Citation Nr: 21076747 Decision Date: 12/27/21 Archive Date: 12/27/21 DOCKET NO. 18-27 155 DATE: December 27, 2021 REMANDED Entitlement to a rating in excess of 10 percent for left knee Osgood-Schlatter's disease with limitation of extension is remanded. Entitlement to a rating in excess of 10 percent for right knee Osgood-Schlatter's disease with limitation of flexion is remanded. Entitlement to an initial compensable rating for right knee Osgood-Schlatter's disease with limitation of extension is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Marine Corps from January 1991 to December 1992. This matter comes before the Board of Veterans' Appeals (Board) on appeal from an April 2015 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO). In May 2021, the Veteran testified at a hearing before the undersigned Veterans Law Judge. The Board remanded the claims for further development in May 2021. The Veteran was recently afforded a VA examination for his service-connected bilateral knee disabilities in September 2021. However, this examination does not comply with Sharp v. Shulkin, 29 Vet. App. 26, 33 (2017) (the examiner should "estimate the functional loss that would occur during flares"), as the examiner did not provide an opinion describing any additional functional loss experienced by the Veteran during flare-ups. Instead, despite noting the Veteran's reports of monthly flare-ups and pain that makes him miss work, the examiner found no additional functional loss during a flare-up, which the Board finds difficult to comprehend. Furthermore, the examiner indicated that that the Veteran's symptoms had worsened but noted normal, full range of motion in both knees, which conflicts with the evidentiary record. See April 2015 VA examination report (flexion to 130 degrees) and June 2020 VA treatment record (flexion to 120 degrees). To ensure that the Veteran is afforded every consideration, he should be afforded a new VA examination with a different examiner on remand, and any outstanding treatment records should also be secured. The matters are REMANDED for the following action: 1. Obtain any outstanding VA treatment records. 2. With any necessary assistance from the Veteran, obtain any outstanding relevant private treatment records. 3. Then schedule the Veteran for a VA examination with an examiner other than the September 2021 VA examiner to determine the current nature and severity of his bilateral knee disabilities. The claims file should be made available to and reviewed by the examiner and all findings should be reported in detail. The examiner should conduct range of motion studies. The joints involved should be tested for pain (1) on active motion, (2) on passive motion, (3) in weight-bearing, and (4) in nonweight-bearing. If the examiner is unable to conduct the required testing or concludes that the required testing is not necessary in this case, he or she should clearly explain why that is so. In assessing functional loss, considering the Veteran's reported history (see May 2021 Board Hearing Testimony and September 2021 VA examination report) and description of flare-ups therein, please provide an opinion describing functional impairment of the Veteran's left and right knees due to flare-ups, accounting for pain, incoordination, weakened movement, and excess fatigability on use, and, to the extent possible, report such impairment in terms of additional degrees of limitation of motion. If unable to provide such an opinion without resorting to speculation, please provide a rationale for this conclusion, with specific consideration of the instructions in the VA Clinician's Guide to estimate, "per [the] veteran," what extent, if any, flare-ups affect functional impairment. The examiner must include a discussion of any specific facts that cannot be determined if unable to opine without speculation (e.g., lack of sufficient information/evidence, the limits of medical knowledge, etc.). Noting that the Veteran was not examined during a flare-up will not suffice. A complete rationale shall be given for all opinions and conclusions expressed. S. BUSH Veterans Law Judge Board of Veterans' Appeals Attorney for the Board S.S. Mahoney 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.