Citation Nr: 21074517 Decision Date: 12/15/21 Archive Date: 12/15/21 DOCKET NO. 15-41 645 DATE: December 15, 2021 REMANDED An initial rating in excess of 10 percent for a right knee patellofemoral syndrome with chronic strain. REASONS FOR REMAND The Veteran had active duty service from January 1984 to January 1987, from July 1991 to September 1992, and from May 1994 to September 1994. This matter comes before the Board of Veterans' Appeals (Board) from a December 2012 rating decision. Most recently, in August 2021, the Board denied an initial rating in excess of 20 percent for left lower extremity radiculopathy and remanded the claim remaining on appeal for additional development. An initial rating in excess of 10 percent for a right knee patellofemoral syndrome with chronic strain. The Veteran is seeking a higher rating for a right knee disability. The Veteran was afforded a VA examination for this claim in May 2021. The examiner reported right knee diagnoses of patellofemoral syndrome with chronic strain in 1983, prepatellar bursitis in 2019, degenerative arthritis other than post-traumatic in 2019, meniscal tear in 2019, and anterior cruciate ligament tear in 2019. The examiner found that the Veteran's service-connected right knee patellofemoral syndrome with chronic strain is completely resolved based on 2010 and 2012 VA examinations showing no right knee symptoms. The examiner also reported that the Veteran's present conditions of degenerative joint disease, anterior cruciate ligament (ACL) tear, and prepatellar bursitis started in 2019 and are of a different etiology that the Veteran's service-connected disability. The Board notes that the 2010 knee examination does include findings of current right knee symptoms. Pursuant to the August 2021 Board remand, the Veteran was afforded another examination in September 2021. The examiner reported right knee diagnoses of patellofemoral syndrome with chronic strain in 2019, degenerative arthritis other than post-traumatic in 2019, meniscal tear in 2019, and ACL tear in 2019. The examiner also noted a previous diagnosis of right prepatellar bursitis, resolved. The examiner reported the Veteran had a meniscus tear in 2020 that required surgery. The examiner found that the Veteran's meniscal and ACL tears occurred in 2019 and were not incurred in or caused by service. The Board finds that a remand is necessary to obtain an opinion in regard to whether the Veteran's additional right knee diagnoses are related to service or caused or aggravated by his service-connected right knee disability. See Mittleider v. West, 11 Vet. App. 181, 182 (1998). The claim is are REMANDED for the following action: Schedule the Veteran for a VA examination to assess nature, etiology, and severity of the right knee disabilities. The entire claims file should be reviewed by the examiner. Thereafter, the examiner is asked to: (a.) Identify all right knee disorders present since October 2010. (b.) For each disorder other than the patellofemoral syndrome with chronic strain diagnosed in the 1980's, state whether it is at least as likely as not that it had its onset during service, within one year of discharge, or is otherwise related to service. (c.) For each disorder other than the patellofemoral syndrome with chronic strain diagnosed in the 1980's, state whether it is at least as likely as not caused or aggravated by the patellofemoral syndrome with chronic strain diagnosed in the 1980's. Aggravation means an increase in severity beyond the natural progress of the disease. (d.) Assess the severity of all right knee disorders present since October 2010. This should include testing for pain on both active and passive motion, in weight-bearing and nonweight-bearing and, if possible, with the range of the opposite undamaged joint. If there are flare-ups and the examination is not conducted during a flare-up, the functional impact of a flare-up in terms of degrees of range of motion should be estimated. (e.) In assessing the Veteran's right knee symptoms should be differentiated between the diagnosed right knee disorders to the extent possible. If differentiation is not possible, this should be stated. A rationale should be provided for opinions expressed. DAVID JIMERFIELD Acting 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.