Citation Nr: 21000339 Decision Date: 01/05/21 Archive Date: 01/05/21 DOCKET NO. 16-13 525 DATE: January 5, 2021 REMANDED The claim of entitlement to an initial rating in excess of 10 percent prior to May 16, 2017, and in excess of 20 percent thereafter, for right knee patellofemoral syndrome, is remanded. The claim of entitlement to an initial compensable rating prior to May 24, 2012, and in excess of 10 percent thereafter, for left knee degenerative joint disease (DJD), is remanded. REASONS FOR REMAND The Veteran served on active duty from August 1974 to August 1996. In August 2019, a videoconference hearing was held before the undersigned judge. The claims were remanded that same month for additional evidentiary development. Unfortunately, another remand is required as there has not been substantial compliance with the Board’s remand directives. Stegall v. West, 11 Vet. App. 268 (1998) (finding that a remand by the Board confers on the Veteran the right to compliance with its remand orders). 1. The claim of entitlement to an initial rating in excess of 10 percent prior to May 16, 2017, and in excess of 20 percent thereafter, for right knee patellofemoral syndrome, is remanded. 2. The claim of entitlement to an initial compensable rating prior to May 24, 2012, and in excess of 10 percent thereafter, for left knee DJD, is remanded. In August 2019, the Board remanded the issues on appeal for additional evidentiary development, to include a new examination because the Veteran testified that the severity of his knee conditions had worsened since he was last examined by VA in May 2017. The remand directives called for active and passive range of motion (ROM) testing. If pain on motion of either knee was shown, the examiner was to state at what degree the pain began. These specifications, if provided, would have complied with the Court’s precedential decision of Correia v. McDonald, 28 Vet. App. 158 (2016). Specifically, examinations for joints disabilities generally must include ROM measurements. Correia, supra, at 158, 169. In conducting these measurements, the examiner should also note whether pain on motion is present, and, if so, where in the ROM the pain sets in and whether that pain causes functional loss. Id. In the present case, while additional VA examination was conducted in January 2020, the report is not in full compliance with Correia directives and additional examination must be obtained. Specifically, it is noted that while pain in both lower extremities was noted, and the examiner did provide ROM results due to this pain, her examination report does not note where pain itself began. Therefore, the Board is unable to properly assess the functional impairment caused by the disabilities and a new examination is needed. The matters are REMANDED for the following action: 1. After securing any necessary consent form from the Veteran, obtain any outstanding treatment records, to include any VA and/or private treatment records, pertaining to the issues on appeal. 2. Schedule the Veteran for an appropriate VA examination to determine the current nature and severity of his bilateral knee disabilities. The claim file should be made available to and reviewed by the examiner and the examination report should state a review of the file was completed. All findings should be reported in detail. The examiner should identify all knee pathology found to be present. The examiner should conduct ROM studies. The joints involved should be tested in both active and passive motion, in weight-bearing and non-weight-bearing and, if possible, with ROM measurements of the opposite undamaged joint. If the examiner is unable to conduct the required testing or concludes that the required testing is not necessary in this case, he or she should clearly explain why that is so. The examiner should describe any pain, weakened movement, excess fatigability, instability of station and incoordination present. If pain is noted, the point during ROM at which pain starts must be clearly indicated. The examiner should also state whether the examination is taking place during a period of flare-up. If not, the examiner should ask the Veteran to describe the flare-ups he experiences, including frequency, duration, characteristics, precipitating and alleviating factors, severity and/or extent of functional impairment he experiences during a flare-up of symptoms and/or after repeated use over time. Based on the Veteran’s lay statements and the other evidence of record, the examiner should provide an opinion estimating any additional degrees of limited motion caused by functional loss during a flare-up or after repeated use over time. If the examiner cannot estimate the degrees of additional ROM loss during flare-ups or after repetitive use without resorting to speculation, the examiner should state whether the need to speculate is caused by a deficiency in the state of general medical knowledge (i.e. no one could respond given medical science and the known facts) or by a deficiency in the record or the examiner (i.e. additional facts are required, or the examiner does not have the needed knowledge or training). 3. If upon completion of the above action the appeal remains denied, the case should be returned to the Board after compliance with appellate procedures. E. I. VELEZ Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board T. Hal Smith, 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.