Citation Nr: 21076469 Decision Date: 12/23/21 Archive Date: 12/23/21 DOCKET NO. 15-33 113 DATE: December 23, 2021 REMANDED Entitlement to a disability rating in excess of 20 percent for the Veteran's right shoulder disability is remanded. Entitlement to a disability rating in excess of 10 percent for the Veteran's left knee disability remanded. Entitlement to a disability rating in excess of 10 percent for the Veteran's right knee disability is remanded. REASONS FOR REMAND The Board acknowledges the Veteran's claims have been remanded multiple times. The claims were most recently remanded in August 2021 and unfortunately the Board finds another remand is necessary. The Veteran is entitled to substantial compliance with the Board's remand directives. See Stegall v. West, 11 Vet. App. 268 (1998); Dyment v. West, 13 Vet. App. 141, 146-47 (1999). If the Board proceeds with final disposition of an appeal and the remand orders have not been complied with, the Board itself errs in failing to ensure compliance. Stegall, 11 Vet. App. at 271. The August 2021 remand specifically directed the examiner to address consider, discuss, and reconcile the discrepancies between the previous VA examinations. The Board concedes that the September 2021 VA examiner evaluated the Veteran's disabilities and had her undergo all the requisite testing. Specifically, the examiner evaluated the Veteran's active, passive, weight-bearing, and non-weight bearing range of motions as well as providing opinions on how flareups and repetitive use over time would impact the Veteran's range of motion. See Correia v. McDonald, 28 Vet. App. 158 (2016); Sharp v. Shulkin, 29 Vet. App. 26 (2017). Nevertheless, because there has not been substantial compliance with the August 2021 remand directives, another remand is necessary. The Board stresses the importance of carefully following the directives of this remand in order to allow for a final resolution of these issues. The matters are REMANDED for the following action: 1. Return the Veteran's claims file to the examiner who conducted the September 2021 bilateral knee and right shoulder VA examinations so a supplemental opinion may be provided. If that examiner is no longer available, provide the Veteran's claims file to a similarly qualified clinician. The entire claims file and a copy of this remand must be made available to the examiner for review, and the examiner must specifically acknowledge receipt and review of these materials in any reports generated. A new examination is only required if deemed necessary by the examiner. The examiner should consider, discuss, and reconcile the differences in the lay evidence and medical evidence of record. The examiner should address the inconsistencies in the March 2013, January 2017, October 2018, September 2020, and April 2021 VA examinations of record. Specifically, the examiner should address the varying reports of flareups, additional functional loss after repetitive use over a period of time, pain on passive motion, and functional impacts on occupational tasks. The examiner must provide all findings, along with a complete rationale for his or her opinion(s) in the examination report. If any of the above requested opinions cannot be made without resort to speculation, the examiner must state this and provide a rationale for such conclusion. 2. Ensure that the directives specified in this remand have 3been implemented. If they have not, appropriate corrective action must be undertaken before readjudication. Stegall v. West, 11 Vet. App. 268 (1998). 3. Then, readjudicate the claims. If any decision is adverse to the Veteran, issue a Supplemental Statement of the Case and allow the applicable time for response. Then return the case to the Board. Nykeia F. Miller Acting Veterans Law Judge Board of Veterans' Appeals Attorney for the Board R. Brunot, 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.