Citation Nr: 21070603 Decision Date: 11/24/21 Archive Date: 11/24/21 DOCKET NO. 15-04 034 DATE: November 24, 2021 REMANDED Entitlement to an initial evaluation in excess of 10 percent for left knee arthralgia, is remanded. Entitlement to an initial evaluation in excess of 10 percent for right knee arthralgia, is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Air Force from May 2002 to March 2005 with additional training in the Air National Guard of Puerto Rico from March 2005 to June 2007. This matter comes before the Board of Veterans' Appeals (Board) from an August 2012 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO). In October 2020 , the Board denied a rating in excess of 10 percent for right and left arthralgia, a knee condition. The Veteran appealed the Board's October 2020 decision to the United States Court of Appeals for Veteran's Claims (Court). A July 2021 Court Order vacated and remanded the Board's decision for compliance with the Joint Motion for Remand (JMR). Left knee and right knee arthralgia. The Veteran contends that an increased rating is warranted for his service-connected knees. The parties to the July 2021 JMR found that the Board did not properly address evidence of instability including inconsistencies between August 2004 examination observations and those noted in September 2019. The Board did not assign appropriate weight to reports of the use of support devices that suggested instability as compared to an examiner's finding of no instability and did not explain why diagnoses of ligament tear and chronic strain were not secondary to the original diagnosis of arthralgia and should have separate ratings even though the examiner explained that these were progressions of the original arthralgia disabilities. In light of the points raised by the JMR and Board review of the claims file, additional development is warranted. In September 2021, the Veteran provided comments about his September 2019 VA examination and pointed to some irregularities. The Veteran reported the examination was quick and that the examiner incorrectly stated that he did not have a flare-up that day. However, the examiner clearly noted that the Veteran was having a flare up that day. The examiner noted that there was no knee instability, but the Veteran indicated that it was not true because his knees were giving out all the time. The Veteran stated his right knee popped and would get so swollen that he could not bend, which required crutches. The Veteran reported that he experienced flare-ups of his left knee that occurred once a month that were severe with swelling and instability. The flare-ups lasted a few days to a week. The Veteran stated that his flare-ups occurred when overcompensating his right leg. The Veteran also submitted a copy of his handwritten questionnaire that appeared to have been submitted to the September 2019 examiner. The matters are REMANDED for the following action: Schedule the Veteran for an examination by an appropriate clinician to determine the current severity of his service-connected knee arthralgia and the May 2020 addendum diagnosis of a progression of the disabilities to right knee anterior cruciate ligament (ACL) tear and left knee strain. The examiner should provide a full description of the disability and report all signs and symptoms necessary for evaluating the Veteran's disability under the rating criteria. In addition, the examiner should address whether the Veteran has an additional disability that is secondary to his bilateral knee arthralgia or a supported additional service-connected disability that is warranted a separate rating or is a progression or worsening of the initial knee arthralgia disability. Attention is called to the VA examination in September 2019 and the May 2020 addendum noting that the Veteran did not have instability. The current examiner should clarify whether the Veteran's use of assistive devices shows the Veteran has functional knee instability and also reference the Veteran's September 2021 statement, indicating knee instability. The examiner should also consider all potentially applicable Diagnostic Codes. J.W. FRANCIS Veterans Law Judge Board of Veterans' Appeals Attorney for the Board E.Long-Ellis, Associate 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.