Citation Nr: 21068081 Decision Date: 11/09/21 Archive Date: 11/09/21 DOCKET NO. 18-28 296A DATE: November 9, 2021 ORDER Entitlement to a rating in excess of 10 percent for Osgood-Schlatter's Disease, left knee prior to February 18, 2020, is denied. Entitlement to a rating in excess of 30 percent for Osgood-Schlatter's Disease, left knee beginning on February 18, 2020, is denied. FINDINGS OF FACT 1. Prior to February 18, 2020, the Veteran's left knee disability has been manifested by painful motion with full extension and flexion. 2. Beginning on February 18, 2020, the Veteran's left knee disability has been manifested by painful motion with full extension and flexion limited to, at worst, 10 degrees during a flare-up. CONCLUSIONS OF LAW 1. The criteria for a rating in excess of 10 percent for a left knee disability have not been met for the period prior to February 18, 2018. 38 U.S.C. § 1155 (2018); 38 C.F.R. §§ 4.7, 4.40, 4.59, 4.71a, Diagnostic Codes 5260, 5261 (2020). 2. The criteria for a rating in excess of 30 percent for a left knee disability have not been met for the period beginning February 18, 2018. 38 U.S.C. § 1155 (2018); 38 C.F.R. §§ 4.7, 4.40, 4.45, 4.71a, Diagnostic Code 5260 (2020). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran had active air service from March 2002 to September 2005. This matter comes before the Board of Veterans' Appeals (Board) on appeal from an April 2016 rating decision issued by the Department of Veterans Affairs (VA) Regional Office (RO). In connection with this appeal, the Veteran testified at a videoconference hearing before the undersigned Veterans Law Judge in February 2020. The Board previously remanded the case for further development in February 2020. The case has since been returned to the Board for appellate review. The Veteran has asserted that he is entitled to higher ratings for his left knee disability as his symptoms are worse than those contemplated by the currently assigned ratings. The Veteran is currently assigned a 10 percent rating prior to February 18, 2020, and a 30 percent rating thereafter. The Veteran was afforded a VA examination in March 2016. At that examination, The Veteran reported that he had pain in his knee when he walked for 30 minutes, did squats, or kept his knee in a flexed position. He denied flare-ups. The examiner found no instability, and normal strength. During examination, the Veteran was able to flex his knee to 140 degrees, and extend his knee to 0 degrees. The examiner noted that there was pain on examination, but that it did not result in functional loss. There was no evidence of pain with weight bearing. The Veteran was not examined immediately after repetitive use over time. There was no ankylosis, and the Veteran did not have a meniscal condition. The examiner noted that the Veteran did not have any other pertinent physical findings. The examiner did note that the Veteran's left knee disability impacted his ability to work in that he was unable to drive for long periods, he was unable to keep his left knee flexed due to pain, and that he was limited in his ability to squat. At the Veteran's February 2020 Board hearing, the Veteran testified that his left knee disability had worsened. Subsequently, the Veteran was afforded another VA examination in December 2020. At that time, examiner noted that the Veteran had diagnoses of Osgood Schlatter, a mild ACL sprain, and left knee effusion. The Veteran reported that he experienced flare-ups. During examination, the Veteran was able to flex his knee to 100 degrees, and extend his knee to 0 degrees. Pain that caused functional loss was noted on flexion and extension. The examiner noted that there was pain with weight bearing, and localized tenderness or pain on palpation of the joint. The Veteran was able to perform repetitive-use testing with at least three repetitions, but there was no range of motion (ROM) loss after three repetitions. The Veteran was not examined immediately after repetitive use over time; however, the examiner stated that pain and lack of endurance significantly limited functional ability with repeated use over a period of time. The examiner was able to describe the functional loss in terms of limitation of motion, noting that the Veteran was able to flex his knee to 80 degrees, and extend to 0 degrees. Further, the examination was conducted during a flare-up, and the examiner found that pain and