Citation Nr: 21004867 Decision Date: 01/28/21 Archive Date: 01/28/21 DOCKET NO. 16-35 024 D ATE: January 28, 2021 REMANDED Entitlement to a compensable rating for limitation of extension of the left knee, patellofemoral pain syndrome, medial collateral ligament strain, prior to April 11, 2019, and in excess of 40 percent thereafter, is remanded. Entitlement to a rating in excess of 10 percent for limitation of flexion of the left knee, patellofemoral pain syndrome, medial collateral ligament strain, prior to April 11, 2019, and in excess of 20 percent thereafter, is remanded. Entitlement to a rating in excess of 10 percent for impairment of the left knee, patellofemoral pain syndrome, medial collateral ligament strain, is remanded. REASONS FOR REMAND The Veteran served on active duty in the U.S. Army from July 2006 to November 2007, to include service in Southwest Asia from September 2006 to October 2007. He also had service in the Army National Guard. His decorations include the Combat Action Badge. This matter comes to the Board of Veterans’ Appeals (Board) on appeal from a September 2015 rating decision issued by the Department of Veterans Affairs (VA) Regional Office (RO) in San Juan, the Commonwealth of Puerto Rico. The RO granted 10 percent ratings, each, for limitation of flexion and impairment of the left knee, effective September 18, 2015. This case was previously before the Board in June 2018, when it was remanded to the agency of original jurisdiction (AOJ) for additional development. In September 2019, after taking further action, the AOJ assigned a 20 percent rating for limitation of flexion of the left knee, and a 40 percent rating for limitation of extension of the left knee, effective April 11, 2019. The previously assigned ratings were otherwise confirmed and continued and the case was returned to the Board. 1. Entitlement to a compensable rating for limitation of extension of the left knee, patellofemoral pain syndrome, medial collateral ligament strain, prior to April 11, 2019, and in excess of 40 percent thereafter, is remanded. 2. Entitlement to a rating in excess of 10 percent for limitation of flexion of the left knee, patellofemoral pain syndrome, medial collateral ligament strain, prior to April 11, 2019, and in excess of 20 percent thereafter, is remanded. 3. Entitlement to a rating in excess of 10 percent for impairment of the left knee, patellofemoral pain syndrome, medial collateral ligament strain, is remanded. Although the Board regrets the additional delay, a remand is necessary to ensure that there is a complete record upon which to decide the Veteran’s claim and to afford him every possible consideration. Pursuant to the Board’s June 2018 remand, the Veteran was afforded a VA examination in April 2019. Although the examiner addressed whether pain, weakness, fatigability, and/or incoordination significantly limited functional ability with flare ups as of the date of the examination, no opinion was offered with respect to the earlier portion of the period on appeal. Because the record does not otherwise contain the data necessary to permit such an assessment, an addendum opinion is necessary. See Chotta v. Peake, 22 Vet. App. 80 (2008) (when there is an absence of medical evidence during a certain period of time, a retroactive medical evaluation may be warranted).  These matters are REMANDED for the following action: 1. Obtain copies of records pertaining to any VA treatment the Veteran has received since the time that such records were last procured, following the procedures set forth in 38 C.F.R. § 3.159. The evidence obtained, if any, should be associated with the record. 2. After the foregoing development has been completed, make arrangements to return the Veteran’s claims file to the VA examiner who conducted the April 2019 examination of the Veteran’s left knee. The examiner should be asked to review the record for purposes of providing a retrospective opinion with respect to the severity of the Veteran’s left knee disability during the period from September 18, 2015 to April 2019. Specifically, the examiner should be asked to indicate whether it is at least as likely as not (i.e., whether it is 50 percent or more probable) that, during all or any portion of the period in question from September 18, 2015, the Veteran had pain in the left knee on active motion, passive motion, in weight bearing, and in non-weight bearing. The examiner should also be asked to indicate whether it is at least as likely as not that, during all or any portion of the period in question from September 18, 2015, the Veteran experienced functional loss in the left knee due to flare-ups and repeated use over time. If the answer to that question is yes, the examiner should express the loss in terms of degrees of additional loss in range of motion (i.e., in addition to that observed clinically), if feasible, taking into account all of the evidence, including the Veteran’s competent statements with respect to the frequency, duration, characteristics, and severity of his limitations. In so doing, the examiner should offer an opinion as to whether it is at least as likely as not that the additional loss of function experienced by the Veteran as demonstrated in the report of the April 2019 examination has been present to the same degree since September 18, 2015. If the April 2019 examiner is no longer employed by VA or is otherwise unable to provide the opinion(s) requested, arrange to obtain the requested information from another qualified examiner. The need for another examination and/or telephonic or video interview of the Veteran is left to the discretion of the examiner(s) selected to offer the requested opinions. Governing law requires that if a veteran is not exhibiting functional loss due to flare-ups and/or repeated use over time when examined, examiners will nevertheless offer opinions with respect to functional loss based on estimates derived from information procured from relevant sources, including lay statements of the Veteran. An examiner must do all that reasonably should be done to become informed before concluding that an opinion cannot be provided without resorting to speculation. That said, if it is the examiner’s conclusion that he or she cannot feasibly provide the requested opinion(s), even considering all of the available evidence, it must be so stated, and the examiner must provide the reasons why offering such opinion(s) is not feasible. In so doing, the examiner should explain whether the inability to provide a more definitive opinion is the result of the need for additional information, or whether he or she has exhausted the limits of current medical knowledge in providing an answer to a particular question. 3. After completing the above, and any other development as may be indicated by any response received as a consequence of the actions taken in the preceding paragraphs, the issues on appeal should be readjudicated based on the entirety of the evidence. If any benefit sought remains denied, the Veteran should be issued a supplemental statement of the case. An appropriate period of time should be allowed for response. DAVID A. BRENNINGMEYER Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board A. Smith, 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.