Citation Nr: 20051685 Decision Date: 08/04/20 Archive Date: 08/04/20 DOCKET NO. 08-17 337 DATE: August 4, 2020 REMANDED The issue of an initial rating of more than 10 percent since May 18, 1988, for right knee patellofemoral arthrosis with limitation of flexion, is remanded. The issue of a rating of more than 30 percent since April 11, 2011, for right knee limitation of extension is remanded. The issue of an initial rating of more than 10 percent from May 18, 1988, to April 10, 2011, and a rating of more than 30 percent since April 11, 2011, for left knee patellofemoral syndrome, is remanded. The issue of whether the Veteran is entitled to a separate rating for left knee instability since May 18, 1988, is remanded. The issue of whether the Veteran is entitled to an increased rating for the right knee based on extraschedular consideration for any period since May 18, 1988, is remanded. The issue of whether the Veteran is entitled to an increased rating for the left knee based on extraschedular consideration for any period since May 18, 1988, is remanded. REASONS FOR REMAND The Veteran served in the U.S. Navy from December 1986 to May 1988. In October 2010, the Veteran was afforded a hearing at the VA Central Office before the undersigned Veterans Law Judge. In December 2014, the Board denied increased ratings for the right and left knees. The Veteran appealed to the United States Court of Appeals for Veterans’ Claims (Court). In an October 2016 Memorandum Decision, the Court vacated portions of the December 2014 Board decision and remanded the Veteran’s appeal to the Board. The Court specifically vacated and remanded the issues of whether the Veteran was entitled to increased ratings for right and/or left knee limitation of extension and/or limitation of flexion based on functional impairment; whether the Veteran was entitled to a separate compensable rating for left knee instability; and whether the Veteran was entitled to increased ratings based on extraschedular consideration. In the October 2016 Memorandum Decision, the Court specifically stated: “The Board reached several conclusions that the appellant does not challenge. The Board concluded that (1) for the period prior to April 11, 2011, the appellant is not entitled to separate disability ratings under [diagnostic codes] 5003, 5256, 5258, 5259, and 5262; (2) the appellant is not entitled to an earlier effective date for the 10% disability rating assigned to compensate her for right knee instability; (3) the appellant is not entitled to a disability rating greater than 10% for right knee instability; (4) for the period after April 11, 2011, the appellant is not entitled to separate disability ratings under [diagnostic codes] 5256, 5258, 5259, and 5262; and (5) the appellant is not entitled to a separate disability rating for knee scarring. These issues are all deemed abandoned on appeal.” The issues on appeal are therefore limited to those stated on the first page of this decision. 1. The issue of an initial rating of more than 10 percent since May 18, 1988, for right knee patellofemoral arthrosis with limitation of flexion, is remanded. 2. The issue of a rating of more than 30 percent since April 11, 2011, for right knee limitation of extension is remanded. 3. The issue of an initial rating of more than 10 percent from May 18, 1988, to April 10, 2011, and a rating of more than 30 percent since April 11, 2011, for left knee patellofemoral syndrome, is remanded. 4. The issue of whether the Veteran is entitled to a separate rating for left knee instability since May 18, 1988, is remanded. 5. The issue of whether the Veteran is entitled to an increased rating for the right knee based on extraschedular consideration for any period since May 18, 1988, is remanded. 6. The issue of whether the Veteran is entitled to an increased rating for the left knee based on extraschedular consideration for any period since May 18, 1988, is remanded. The matters are REMANDED for the following action: 1. BACKGROUND FOR THE RO ADJUDICTOR: The Veteran was last afforded a VA knees examination in March 2019. The examination report is inadequate, however, because it fails to comply with Mitchell v. Shinseki, 25 Vet. App. 32 (2011) and Sharp v. Shulkin, 29 Vet. App. 26 (2017). The examiner indicated that the Veteran had pain during range of motion which caused functional loss but failed to state the degree at which the pain and functional impairment began. The examiner also stated that it was not possible to determine, without resorting to mere speculation, the estimated loss of range of motion in the knees following repeated use over time and during flare-ups. The examiner must attempt to estimate the loss of range of motion. A remand is necessary to obtain a new examination. 2. Schedule the Veteran for a VA knees examination to obtain an opinion as to the current nature of her right and left knee symptoms. All indicated tests and studies should be accomplished and the findings reported in detail. All relevant medical records must be made available to the examiner for review of pertinent documents. The examination report should specifically state that such a review was conducted. The examiner must provide a comprehensive explanation for all opinions provided. The examination report: (a.) must include range of motion testing on passive AND active motion. (b.) must address whether there is pain on weight bearing AND non-weight-bearing. (c.) must indicate the degree at which pain begins during each range of motion. (d.) must include an estimate of the degrees of range of motion lost during flare-ups AND following repeated use over time. (Continued on the next page)   3. Readjudicate the issues on appeal. If any benefit sought on appeal remains denied, the Veteran should be provided a supplemental statement of the case (SSOC). An appropriate period should be allowed for response before the case is returned to the Board. Vito A. Clementi Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board J. E. Miller, 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.