Citation Nr: 21071377 Decision Date: 11/30/21 Archive Date: 11/30/21 DOCKET NO. 17-22 598 DATE: November 30, 2021 REMANDED Entitlement to an initial rating in excess of 20 percent for a right knee meniscus tear, prior to March 18, 2014, is remanded. Entitlement to a rating in excess of 30 percent for a right knee total arthroplasty, from May 1, 2015, forward, is remanded. Entitlement to a rating in excess of 30 percent for a left knee total arthroplasty, from July 1, 2016, forward, is remanded. Entitlement to a total disability rating based upon individual unemployability (TDIU) prior to July 1, 2016, is remanded. REASONS FOR REMAND The Veteran served on active duty from March 1964 to April 1967. As a result of his military service, the Veteran received the Combat Infantryman's Badge, among other decorations. This matter comes before the Board of Veterans' Appeals (Board) from April 2015 and November 2015 rating decisions of the Department of Veterans Affairs (VA) Regional Office (RO). These issues were previously remanded by the Board in September 2019 and have since been returned for further adjudication. The Veteran was granted a temporary 100 percent rating for purposes of convalescence for his right knee disability, effective March 18, 2014 to April 30, 2015, and a 30 percent rating thereafter. Additionally, he was granted a temporary 100 percent rating for purposes of convalescence for his left knee disability, effective May 11, 2015 to June 30, 2016. As such, the Board has limited its consideration of the periods on appeal accordingly. During the pendency of the appeal, the Veteran was granted entitlement to a TDIU from July 1, 2016, forward. As his claims for increased ratings date back to September 2006, the issue of entitlement to a TDIU prior to July 1, 2016, remains on appeal. See Rice v. Shinseki, 22 Vet. App. 447, 454-455 (2009). Entitlement to an initial rating in excess of 20 percent for a right knee meniscus tear, prior to March 18, 2014, is remanded. Entitlement to a rating in excess of 30 percent for a right knee total arthroplasty, from May 1, 2015, forward, is remanded. Entitlement to a rating in excess of 30 percent for a left knee total arthroplasty, from July 1, 2016, forward, is remanded. Entitlement to a TDIU prior to July 1, 2016, is remanded. In September 2019, the Board remanded these issues to obtain a new VA examination to comply with Correia v. McDonald, 28 Vet. App. 158 (2016) and Sharp v. Shulkin, 29 Vet. App. 26 (2017). In December 2019, the Veteran underwent a VA examination. While the examiner stated that the Veteran does not suffer from flare-ups, the Veteran reported that his knee pain is aggravated when engaged in prolonged walking. As such, the evidence demonstrates that the Veteran suffers from flare-ups with prolonged walking and testing during a flare-up is needed. Additionally, the examiner stated that there was pain that caused functional loss during both weight-bearing, non-weight bearing, active, and passive motion, but did not provide a range of motion estimate as to how the pain further limited the Veteran's range of motion compared to his normal range of motion when not under pain. As such, remand is necessary to obtain these range of motions. If an estimate cannot be provided without resort to speculation, it must be clear whether this is due to a lack of knowledge among the medical community at large, or insufficient knowledge of the specific examiner. As the case must be remanded, the Veteran's updated treatment records should also be obtained, as set forth below. Finally, because the claim for a TDIU is inextricably intertwined with the claims for increased ratings, adjudication is deferred at this time. The matters are REMANDED for the following action: 1. Obtain the Veteran's VA treatment records, dated from April 2021 forward. 2. Obtain the Veteran's treatment records from Henry Ford Hospital, to include from Dr. Zvirbulis, dated from August 2010 to May 2014 and from March 2015 forward. 3. After the above development is completed, schedule the Veteran for an examination or telehealth interview, review of the record, etc. if an in-person examination is not feasible, by an appropriate examiner to determine the current severity of his service-connected knee disabilities. (a.) The examiner must test the Veteran's active motion, passive motion, and pain with weight-bearing and without weight-bearing and provide range of motion estimates under each condition. (b.) The examiner must attempt to elicit information regarding the severity, frequency, and duration of any flare-ups, and the degree of functional loss during flare-ups. If it is not possible to provide a specific measurement based on direct observation, the examiner should provide an estimate, if at all possible, of the additional impairment due to flare-ups based on the other evidence of record and the Veteran's statements. If it is not possible to provide a specific measurement without speculation, the examiner must state whether the need to speculate is due to a deficiency in the state of general medical knowledge (no one could respond given medical science and the known facts), a deficiency in the record (additional facts are required), or the examiner (does not have the knowledge or training). P.M. DILORENZO Veterans Law Judge Board of Veterans' Appeals Attorney for the Board M. Hofmeister 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.