Citation Nr: 21068070 Decision Date: 11/09/21 Archive Date: 11/09/21 DOCKET NO. 13-11 793 DATE: November 9, 2021 REMANDED Entitlement to a rating in excess of 10 percent for service-connected right thumb degenerative joint disease is remanded. Entitlement to a rating in excess of 10 percent for service-connected right knee instability is remanded. Entitlement to a rating in excess of 10 percent for service-connected right knee degenerative arthritis is remanded. REASONS FOR REMAND The Veteran served on active duty from December 1974 to February 1991. This matter originally came before the Board of Veterans' Appeals (Board) from September 2008 and November 2015 rating decisions issued by Department of Veterans Affairs (VA) Regional Offices (ROs). The Veteran testified at a September 2014 Travel Board hearing before the undersigned Veterans Law Judge. A copy of the hearing transcript is associated with the claims file. This matter has previously been remanded by the Board for further development, most recently in February 2021. This matter is again before the Board. Entitlement to a rating in excess of 10 percent for service-connected right thumb degenerative joint disease, a rating in excess of 10 percent for service-connected right knee instability, and a rating in excess of 10 percent for service-connected right knee degenerative arthritis are remanded. The Veteran contends that increased ratings for service-connected right thumb degenerative joint disease, right knee degenerative arthritis, and right knee instability are warranted. The Veteran was most recently afforded VA examinations for his right thumb and right knee disabilities in July 2021. Although the Veteran reported moderate flare-ups in the form of sharp pain with the right thumb and right knee disabilities that lasted the day, the examiner determined that pain, weakness, fatigability, or incoordination did not significantly limit functional ability with flare-ups and did not provide range of motion estimates during flare-ups. The examiner provided no rationale for this opinion and his determination contradicts the Veteran's reports and other medical evidence of record reflecting functional limitations during flare-ups. Accordingly, an addendum opinion is necessary on remand to determine any additional functional loss caused by flare-ups. The matters are REMANDED for the following action: 1. Obtain updated VA treatment records. 2. Provide the Veteran with an opportunity to identify any outstanding private records relevant to his claims. After obtaining any necessary authorization from the Veteran, any outstanding treatment records should be obtained. 3. Forward the record and a copy of this Remand to the examiner who completed the July 2021 thumb and knee examinations, or, if that examiner is unavailable, to a suitably qualified examiner for completion of an addendum opinion. The examiner may schedule a new examination, if necessary, for completion of an adequate opinion. The examiner should indicate whether there would be additional functional impairment during flare-ups of the service-connected right thumb or right knee, in terms of the degree of additional range-of-motion loss, if possible. If unable to measure during a flare-up, the examiner should estimate any additional functional loss during flare-ups based, for example, on the Veteran's statements as to the frequency, duration, characteristics, severity, or functional loss during flare-ups, if feasible. If it is not feasible to determine, even by estimation, the extent to which the Veteran experiences additional functional loss during flare-ups without resorting to speculation, the examiner must provide an explanation for why that is so, to include a description of what information would be necessary for an estimation to be made. The examiner must provide a complete rationale for the opinion(s) expressed. MARJORIE A. AUER Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Gastoukian, Kelly 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.