Citation Nr: 21003023 Decision Date: 01/19/21 Archive Date: 01/19/21 DOCKET NO. 18-37 056 DATE: January 19, 2021 REMANDED Entitlement to a rating in excess of 10 percent for left knee patellofemoral syndrome is remanded. Entitlement to a rating in excess of 10 percent for right knee patellofemoral syndrome is remanded. REASONS FOR REMAND The Veteran served on active duty from December 1975 to June 1982. These matters come before the Board of Veterans' Appeals (Board) from an August 2020 Joint Motion for Remand (JMR) of the Court of Appeals for Veterans Claims (CAVC). 1. Entitlement to a rating in excess of 10 percent for left knee patellofemoral syndrome is remanded. 2. Entitlement to a rating in excess of 10 percent for right knee patellofemoral syndrome is remanded. An August 2019 Board decision denied the Veteran’s claims for entitlement to a rating in excess of 10 percent for left knee patellofemoral syndrome and entitlement to a rating in excess of 10 percent for right knee patellofemoral syndrome. The Veteran appealed the Board decision to CAVC. The subsequent August 2020 Joint Motion for Remand found that the April 2016 VA examination was inadequate because, the examiner failed to: 1. provide the degree of additional range of motion loss due to pain, weakness, fatigability or incoordination during flare-ups and 2. properly explain whether he could feasibly provide such estimates. Further, the examiner provided an inadequate explanation for why an estimate of additional range of motion loss after repetitive use or during flare-ups could not be provided. The Joint Motion for Remand also noted that the April 2016 examiner erred by not gathering more details about the frequency of the Veteran’s flare-ups and by not estimating the additional functional loss due to flare-ups or repetitive use over time, to the extent it was medically possible. As such, this matter must be remanded for a new, adequate VA examination. The matters are REMANDED for the following action: 1. Obtain all outstanding VA treatment records. 2. After all outstanding treatment records have been obtained, schedule the Veteran for an examination by an appropriate clinician to determine the severity of his service-connected right knee disability and service connected left knee disability. The examiner should provide a full description of the disabilities and report all signs and symptoms necessary for evaluating the Veteran’s disabilities under the rating criteria. In so doing, the examiner must test the Veteran’s active motion, passive motion, and pain with weight-bearing and without weight-bearing for each knee. If it is not possible to provide a specific measurement without speculation, the examiner must state whether the need to speculate is due to a deficiency in the state of general medical knowledge (no one could respond given medical science and the known facts), a deficiency in the record (additional facts are required), or the examiner (does not have the knowledge or training). The examiner must also attempt to elicit information regarding the severity, frequency, and duration of any flare-ups, and the degree of functional loss during flare-ups for each knee. If it is not possible to provide a specific measurement based on direct observation, the examiner should provide an estimate, if at all possible, of the additional impairment due to flare-ups based on the other evidence of record and the Veteran’s statements. If it is not possible to provide a specific measurement without speculation, the examiner must state whether the need to speculate is due to a deficiency in the state of general medical knowledge (no one could respond given medical science and the known facts), a deficiency in the record (additional facts are required), or the examiner (does not have the knowledge or training). Jennifer White Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board A. Wimbish, Associate 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.