Citation Nr: 21065390 Decision Date: 10/26/21 Archive Date: 10/26/21 DOCKET NO. 13-29 092 DATE: October 26, 2021 REMANDED Entitlement to a rating in excess of 10 percent for left knee arthritis is remanded. REASONS FOR REMAND The Veteran served on active duty from September 1967 to September 1970. This matter came before the Board of Veterans Appeals (Board) on appeal from an April 2011 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO). This case has a lengthy procedural history, to include an appeal to the United States Court of Appeals for Veterans Claims ("the Court"). August 2015 and March 2018 Board decisions remanded the issue on appeal for further development. An August 2020 Board decision denied entitlement to a rating in excess of 10 percent for left knee arthritis and entitlement to service connection for a right knee disability. In June 2021, the Court granted a Joint Motion for Partial Remand (JMPR), vacating the portion of the August 2020 Board decision that denied entitlement to a rating in excess of 10 percent for left knee arthritis and remanding the issue for readjudication in accordance with the JMPR. The JMPR noted that the Veteran is not appealing the portion of the August 2020 Board decision that denied entitlement to service connection for a right knee disability. As such, that issue is not before the Board. Entitlement to a rating in excess of 10 percent for left knee arthritis The March 2018 Board remand requested a new VA knee examination. A VA knee examination was conducted in February 2020. However, while the examiner found pain on range of motion testing, he did not note the point during range of motion where pain began. This does not allow the Board to properly assess the functional impairment caused by the disability. Examinations for joint disabilities generally must include range of motion measurements. See Correia v. McDonald, 28 Vet. App. 158, 169 (2016). In conducting these measurements, the examiner should note when any incoordination, weakened movement, or excess fatigability sets in. Id. The examiner should also note whether pain on motion is present, and, if so, where in the range of motion the pain sets in and whether that pain causes functional loss. Id. As the February 2020 examiner did not provide the required information regarding pain, remand is required to obtain an accurate picture of the Veteran's level of functional impairment. The Board also notes that effective February 7, 2021, the Diagnostic Codes applicable to knee disabilities have changed. As pertinent to this issue, Diagnostic Code 5257 now requires additional evidence, such as type and treatment, to rate knee instability if such is present. See Schedule for Rating Disabilities: Musculoskeletal System and Muscle Injuries, 85 Fed. Reg. 76453, 76463 (Nov. 30, 20202) (to be codified at 4.71a, Diagnostic Code 5257). The examination should be conducted in such a way that it includes findings consistent with the new requirements of Diagnostic Code 5257. The matters are REMANDED for the following action: 1. Schedule the Veteran for an appropriate VA examination to determine the current nature and severity of his left knee disability. The claim file should be made available to and reviewed by the examiner and the examination report should state a review of the file was completed. All findings should be reported in detail. The examiner should identify all left knee pathology found to be present. The examiner should conduct range of motion studies. The joints involved should be tested in both active and passive motion, in weight-bearing and non-weight-bearing and, if possible, with range of motion measurements of the opposite undamaged joint. If the examiner is unable to conduct the required testing or concludes that the required testing is not necessary in this case, he or she should clearly explain why that is so. The examiner should describe any pain, weakened movement, excess fatigability, instability of station and incoordination present. If pain is noted, the point during range of motion at which pain starts must be clearly indicated. The examiner should also state whether the examination is taking place during a period of flare-up. If not, the examiner should ask the Veteran to describe the flare-ups he experiences, including: frequency, duration, characteristics, precipitating and alleviating factors, severity and/or extent of functional impairment he experiences during a flare-up of symptoms and/or after repeated use over time. Based on the Veteran's lay statements and the other evidence of record, the examiner should provide an opinion estimating any additional degrees of limited motion caused by functional loss during a flare-up or after repeated use over time. If the examiner cannot estimate the degrees of additional range of motion loss during flare-ups or after repetitive use without resorting to speculation, the examiner should state whether the need to speculate is caused by a deficiency in the state of general medical knowledge (i.e. no one could respond given medical science and the known facts) or by a deficiency in the record or the examiner (i.e. additional facts are required, or the examiner does not have the needed knowledge or training). 2. If upon completion of the above action the appeal 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 Y. Akkad 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.