Citation Nr: 21070271 Decision Date: 11/23/21 Archive Date: 11/23/21 DOCKET NO. 18-43 988 DATE: November 23, 2021 REMANDED Entitlement to a disability rating in excess of 10 percent for left knee arthritis is remanded. REASONS FOR REMAND The Veteran served on active duty from June 1974 to June 1977. He also served on a period of service from June 1977 to September 1978 with discharge under conditions other than honorable discharge. This matter comes before the Board of Veterans' Appeals (Board) on appeal from an October 2017 rating decision issued by the Department of Veterans Affairs (VA) Regional Office (RO). In November 2021, the Veteran testified at a virtual Board hearing before the undersigned Veterans Law Judge (VLJ). Entitlement to a disability rating ine excess of 10 percent for left knee arthritis is remanded. During the November 2021 Board hearing, the Veteran testified that the symptoms of his left knee disability has worsened since his last VA examination in June 2021. Specifically, he stated that he has increased pain and decreased range of motion in the knee. VA's duty to assist includes the conduct of a thorough and comprehensive medical examination. Robinette v. Brown, 8 Vet. App. 69, 76 (1995). This includes providing a new medical examination when a veteran asserts or provides evidence that a disability has worsened, and the available evidence is too old for an adequate evaluation of the current condition. Weggenmann v. Brown, 5 Vet. App. 281, 284 (1993); see also Caffrey v. Brown, 6 Vet. App. 377, 381 (1994) (finding that VA should have ordered a contemporaneous examination of veteran because a 23-month-old exam was too remote in time to adequately support the decision in an appeal for an increased rating). Accordingly, a more contemporaneous VA examination is required to provide a current picture of the Veteran's service-connected knee disabilities at issue on appeal. 38 C.F.R. §§ 3.326, 3.327. The matter is REMANDED for the following actions: 1. Obtain any outstanding VA treatment records from the (VAMC) in Memphis, Tennessee, dated from July 2021 to the present. All efforts to obtain additional evidence must be documented in the claims file. 2. Schedule the Veteran for an appropriate VA examination by a competent medical professional to determine the current nature and severity of his service-connected left knee arthritis. The entire record must be made available to and be reviewed by the examiner. The examiner should take a history from the Veteran as to the progression of his service-connected left knee disability. Any indicated evaluations, studies, and tests should be conducted. The examiner must address each of the following inquiries: a) The examiner should describe all symptoms associated with the Veteran's service-connected left knee disability. b) For both knees, the examiner should test for pain on motion in active motion, passive motion, weight-bearing, and nonweight-bearing. If pain is noted on range-of-motion testing. c) The examiner should ask the Veteran to report any range of motion loss during flare-ups or following repeated use over time. The Veteran should be asked to identify: (1) the frequency of flare-ups; (2) the duration of flare-ups; (3) any precipitating factors; and (4) any alleviating factors. Even if the Veteran is not experiencing a flare-up at the time of the examination, the examiner must elicit relevant information as to his flare-ups and ask him to describe the additional functional loss, if any, he suffers during flare-ups or following repeated use over time. d) Where the examination does not occur during a flare-up, based upon the evidence of record, and the information elicited on examination, state whether it is at least as likely as not (50 percent probability or greater) that during a flare-up limitation of flexion is limited to 30 degrees (the measurement required for the next higher rating), and/or extension is limited to 15 degrees. If limitation of flexion is limited to less than 30 degrees, or limitation of extension is limited to more than 15 degrees, estimate the additional degree of motion loss. e) Additionally, the extent it is possible, based on the Veteran's reported history and the contemporaneous medical evidence, the examiner should provide an estimate of the functional loss, including loss of range of motion, due to flare-ups or following repeated use over time. If the examiner cannot provide the above-requested estimates based on the information provided by the Veteran and the contemporaneous medical evidence available, the examiner should state so clearly and provide a detailed explanation as to whether such an estimate would be unknowable to the medical community to any degree of medical certainty, in spite of such evidence. See Sharp v. Shulkin, 29 Vet. App. 26, 33 (2017). 3. After completing the above development, and any other development deemed necessary, readjudicate the issue on appeal taking into consideration any newly acquired evidence. If the benefit sought remains denied, provide an additional supplemental statement of the case to the Veteran, and return the appeal to the Board for appellate review, after the Veteran and his representative have had an adequate opportunity to respond. L. CHU Veterans Law Judge Board of Veterans' Appeals Attorney for the Board M. J. In, 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.