Citation Nr: 21008492 Decision Date: 02/17/21 Archive Date: 02/17/21 DOCKET NO. 19-37 977 DATE: February 17, 2021 REMANDED Entitlement to a rating in excess of 10 percent for patellofemoral pain syndrome of the left knee is remanded. Entitlement to a rating in excess of 10 percent for patellofemoral pain syndrome of the right knee is remanded. Entitlement to a total disability rating based on individual unemployability due to service-connected disabilities (TDIU) is remanded. REASONS FOR REMAND The Veteran served on active duty from September 1992 to September 1996 and from January 1998 to January 2002. He testified at a hearing before the undersigned in February 2021. Ratings for Left and Right Knee Disabilities The Veteran most recently underwent a VA knee examination in June 2019. He and his representative report that his knee disabilities have worsened since that time. Specifically, the Veteran testified that a few months ago he went from using a cane to being prescribed a walker. See February 2021 hearing transcript. These issues are therefore remanded to request that current treatment records be obtained followed by a new VA examination. See 38 C.F.R. §§ 4.1, 4.2; Snuffer v. Gober, 10 Vet. App. 400, 403 (1997). TDIU As the increased rating issues being remanded are inextricably intertwined with the issue of entitlement to TDIU, they must be adjudicated prior to further consideration of the TDIU issue. See Harris v. Derwinski, 1 Vet. App. 180, 183 (1991). Additionally, the claims file shows that the Veteran submitted an application for VA vocational rehabilitation and employment services in 2018. It is not clear that all relevant vocational rehabilitation records have been obtained. On remand, all outstanding VA records relating to the Veteran’s vocational rehabilitation should be obtained. The matters are REMANDED for the following action: 1. With any assistance needed from the Veteran, undertake appropriate development to obtain any pertinent, outstanding VA or private medical records. 2. Obtain any outstanding VA records relating to the Veteran’s VA vocational rehabilitation and employment services. 3. After the above records development is completed, afford the Veteran a VA examination to determine the nature and severity of his service-connected right and left knee disabilities. All indicated evaluations, studies, and tests deemed to be necessary should be accomplished. All pertinent evidence of record should be made available to and reviewed by the examiner. All information required for rating purposes should be provided to the examiner. Regarding each knee, the examination must be conducted in accordance with the current disability benefits questionnaire or examination worksheet applicable to the disability. Ranges of motion in active motion, passive motion, weight-bearing, and nonweight-bearing, for the right knee and the left knee must be conducted. 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. The examiner should also indicate whether there is recurrent subluxation or lateral instability of the right knee and the left knee, and if so, the examiner should estimate the severity of any recurrent subluxation or lateral instability. If stability testing cannot be conducted, it should be explained why. The examiner must also provide an opinion concerning the functional impairment of the Veteran’s service-connected right knee and left knee disabilities. The rationale for all opinions offered must be provided. A. ISHIZAWAR Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Fletcher, Kathleen 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.