Citation Nr: 21068759 Decision Date: 11/12/21 Archive Date: 11/12/21 DOCKET NO. 18-22 469 DATE: November 12, 2021 REMANDED Entitlement to a rating in excess of 10 percent for a left knee disability is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Army from July 1979 to May 1992. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a May 2017 rating decision issued by a Department of Veterans Affairs (VA) Regional Office (RO). In November 2020, the Veteran provided testimony during a Board hearing before the undersigned Veterans Law Judge. The Veteran was afforded VA knee examinations in April 2017, October 2018, and May 2021. No supplemental statement of the case was issued after the most recent VA examination, which alone warrants remand. However, the 2017 and 2018 examination reports are contradictory in nature as to the severity of his left knee disability, particularly in light of endorsement of flare-ups and occasional use of assistive devices in April 2017, and no reports of flare-ups/functional loss in October 2018 (although the Veteran reported worsening in his knees and popping/pain when going up and down stairs, and occasional use of assistive devices). Moreover, there was no range of motion testing conducted on the left side in May 2021, as that examination was in relation to a claim for a right knee disability (however, that report contains some relevant information for the left side). On remand, an updated VA examination that adequately addresses the Veteran's left knee disability, including any additional loss of motion due to reported flare-ups, is needed. Any outstanding VA treatment records should also be secured. The matters are REMANDED for the following action: 1. Obtain any outstanding VA treatment records. 2. Then schedule the Veteran for a VA examination to determine the current nature and severity of his left knee disability. The claims file should be made available to and reviewed by the examiner and all findings reported in detail. The examiner is asked to address the following: (a) Please provide an opinion as to the full range of motion of the Veteran's left knee in (1) active motion, (2) passive motion, (3) in weight-bearing (4) in nonweight-bearing, and (5), if applicable, with range of motion of the opposite undamaged joint. Please specify range of motion measurements in all areas outlined above. If the examiner cannot provide an opinion without resorting to speculation, he/she should explain why an opinion cannot be provided (e.g. lack of sufficient information/evidence, the limits of medical knowledge, etc.). Additionally, if range of motion testing is unable to be done permanently, please indicate such in the report. (b) Considering the Veteran's reported history, to include in his 2017 VA examination and during his November 2020 Board hearing, please also provide an opinion describing functional impairment of the Veteran's left knee disability, accounting for pain, incoordination, weakened movement, and excess fatigability on use, and, to the extent possible, report such impairment in terms of additional degrees of limitation of motion. If unable to provide such an opinion without resorting to speculation, please provide a rationale for this conclusion, with specific consideration of the instructions in the VA Clinician's Guide to estimate, "per [the] veteran", what extent, if any, flare-ups affect functional impairment. The examiner must include a discussion of any specific facts that cannot be determined if unable to opine without speculation. A full and complete rationale must be provided for all opinions expressed. If unable to opine without speculation, please provide a rationale for this conclusion. S. BUSH Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Asante, Ruby 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.