Citation Nr: 21000471 Decision Date: 01/05/21 Archive Date: 01/05/21 DOCKET NO. 18-52 493 DATE: January 5, 2021 REMANDED Entitlement to a rating in excess of 30 percent for status post left total knee replacement (left knee disability) is remanded. REASONS FOR REMAND The Veteran served on active duty from April 1966 to April 1969. In July 2019, the Board denied the Veteran’s claim for an increased rating for the service-connected left knee disability. The Veteran appealed the Board’s decision to the United States Court of Appeals for Veterans Claims (Court). In a July 2020 Order, the Court granted a Joint Motion for Remand (JMR), which vacated and remanded the July 2019 Board decision. The case has been returned to the Board for further adjudication. Entitlement to a rating in excess of 30 percent for a left knee disability is remanded. In the July 2020 JMR noted above, the parties agreed that the June 2018 VA examination, used to deny the Veteran’s claim for an increased rating for his left knee disability, is inadequate for evaluation purposes. In this regard, the June 2018 VA examiner stated that he was unable to express an opinion as to whether pain, weakness, fatigability or incoordination significantly limit functional ability after repetitive use over time or with flare-ups without resorting to mere speculation. See June 2018 VA examination report. VA regulations provide that, where an examination report does not contain sufficient detail, it is incumbent upon the rating board to return the report as inadequate for evaluation purposes. 38 C.F.R. § 4.2 (2019); see 38 C.F.R. § 19.9 (2019). The examiner was not required to state with absolute certainty whether pain, weakness, fatigability cor incoordination significantly limit functional ability after repetitive use over time or with flare-ups, although the opinion implies that he was under the impression that the opinion required such certainty. In addition, an examiner's reports that he or she cannot provide an opinion without resort to speculation is inadequate unless the examiner provides a rationale for that statement and states whether there is additional evidence that would enable the necessary opinion to be provided. Jones v. Shinseki, 23 Vet. App. 382 (2010). The examiner did not adequately explain why he could not provide the requested opinion, nor did he indicate whether there was other evidence or information that he could use to adequately form the opinion. Therefore, the Board finds that a new VA examination is needed to determine to determine the nature and severity of the service-connected left knee disability. Barr v. Nicholson, 21 Vet. App. 303 (2007). The matters are REMANDED for the following action: 1. Updated treatment records should be obtained and added to the claims folder/efolder. 2. Following completion of the above, schedule the Veteran for an appropriate VA examination to determine the current severity of his service-connected left knee disability. The claims folder should be made available to the examiner for review prior to the examination and the examiner should acknowledge such review in the examination report or in an addendum. The examiner should indicate the nature and severity of all manifestations of the left knee disability. Any testing deemed necessary should be performed, including X-rays and appropriate range of motion studies. The examiner should specifically report the ranges of left knee flexion and extension in degrees on active motion, passive motion, weight-bearing and nonweight-bearing, as well as whether the left knee disability is manifested by weakened movement, excess fatigability, incoordination, flare-ups or pain. Such inquiry should not be limited to muscles or nerves. These determinations should be expressed in terms of the degree of additional range-of-motion loss due to any weakened movement, excess fatigability, incoordination, pain or flare-ups. If the examiner is unable to conduct the requested testing, or concludes the requested testing is not necessary, (s)he should clearly explain why that is so. Correia v. McDonald, 28 Vet. App. 158 (2016). If there is pain on motion, the examiner should report the point in the range of motion when the pain becomes apparent. The examiner should also report whether there is instability or subluxation in the left knee and express an opinion as to the severity of such instability or subluxation. In addition, the examiner should indicate whether, and to what extent, the Veteran likely experiences functional loss due to pain and/or any other symptoms noted above during flare-ups and/or with repeated use; to the extent possible, the examiner should express any additional functional loss in terms of additional degrees of limited motion. If the examiner cannot provide an opinion without resort to speculation, the examiner should provide an explanation as to why this is so and whether there is additional evidence that would permit the opinion to be provided. 3. After completion of the above and any other development deemed necessary, review the expanded record, and readjudicate the claim. If the claim remains denied, the Veteran and his representative should be furnished an appropriate supplemental statement of the case, afforded an opportunity to respond, and the case should thereafter be returned to the Board for further appellate review, if in order. KELLI A. KORDICH Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board F. Yankey, 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.