Citation Nr: 21005796 Decision Date: 02/02/21 Archive Date: 02/02/21 DOCKET NO. 08-26 718 DATE: February 2, 2021 REMANDED For the period prior to June 15, 2009, an evaluation in excess of 10 percent for the Veteran's service-connected left knee disability, limitation of extension, is remanded. For the period prior to June 15, 2009, an evaluation in excess of 10 percent for the Veteran's service-connected left knee disability, limitation of flexion, is remanded. For the period prior to June 15, 2009, an evaluation in excess of 10 percent for the Veteran's service-connected left knee disability, instability, is remanded. REASONS FOR REMAND This appeal initially came to the Board of Veterans’ Appeals (Board) from a March 2007 rating decision. In July 2012, the Board denied entitlement to an evaluation in excess of 10 percent for the Veteran’s left knee disability prior to June 15, 2009. The Veteran appealed the Board’s decision to the United States Court of Appeals for Veterans Claims (Court). In February 2014, the Court issued a Memorandum Decision vacating and remanding the Board’s denial. After remanding the claim for additional development in October 2014, the Board again denied the claim in November 2015. The Veteran also appealed this decision to the Court. In September 2016, the Court issued an order granting a September 2016 Joint Motion for Remand (JMR). After remanding the claim for additional development in August 2017, in August 2019, the Board denied the Veteran’s claim for ratings in excess of 10 percent for limited left knee flexion and in excess of 10 percent for left instability prior to June 15, 2009 and granted a 10 percent rating, but no greater, for the Veteran’s left knee limited extension prior to June 15, 2009. The Veteran also appealed this decision to the Court. In August 2020, the Court issued an order granting a JMR for partial remand, specifically vacating the Board decision denying a rating in excess of 10 percent for left knee limited extension, a rating in excess of 10 percent for left knee limited flexion, and a rating in excess of 10 percent for left knee instability prior to June 15, 2009. The Court remanded the Veteran’s claim for action consistent with the JMR. The Veteran’s appeal is now again before the Board. In the August 2020 JMR, the parties agreed that a May 2019 VA medical opinion was inadequate as it did not substantially comply with the Board’s October 2014 and August 2017 remand directives. In October 2014 and August 2017 remands, the Board ordered that an addendum VA opinion be obtained regarding the Veteran’s left knee symptoms documented in May 2006 and March 2009 VA examinations with respect to the nature and severity of the Veteran’s service-connected left knee disability prior to June 15, 2009. Specifically, the Board ordered that the examiner provide a range of motion for the Veteran’s left knee, to include limitation due to pain and during a flare-up. The Board also ordered that the examiner should state whether limitation or motion or other functional loss was experienced. The Board acknowledges that the remand directives require that a retrospective opinion be obtained and notes that it is only the nature and severity of the Veteran’s service-connected left knee disability prior to June 15, 2009 that is at issue in this appeal. The matters are REMANDED for the following action: Obtain an addendum opinion from an appropriate examiner as to the nature and severity of the Veteran’s service-connected left knee disability prior to June 15, 2009. (Continued on the next page)   After reviewing the May 2006 and March 2009 VA examinations, as well as any other pertinent evidence of record, the examiner should opine whether the Veteran’s pain would significantly limit functional ability during flare-ups or when the left knee is repeatedly used over time. The examiner should report the additional functional loss in terms of the degree of additional range of motion loss due to pain on use, weakened movement, excess fatigability, diminished endurance, incoordination, or during flare-ups. A full rationale for all requested opinions shall be provided. If the examiner cannot provide an opinion without resorting to mere speculation, he or she shall provide a complete explanation stating why this is so and list any additional information that would be helpful in clarifying the Veteran’s left knee disability prior to June 15, 2009. In so doing, the examiner shall explain whether the inability to provide a more definitive opinion is the result of a need for additional information (for example, the need to obtain a more thorough history from the Veteran) or that he or she has exhausted the limits of current medical knowledge in providing an answer to that particular question(s). If the examiner needs additional information from the Veteran, he or she must contact the Veteran to obtain that information. If the examiner cannot contact the Veteran, all efforts to make contact should be documented. H. SEESEL Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board A. Christensen 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.