Citation Nr: 21072419 Decision Date: 12/03/21 Archive Date: 12/03/21 DOCKET NO. 17-24 581 DATE: December 3, 2021 REMANDED Entitlement to an initial rating in excess of 10 percent for right knee patellofemoral pain syndrome is remanded. Entitlement to an initial rating in excess of 10 percent for left knee patellofemoral pain syndrome is remanded. REASONS FOR REMAND The Veteran had active duty from December 2009 to November 2013. In August 2019, the North Carolina Department of Military and Veterans Affairs informed the Veteran and the Department of Veterans Affairs (VA) that it was "revoking our Power of Attorney to continue providing accredited representation of the above claimant due to lack of in-state residency." In October 2021, the Board of Veterans' Appeals (Board) granted the representative's Motion to Withdraw from representing the Veteran before the Board pursuant to 38 C.F.R. § 20.608(b). The Board informed the Veteran that he could choose to appoint a new representative or to represent himself in the instant appeal. The Board clarified that, if the Veteran did not respond to the notification within 30 days, it would be assumed that the Veteran wished to represent himself. No response has been received from the Veteran. Entitlement to initial ratings in excess of 10 percent for bother right knee patellofemoral pain syndrome and left knee patellofemoral pain syndrome is remanded. The report of a January 2020 knee examination conducted for VA states that the Veteran complained of pain in the knees when sitting or standing for prolonged periods, climbing stairs and squatting. The Veteran was diagnosed with right knee and left knee patellofemoral pain syndrome. On examination of the knees, the Veteran exhibited a range of motion of 0 to 100 degrees, bilaterally, with pain on flexion. The examiner concurrently commented that the knee pain did not cause functional loss and the diagnosed right knee and left knee disabilities resulted in functional impairment including "difficulty with prolonged standing, sitting, going up and down stairs." The examiner did not identify the degree of flexion at which the identified right knee and left knee pain was exhibited. In light of that deficiency, the Board finds that the Board finds that the functional loss associated with the service connected knee disabilities is unclear, and the examination report is of limited probative value. VA's duty to assist includes, in appropriate cases, the duty to conduct a thorough and contemporaneous medical examination which is accurate and fully descriptive. McLendon v. Nicholson, 20 Vet. App. 79 (2006); Green v. Derwinski, 1 Vet. App. 121, 124 (1991). When VA undertakes to obtain an evaluation, it must ensure that the evaluation is adequate. Barr v. Nicholson, 21 Vet. App. 303, 312 (2007). Clinical documentation dated after December 2019 is not of record. VA should obtain all relevant VA and private treatment records which could potentially be helpful in resolving the Veteran's claims. Murphy v. Derwinski, 1 Vet. App. 78 (1990); Bell v. Derwinski, 2 Vet. App. 611 (1992). The matters are REMANDED for the following action: 1. Ask the Veteran to complete a VA Form 21-4142 for each private healthcare provider who treated him for the service connected right knee and left knee disabilities. Make two requests for the authorized records from all identified healthcare providers unless it is clear after the first request that a second request would be futile. 2. Obtain the Veteran's VA clinical documentation not already of record, including treatment records dated after December 2019. 3. Schedule the Veteran for a VA examination conducted by a medical doctor to assist in determining the current nature and severity of right knee and left knee patellofemoral pain syndrome. The examiner must review the record and should note that review in the report. A rationale for all opinions should be provided. The examiner should: (a) Provide ranges of motion for weight-bearing and nonweight-bearing and passive and active motion of both knees. The examiner should specifically indicate the degree at which the Veteran experiences pain on motion of the right knee and the left knee. (b) State whether there is any additional loss of function of the right knee and the left knee due to painful motion, weakened motion, excess motion, fatigability, incoordination, or on flare up. (c) State whether there is any recurrent lateral instability or subluxation of the knees and, if so, the severity of any instability or subluxation. J. T. HUTCHESON Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Brendan A. Evans, 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.