Citation Nr: 21065082 Decision Date: 10/25/21 Archive Date: 10/25/21 DOCKET NO. 17-02 988 DATE: October 25, 2021 REMANDED Entitlement to a rating in excess of 10 percent for service-connected left knee strain/meniscal tear with osteoarthritis is remanded. REASONS FOR REMAND The Veteran had active service from November 1994 to December 1996 and from May 2003 to December 2003. In November 2019, the Veteran testified at a Board of Veterans' Appeals (Board) videoconference hearing before the undersigned Veterans Law Judge. A transcript of the hearing is associated with the file. In December 2019, February 2021, and May 2021, this issue was remanded for additional evidentiary development. As will be explained below, another remand is unfortunately required. Entitlement to a rating in excess of 10 percent for service-connected left knee strain/meniscal tear with osteoarthritis is remanded. The Board remanded this matter on May 14, 2021, to obtain an examination that adequately addressed range of motion measurements and which specifically noted the exact point where pain began. Unfortunately, the RO relied on an inadequate May 13, 2021, VA examination (conducted prior to the Board remand) and issued an August 2021 supplemental statement of the case. Accordingly, the Board has no choice but to remand this matter again for compliance with its remand directives. The matter is REMANDED for the following action: 1. Obtain copies of VA treatment records from June 2021 to the present. 2. Then arrange for an orthopedic examination of the Veteran (or telehealth interview) to assess the current severity of his service-connected left knee disability, to include a retrospective opinion to the extent possible. The examiner must review the entire record in conjunction with the examination and note such review was conducted. Pathology, symptoms (frequency and severity), and any associated impairment of function should be described in detail. (a) Range of motion measurements should be included for active and passive motion in both weight-bearing and nonweight-bearing circumstances for both (i) the present time and (ii) for the period from October 2016, if feasible. The Board again emphasizes that if pain is noted, the point in the range of motion at which pain starts should be clearly noted. (b) The examiner should address whether the Veteran has patellar instability of the left knee. Beginning February 7, 2021, only, patellar instability is defined as a diagnosed condition involving the patellofemoral complex. Does the Veteran require a prescription by a medical provider for a brace, cane, and/or walker for his left knee? (c) The examiner should address whether the Veteran has recurrent subluxation of the left knee consisting of either a sprain or ligament tear that causes persistent instability, and whether he requires the use of an assistive device or bracing for ambulation. If the Veteran has a ligament tear, identify whether it is incomplete, or complete (to include repaired, unrepaired, or failed repair). (d) If feasible, the examiner must assess the additional functional impairment on repeated use or during flare-ups in terms of the degree of additional range of motion loss, using lay observations specifically elicited from the Veteran, to include the period from October 2016. If not feasible, the examiner must provide a detailed explanation and rationale for why such could not be accomplished. Specifically, if the medical professional cannot provide an opinion without resorting to mere speculation, he or she must provide a complete explanation for why an opinion cannot be rendered; a rationale based on the fact that the Veteran is not having a flare-up at the time of the examination will not be deemed adequate. The examiner should describe any pain, weakened movement, excess fatigability, instability of station and incoordination present. (CONTINUED ON NEXT PAGE) 3. If upon completion of the above action the issue remains denied, the case should be returned to the Board after compliance with appellate procedures. E. I. VELEZ Veterans Law Judge Board of Veterans' Appeals Attorney for the Board T. Matta, 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.