Citation Nr: 21061968 Decision Date: 10/06/21 Archive Date: 10/06/21 DOCKET NO. 17-44 930 DATE: October 6, 2021 REMANDED The claim of entitlement to a rating greater than 10 percent for soft tissue calcification beneath the lateral malleolus, left ankle, is remanded. The claim of entitlement to a rating greater than 10 percent for a meniscus tear of the right knee with patellofemoral syndrome is remanded. REASONS FOR REMAND The Veteran served in the Army National Guard, including on a period of active duty for training (ACDUTRA) from March 2000 to July 2000, and periods of active duty (AD) from October 2003 to August 2004 and from December 2008 to December 2009. His claims come before the Board of Veterans' Appeals on appeal of a June 2015 Department of Veterans Affairs (VA) rating decision. The Veteran testified in support of these claims during a virtual hearing held before the undersigned Veterans Law Judge (VLJ) in July 2020. Later in the month, the Board remanded these claims to the Agency of Original Jurisdiction (AOJ) for additional action. Entitlement to a rating greater than 10 percent for soft tissue calcification beneath the lateral malleolus, left ankle Entitlement to a rating greater than 10 percent for a meniscus tear of the right knee with patellofemoral syndrome The Veteran seeks increased ratings for his left ankle and right knee disabilities. The AOJ afforded the Veteran a VA ankle and knee examination in November 2020, but since then, in an August 2021 brief, the Veteran has claimed that the examinations were inadequate. He specifically asserts that the VA examiner described his ankle and knee disabilities differently than he recounted without considering his reports of increased pain and instability and the use of braces and including all necessary information on flare-ups. The Veteran also asserts that he has ankle and knee symptoms not contemplated in the 10 percent ratings assigned his left ankle and right knee disabilities, for which he should be rated. Indeed, the 10 percent ratings are based on painful, limited motion, but the Veteran claims his joints give way, a lay-observable symptom, and the VA examination report confirms ankle instability. The presence of these additional symptoms raises the question of whether the Veteran is entitled to a separate rating or ratings for symptoms not contemplated in the 10 percent ratings. See 38 C.F.R. § 4.20 (directing VA to rate by analogy when a condition is unlisted); see also Morgan v. Wilkie, 31 Vet. App. 162 (2019) (directing VA to exhaust all schedular alternatives before resorting to an extraschedular rating). These matters are REMANDED for the following action: 1. Afford the Veteran a VA left ankle and right knee examination. The examiner should record in detail: (a) the left ankle and right knee symptoms the Veteran is reportedly experiencing ; (b) the extent to which these symptoms are reportedly interfering with the Veteran's ability to function; and (c) the extent to which, during flare-ups, the Veteran's symptoms are reportedly causing additional functional impairment, including range of motion loss (in terms of degrees) and/or more severe instability. The examiner should determine whether the Veteran has right knee instability. The examiner should describe the severity of the Veteran's left ankle instability (and right knee instability, if found), including by characterizing it as slight, moderate, moderately severe or severe. The examiner should indicate whether the Veteran's left ankle or right knee disability causes marked interference with employment. (Continued on the next page) 2. Readjudicate these claims, considering whether any separate or extraschedular rating is assignable for any symptoms not contemplated in the 10 percent ratings assigned the Veteran's left ankle and right knee disabilities. In addressing the left ankle claim, specifically consider whether a separate rating may be assigned the Veteran's left ankle instability under diagnostic code 5284, by analogy to a foot injury. LESLEY A. REIN Veterans Law Judge Board of Veterans' Appeals Attorney for the Board L. N. 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.