, a partial knee arthroplasty with patelloplasty in August 2015, and a total knee arthroplasty in January 2017. Under the circumstances, a new VA examination is needed to ascertain the current level of severity. The agency of original jurisdiction should also obtain any relevant VA treatment records since December 2018. This matter is REMANDED for the following action: 1. Obtain the Veteran's VA treatment records for the period from December 2018 to the present. 2. Arrange to have the Veteran scheduled for an examination of his right knee. The examiner should provide a full description of the Veteran’s associated functional impairments as they relate to the relevant rating criteria. The examination must include testing for pain on both active and passive motion, in weight bearing and non-weight bearing, and, if possible, with the range of the opposite undamaged joint. The examiner must attempt to elicit information regarding functional loss due to flare-ups and repeated use over time. If the Veteran suffers from such loss, the examiner should express the loss in terms of degrees of additional loss in range of motion (i.e., in addition to that observed clinically), if feasible, taking into account all of the evidence, including the Veteran’s competent statements with respect to the frequency, duration, characteristics, and severity of his limitations. Governing law requires that if the Veteran is not exhibiting functional loss due to flare-ups and/or repeated use over time, examiners will nevertheless offer opinions with respect to functional loss based on estimates derived from information procured from relevant sources, including lay statements of the Veteran. An examiner must do all that reasonably should be done to become informed before concluding that an opinion cannot be provided without resorting to speculation. That said, if it is the examiner’s conclusion that he or she cannot feasibly provide the requested opinion(s), even considering all of the available evidence, it must be so stated, and the examiner must provide the reasons why offering such opinion(s) is not feasible. 3. After completing the above and conducting any other development as may be indicated as a consequence of the actions taken in the preceding paragraphs, readjudicate the issue on appeal, taking into consideration the provisions of 38 C.F.R. § 4.30 (“Paragraph 30”) pertaining to post-surgical convalescence, as well as 38 C.F.R. § 4.71a, Diagnostic Code 5055, pertaining to knee replacement (prosthesis). If any benefit sought remains denied, the Veteran and his representative should be issued a supplemental statement of the case. DAVID A. BRENNINGMEYER Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board K. Gielow, 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.