Citation Nr: 21074310 Decision Date: 12/14/21 Archive Date: 12/14/21 DOCKET NO. 14-03 442 DATE: December 14, 2021 REMANDED Entitlement to an initial compensable rating prior to March 7, 2019, in excess of 10 percent from that date to July 30, 2021 and in excess of 30 percent thereafter, for service-connected left knee arthritis with limitation of extension is remanded. Entitlement to a disability rating in excess of 10 percent for service-connected left knee arthritis with limitation of flexion is denied. Entitlement to an initial compensable disability rating prior to January 17, 2020 and in excess of 10 percent thereafter for service-connected left knee arthritis with instability is remanded. Entitlement to a disability rating in excess of 50 percent for service-connected obstructive sleep apnea (OSA) with asthma is remanded. Entitlement to a total disability rating based on individual unemployability (TDIU) is remanded. REASONS FOR REMAND The Veteran served on active duty from July 1987 to December 2010, with 7 months of prior active service. The claims were most recently remanded by the Board in March 2021. There has not been substantial compliance with the remand directives and the claim must be remanded again. Stegall v. West, 11 Vet. App. 268 (1998). 1. Entitlement to an initial compensable rating prior to March 7, 2019, in excess of 10 percent from that date to July 30, 2021 and in excess of 30 percent thereafter, for service-connected left knee arthritis with limitation of extension. 2. Entitlement to a disability rating in excess of 10 percent for service-connected left knee arthritis with limitation of flexion. 3. Entitlement to a compensable initial disability rating prior to January 17, 2020 and in excess of 10 percent thereafter, for left knee arthritis with instability is remanded. The claims are remanded to obtain medical opinions necessary to adjudicate the claims for the entire appeal period. During the course of the appeal, service connection was granted and separate, staged, ratings were assigned for left knee instability and extension. See July 2020 and January 2021 rating decisions. Those ratings are for manifestations of the service-connected left knee disability on appeal and thus the appeal for the separate ratings are pending from December 2010. The initial rating for both disabilities was granted effective dates of VA examinations that the AOJ determined documented the findings. However, findings of record prior to that date are conflicting with regard to manifestations of instability or flexion instability. A retrospective opinion is needed to determine when these were first manifest. 4. Entitlement to a disability rating in excess of 50 percent for service connected OSA with asthma. The claim is remanded again because the July 2021 VA opinion was not responsive to the remand directives. The previous remand instructed examiners to make findings that would allow the Board to determine whether the Veteran's ever had specifically identified respiratory symptoms. The examination indicated only that the Veteran does not currently have symptoms. 5. Entitlement to a TDIU. The claim for TDIU was raised in the Veteran's August 2021 statement. Rice v. Shinseki, 22 Vet. App. 447 (2009). It must be developed on remand. The matters are REMANDED for the following action: 1. Provide the Veteran with a VA Form 21-8940, Application for TDIU and request that he submit the completed form, with all appropriate information. Thereafter, take all appropriate action on the TDIU claim. 2. Obtain an addendum opinion from an appropriate clinician regarding whether left knee instability was identified prior to January 2020 and whether left knee extension was identified prior to March 2019. Copies of all pertinent records must be provided to the examiner. The examiner should review the prior treatment records and VA examination reports and, if reasonably possible, provide a retrospective opinion which addresses all reports of left knee instability and/or giving way and range of motion on extension during the appeal period since December 2010. 3. Obtain an addendum opinion from an appropriate clinician regarding the symptoms and treatment of the Veteran's obstructive sleep apnea with asthma. Copies of all pertinent records must be provided to the examiner. The examiner must specifically state whether the Veteran ever suffered from chronic respiratory failure with carbon dioxide retention or cor pulmonale, whether he required a tracheostomy or whether his service-connected asthma required oral or parenteral corticosteroid use at least three times per year. The examiner is informed that this opinion should focus on whether these symptoms or treatment existed at any point based on the evidence in the Veteran's record. M.E. Larkin Veterans Law Judge Board of Veterans' Appeals Attorney for the Board P.S. McLeod 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.