Citation Nr: 21002980 Decision Date: 01/19/21 Archive Date: 01/19/21 DOCKET NO. 10-34 048 DATE: January 19, 2021 REMANDED Entitlement to an initial rating in excess of 20 percent for a right shoulder strain is remanded. Entitlement to an initial rating in excess of 10 percent for a right knee strain is remanded. REASONS FOR REMAND The Veteran served on active duty from July 1991 to May 1994. This matter is before the Board of Veterans’ Appeals (Board) on appeal from a rating decision issued in July 2009 by a Department of Veterans Affairs (VA) Regional Office (RO). 1. Entitlement to increased ratings for right shoulder and knee disabilities. The Board most recently remanded the issues on appeal in April 2019. In the remand, the Board stated that there had not been substantial compliance with a prior September 2017 Board remand, which in pertinent part requested that in evaluating the severity of the right shoulder and right knee disabilities the examiner specifically state at what degree during the range of motion testing pain began. New examinations were obtained in November 2019, which provided range of motion measurements for both the right shoulder and right knee joints and noted that objective evidence of pain was present on movement of both joints. However, the examiner did not clearly state at what point during the range of motion of either joint the observed pain started. While it is possible that the noted end points of the Veteran’s range of motion of the shoulder and knee are reflective of where the objective evidence of pain began, that is not clear from either of the examination reports. As such, the Board finds that the September 2017 directives have not been substantially complied with, and therefore another remand is necessary to obtain a new examination to determine the current severity of the right shoulder and right knee disabilities. See Stegall v. West, 11 Vet. App. 268, 271 (1998). The matters are REMANDED for the following action: 1. Schedule the Veteran for a VA examination with an appropriate medical professional to determine the current severity of his right shoulder disability. The examiner is asked to provide the following: (a) Report the extent of the symptoms of the right shoulder disability in accordance with VA rating criteria. (b) If pain is present during range of motion testing, the examiner should state the degree at which pain begins. If the documented range of motion reflects where pain begins, the examiner should state as such. (c) Conduct testing for pain on active motion, passive motion, weightbearing, and non-weightbearing. If the examiner is unable to conduct the required testing or concludes that the required testing is not necessary in this case, an explanation must be provided. (d) State whether there is objective evidence of pain on motion, weakness, excess fatigability, and/or incoordination associated. (e) State whether the examination is taking place during a 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 his symptoms and/or after repeated use over time. 2. Schedule the Veteran for a VA examination with an appropriate medical professional to determine the current severity of his right knee disability. The examiner is asked to provide the following: (a) Report the extent of the symptoms of the right knee disability in accordance with VA rating criteria. (b) If pain is present during range of motion testing, the examiner should state the degree at which pain begins. If the documented range of motion reflects where pain begins, the examiner should state as such. (c) Conduct testing for pain on active motion, passive motion, weightbearing, and non-weightbearing. If the examiner is unable to conduct the required testing or concludes that the required testing is not necessary in this case, an explanation must be provided. (d) State whether there is objective evidence of pain on motion, weakness, excess fatigability, and/or incoordination associated. (e) State whether the examination is taking place during a 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 his symptoms and/or after repeated use over time. LESLEY A. REIN Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board C. Wendell, 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.