Citation Nr: 21006972 Decision Date: 02/08/21 Archive Date: 02/08/21 DOCKET NO. 15-14 815 DATE: February 8, 2021 REMANDED Entitlement to a rating in excess of 10 percent for a left knee condition is remanded. Entitlement to a rating in excess of 10 percent for left knee instability is remanded. Entitlement to a rating in excess of 10 percent for a right knee condition 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 1976 to October 1978. The Veteran appeals a February 2014 rating decision by the Agency of Original Jurisdiction (AOJ). The Board of Veterans’ Appeals (Board) finds that further evidentiary development is necessary and remands the case to ensure compliance with the Board’s prior remand instructions. See Stegall v. West, 11 Vet. App. 268, 271 (1998). 1. Knees The July 2018 Board decision remanded the issues for a new VA examination that appropriately included joint testing for pain on both active and passive motion, in weight-bearing and non-weight-bearing range of motion (ROM), and adequately accounted for flare-ups. See Correia v. McDonald, 28 Vet. App. 158, 169-70 (2016); Sharp v. Shulkin, 29 Vet. App. 26, 35 (2019). However, the Board finds the July 2019 VA examination report inadequate. The VA examiner noted flare-ups that limit the Veteran’s ability to walk and that he cannot go up the stairs. The VA examiner then noted that pain and weakness limit the Veteran’s functional ability during flare-ups and described that there is objective limitation in the ability of the Veteran to bend or extend knees due to discomfort and pain. However, the VA examiner was unable to describe the limitation in terms of ROM and did not give a reason despite the description noting functional limitation during flare-ups. Additionally, the May 2020 deferred rating decision noted issues and deficiencies with the July 2019 VA examination report. Importantly, the VA examiner noted contradicting ROM measurements. Therefore, an addendum opinion was requested to clarify issues. The August 2020 addendum report only noted flexion ROM measurements and seemed to disregard any prior finding of limitation of ROM in the left knee. The addendum report also seemed to note improvement in the Veteran’s ROM measurements compared to the prior February 2014 VA examination although previously noting pain getting progressively worse in both knees during the July 2019 VA examination. Overall, given the deficiencies and confusing ROM measurements, the Board finds the July 2019 VA examination report inadequate and remands the case for a new VA examination. 2. TDIU The Veteran claims he cannot work due to his service-connected knee conditions. See June 2014 VA Form 21-526EZ. As the TDIU claim is premised in part on the severity of his service-connected knee conditions, the issue of TDIU is inextricably intertwined with those issues. Accordingly, the Board will defer adjudication on the matter. See Harris v. Derwinski, 1 Vet. App. 180, 183 (1991). Additionally, the July 2018 Board decision instructed that the AOJ provide the Veteran with various forms to obtain his employment information. These forms were mailed in May 2019 correspondence. However, the Board notes that correspondence immediately following the May 2019 notice indicated a different mailing address and there is returned mail of record around this time. Therefore, it is unclear whether the Veteran received the notice and request to fill out these forms. As such, the Veteran should be given another opportunity to fill-out and submit these forms regarding his employment history. The matters are REMANDED for the following action: 1. Obtain any outstanding VA and/or private treatment records relevant to treatment the Veteran received for his bilateral knee conditions that are not already of record. All obtained records should be associated with the evidentiary record. If any identified records are not obtainable (or none exist), the Veteran and his representative should be notified, and the record clearly documented. 2. Obtain a complete post service employment and education history of the Veteran. The employment history should indicate the type of position, whether any position held was full time or part time (including hours per week worked if part time) and the wages earned. Any employment accommodations should be described in detail. 3. Thereafter, schedule the Veteran for an examination of the current severity of his bilateral knee conditions. The examiner must test the Veteran’s active motion, passive motion, and pain with weight-bearing and without weight-bearing (if applicable). The examiner must also attempt to elicit information regarding the severity, frequency, and duration of any flare-ups, and the degree of functional loss during flare-ups. The examiner should identify any symptoms and functional impairments due to the Veteran’s condition and discuss the effect of the Veteran’s condition on any occupational functioning and activities of daily living. If it is not possible to provide a specific measurement, or an opinion regarding flare-ups, symptoms, or functional impairment without speculation, the examiner must state whether the need to speculate is due to a deficiency in the state of general medical knowledge (no one could respond given medical science and the known facts), a deficiency in the record (additional facts are required), or the examiner (does not have the knowledge or training). 4. After the above development has been completed to the extent possible, readjudicate the claims. If any benefit sought remains denied, provide the Veteran and his representative with a supplemental statement of the case (SSOC), and return the case to the Board, if otherwise in order. DONNIE R. HACHEY Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board A. Zheng, 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.