Citation Nr: 20052972 Decision Date: 08/10/20 Archive Date: 08/10/20 DOCKET NO. 14-26 413 DATE: August 10, 2020 REMANDED Entitlement to an increased rating in excess of 10 percent for left knee chondromalacia with degenerative joint disease is remanded. REASONS FOR REMAND The Veteran served honorably on active duty from May 1973 to May 1976. This matter is before the Board of Veterans’ Appeals on appeal from an October 2012 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO). The Board remanded the Veteran’s claim in July 2018. Left knee chondromalacia with degenerative joint disease The Board remanded the claim on appeal in July 2018, in part, to provide the Veteran with a VA examination to determine the current severity of his service-connected left knee disability. In providing the examination, the VA examiner was to ask the Veteran to identify the severity, frequency, duration, precipitating and alleviating factors, and extent of functional impairment resulting from flare-ups. Further, the examiner was to ask the Veteran to identify the extent of his functional loss during flare-ups or after repetitive use and offer range of motion estimates based on this information. If it was not possible to provide the requested information, the examiner must state whether this was because of a deficiency in the state of general medical knowledge (that is, no one could respond, given medical science and the known facts), a deficiency in the record (that is, additional facts are required), or the examiner (that is, the examiner does not have the required knowledge or training). Pursuant to the July 2018 Board remand, the Veteran was afforded a VA examination in May 2019 for his service-connected left knee disability. Pertinently, the Veteran did not identify flare-ups of his left knee during the examination. As such, the examiner did not provide any opinion as to the Veteran’s functional loss during flare-ups or if the Veteran had additional loss of motion during a flare-up. However, as the Board remand instructed the examiner to provide such information, the Board finds that remand is again warranted for compliance with the remand directions. See Stegall v. West, 11 Vet. App. 268, 271 (1998). The matter is REMANDED for the following action: Schedule the Veteran for a VA examination to ascertain the severity of his service-connected left knee chondromalacia with degenerative joint disease. The examiner’s attention is drawn to the following records (the following is a brief factual background and not intended to be a substitute for review of the Veteran’s claims folder): *A December 2013 Progress Note reflecting that the Veteran reports pain with weight-bearing, activity, motion, along with other symptoms of stiffness, popping, or giving way. The examination showed reduced range of motion, medial and lateral joint line tenderness, patella femoral crepitus, a positive lateral McMurray’s sign, and an antalgic gait. *A December 2013 MRI Report showing healed osteochondritis desiccans with overlying cortical irregularity, chondromalacia, osteoarthritis with synovial cyst, a small joint effusion, and a degenerative signal in the medial and lateral menisci. *A January 2014 Progress Note reflecting that the Veteran’s symptoms were unchanged. The examination showed medial and lateral joint line tenderness, range of motion limited secondary to pain, weakness secondary to pain, and a mildly antalgic gait. Range of motion studies MUST include active and passive motion and weight-bearing and non-weight-bearing. The examiner MUST note any further functional limitations due to pain, weakness, fatigue, incoordination, or any other such factors. If the VA examiner is unable to conduct the required testing or concludes that the required testing is not necessary in this case, he or she MUST clearly explain the basis for this decision. All findings should be reported in detail. Regardless of whether flare-ups are identified during the examination, the examiner MUST also ask the Veteran to identify the severity, frequency, duration, precipitating and alleviating factors, and extent of functional impairment resulting from flare-ups. The examiner MUST ask the Veteran to identify the extent of his functional loss during flare-ups or after repetitive use and the examiner MUST offer range of motion estimates based on this information. If it is not possible to provide any of the requested information, the examiner must state whether this is because of a deficiency in the state of general medical knowledge (that is, no one could respond, given medical science and the known facts), a deficiency in the record (that is, additional facts are required), or the examiner (that is, the examiner does not have the required knowledge or training). In providing all the requested opinions, the examiner must consider the Veteran’s competent lay statements regarding the observable symptoms he has experienced, including those associated with flare-ups. S. HENEKS Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Nadia Kamal, 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.