Citation Nr: 20020135 Decision Date: 03/18/20 Archive Date: 03/18/20 DOCKET NO. 18-28 598 DATE: March 18, 2020 REMANDED Entitlement to an increased rating above 40 percent for left ankle arthritis and osteochondritis dissecans postoperative (referred to herein as left ankle condition) is remanded.   REASONS FOR REMAND The Veteran had qualifying service from September 1974 to July 1980 and February 1982 to September 1984. In February 2020, the Veteran testified at a Board Central Office hearing before the undersigned Acting Veterans Law Judge. Entitlement to an increased rating for a left ankle disability The claims file currently contains Richmond VAMC records through October 29, 2018; however, during the February 2020 Board hearing, the Veteran reported left ankle treatment since then. As such, the outstanding treatment records from Richmond VAMC since October 29, 2018, must be obtained. 38 U.S.C. § 5103A (a)(1) (2012); 38 C.F.R. § 3.159 (c)(2) (2018). During the current appeal period, the Veteran has been afforded pertinent VA examinations in February 2017 and December 2017; however, the examinations are inadequate. Specifically, the February 2017 examiner opined that: (a) pain and lack of endurance significantly limited functional ability with repeated use over a period of time (but was unable to describe the limitation in terms of range of motion loss); and (b) pain, lack of endurance, and incoordination significantly limited functional ability with flare-ups (but was unable to describe the limitation in terms of range of motion loss). The February 2017 examiner merely described the flare-ups as episodes of increased pain to a severity of 10 out of 10 (failing to note the frequency, duration, and functional loss during flare-ups) and did not provide any rationale for why she could not describe the limitation with repeated use over a period of time and with flare-ups in terms of range of motion loss. Additionally, the December 2017 examiner opined that: (a) he was unable to say without mere speculation whether pain, weakness, fatigability, or incoordination significantly limited functional ability with repeated use over time because the Veteran was not examined after repeated use over time; and (b) he was unable to say without mere speculation whether pain, weakness, fatigability, or incoordination significantly limited functional ability during flare-ups because the Veteran was not examined during a flare-up. The December 2017 examiner merely described the flare-ups as causing severe pain (failing to note the frequency, duration, and functional loss during flare-ups). The examination does not comply with the requirements in Sharp v. Shulkin, 29 Vet. App. 26, 34-36 (2017). The matters are REMANDED for the following action: 1. Obtain any outstanding treatment records from Richmond VAMC since October 29, 2018. 2. Schedule the Veteran for a VA examination to assess the severity of his left ankle disability. (a.) The examiner should provide a full description of the disability and report all signs and symptoms necessary for evaluating the Veteran’s disability under the rating criteria. (b.) In so doing, the examiner must test the Veteran’s active motion, passive motion, and pain with weight-bearing and without weight-bearing. If it is not possible to provide a specific measurement 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). (c.) 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. If it is not possible to provide a specific measurement based on direct observation, the examiner should provide an estimate, if at all possible, of the additional impairment due to flare-ups based on the other evidence of record and the Veteran’s statements. If it is not possible to provide a specific measurement 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). Corey Bosely Acting Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board H. Daus, 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.