lack of endurance limited the functional ability during flare-ups. The examiner was able to describe the functional loss in terms of limited motion, noting that the Veteran was able to flex his knee to 10 degrees, and extend to 0 degrees. There was no ankylosis, or joint instability. The examiner noted the Veteran's meniscal condition, specifically that that Veteran had a possible meniscus tear around 2018 that caused pain and swelling. The examiner noted that there was a history of recurrent effusion, and that the Veteran left knee swelled two to three times per month. However, the examiner noted the but found that there were no current symptoms. Notably, the examiner did not note that there was any indication of locking. The Veteran does receive treatment at the VA Medical Center for various disabilities, to include his left knee disability. However, other than a possible meniscal tear noted above, there is no indication from the treatment notes of record that the Veteran has left knee impairment that is worse than that reported in his various statements and the VA examination reports of record, to specifically include additional findings of limitation of motion. Further, there is no indication that the Veteran had frequent episodes of locking in his left knee. The Board finds that the Veteran is not entitled to a rating in excess of 10 percent for a left knee disability prior to February 18, 2020, as there is no indication from the record that the Veteran has left knee flexion limited to 45 degrees or less, or left knee extension to 10 degrees or more. In fact, prior to February 18, 2020, the Veteran has been shown to have full flexion and full extension. The Veteran has been assigned the 10 percent rating based solely on painful motion without significant limitation in either extension or flexion. Further, the examiner considered the impacts caused by pain, weakness, fatigability, lack of endurance, or incoordination when reporting the Veteran's functional impairment, to include limitation of motion. As such, even with consideration of all pertinent disability factors, there remains no reasonable basis for assignment of a rating higher than 10 percent prior to February 18, 2020. Therefore, the Board finds that the Veteran is not entitled to a rating in excess of 10 percent for a left knee disability prior to February 18, 2020. 38 C.F.R. §§ 4.40, 4.45, 4.71a, Diagnostic Codes 5260, 5261 (2020). The Board finds that the Veteran is not entitled to a rating in excess of 30 percent for a left knee disability beginning February 18, 2020. Beginning on February 18, 2020, the Veteran is already in receipt of the maximum 30 percent rating under Diagnostic Code 5260 for limitation of flexion. As such, a higher rating under that Diagnostic Code is not warranted. 38 C.F.R. § 4.71a, Diagnostic Code 5260. The Board has also considered whether a separate rating is warranted under any of the diagnostic codes pertaining to the knee. In this regard, the Board again notes that there is no evidence that the Veteran had ankylosis, subluxation or lateral instability, removal of semilunar cartilage, limitation of extension, impairment of the tibia and fibula or shin splints, or genu recurvatum. Accordingly, a separate rating is not warranted for the Veteran's left knee disability. 38 C.F.R. § 4.71a, Diagnostic Codes 5256, 5257, 5259, 5261, 5262, 5263 (2020). Further, Diagnostic Code 5258, for dislocated semilunar cartilage, is not applicable because the Veteran's left knee disability has not resulted in frequent episodes of locking. The Board recognizes that the Veteran meets the other criteria of pain and effusion into the joint, but the requirements of Diagnostic Code 5258 are written in the conjunctive, so locking is a necessary criterion. Accordingly, a separate rating under Diagnostic Code 5258 for the Veteran's possible left meniscus tear is not warranted. 38 C.F.R. § 4.71a, Diagnostic Code 5258 (2020). Accordingly, the Board finds that the preponderance of the evidence is against the claim and entitlement to a rating in excess of 10 percent prior to February 18, 2020, and in excess of 30 percent thereafter for the left knee disability is not warranted. 38 U.S.C. § 5107 (b) (2018); Gilbert v. Derwinski, 1 Vet. App. 49 (1990). Kristin Haddock Veterans Law Judge Board of Veterans' Appeals Attorney for the Board I. Cannaday, 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.