Citation Nr: 21064608 Decision Date: 10/21/21 Archive Date: 10/21/21 DOCKET NO. 17-17 093A DATE: October 21, 2021 ORDER Entitlement to a rating in excess of 30 percent for right knee chondromalacia with degenerative arthritis is remanded. Entitlement to a rating in excess of 30 percent for left knee chondromalacia with degenerative arthritis is remanded. REASONS FOR REMAND The Veteran served on active duty from December 1970 to February 1973. These matters are before the Board of Veterans' Appeals (Board) on appeal of a September 2015 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO). In January 2019, the Board remanded the appeals for further development. The issues have now been returned to the Board. The issues of entitlement to ratings in excess of 30 percent for right and left knee chondromalacia with degenerative arthritis are remanded. In November 2020 statements, the Veteran asserted that additional relevant VA treatment records were outstanding since the Agency of Original Jurisdiction (AOJ) most recently obtained records in June 2018. It appears that, apart from records submitted by the Veteran, VA treatment records have not been associated with the claims file since the Board's January 2019 remand. Remand is required to obtain these outstanding VA treatment records. Additionally, an October 2020 VA medical examiner opined that bilateral meniscal tears were not a progression of the service-connected right and left knee chondromalacia with degenerative arthritis. However, in November 2020, the Veteran submitted a research article noting a statistically significant correlation between chondromalacia patella and meniscal tear and between osteoarthritis and meniscal tear. On remand, a VA examiner should provide a medical opinion that addresses the findings of this research article. Finally, the Veteran has described side effects of medications taken for his knee conditions. The opinion obtained on remand should also address any side effects due to medications taken for those disorders. The matters are REMANDED for the following action: 1. Obtain all outstanding VA treatment records. 2. Schedule the Veteran for an examination by an appropriate clinician to assess the symptoms of his service-connected right and left knee chondromalacia with degenerative arthritis. The examiner should provide a full description of the disabilities and report all signs and symptoms necessary for evaluating the Veteran's disability under the rating criteria. a. The examiner must describe any side-effects of medications taken for right and left knee chondromalacia with degenerative arthritis, as well as any functional impairment attributable to those side effects. As appropriate, the examiner should complete a corresponding disability benefits questionnaire which better describes the side-effects found. b. The examiner must state whether it is at least as likely as not (50 percent probability or greater) that meniscal tears are a progression of, or proximately caused or aggravated by, the service-connected right and left knee chondromalacia with degenerative arthritis. In doing so, the examiner should consider and discuss the research article submitted by the Veteran in November 2020 discussing the statistically significant correlation between chondromalacia patella and meniscal tear and between osteoarthritis and meniscal tear. c. If the examiner concludes that the meniscal tears are not at least as likely as not a progression of, or proximately caused or aggravated by, the service-connected right and left knee chondromalacia with degenerative arthritis, the examiner must state whether it is possible to distinguish the symptoms of right and left knee chondromalacia with degenerative arthritis from any nonservice-connected knee disorders. If possible, the examiner must specifically distinguish which knee symptoms are attributable to right and left knee chondromalacia with degenerative arthritis as opposed to any other diagnosed knee disorder. d. The examiner must test the Veteran's active motion, passive motion, and pain with weight-bearing and without weight-bearing. If any requested testing cannot be completed, the examiner should state why that is the case. e. The examiner must also attempt to elicit information regarding the severity, frequency, and duration of any flare-ups, and provide, to the extent possible, an estimate of the additional degrees of limited motion of the right and left knee during flare-ups. f. If the examiner cannot provide the above-requested opinion regarding flare-ups without resorting to speculation, he or she should state whether all procurable medical evidence has been considered, to specifically include the Veteran's description as to the severity, frequency, and duration of the flare-ups and his description as to the extent of functional loss during a flare-up and after repetitive use over time; whether the inability is due to the limits of medical community or the limits of the examiner's medical knowledge; and whether there is additional evidence, which if obtained, would permit the opinion to be provided. L. STEPANICK Acting Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Bametzreider, Paul J. 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.