Citation Nr: 21012598 Decision Date: 03/04/21 Archive Date: 03/04/21 DOCKET NO. 09-05 708 DATE: March 4, 2021 REMANDED An initial rating in excess of 10 percent for a right shoulder condition prior to May 23, 2016, in excess of 20 percent prior to May 1, 2020, and in excess of 30 percent, thereafter, is remanded. Service connection for a right knee condition is remanded. Service connection for a left knee condition is remanded. REASONS FOR REMAND The Veteran served on active duty in the U.S. Navy from July 1975 to July 1979, January 1981 to July 1993, and January 2004 to May 2004. In July 2014, the Board of Veterans’ Appeals (Board) remanded the issues of entitlement to an increased rating for the Veteran’s right shoulder condition and service connection for bilateral knee condition for further development. Specifically, the Board instructed the regional office (RO) to obtain updated medical records, to schedule the Veteran for a VA examination pertaining to his right shoulder claim, and to schedule the Veteran for a hearing before a local hearing officer. The Veteran elected to have an informal conference in lieu of a hearing due to COVID-19, which took place in May 2020. See April 2020 Correspondence; May 2020 Email Correspondence. As an initial matter, the Board notes that the RO issued a rating decision in October 2020 that increased the rating of the Veteran’s right shoulder condition to 20 percent, effective May 23, 2016, to 100 percent, effective February 11, 2020, and to 30 percent, effective May 1, 2020. However, as this action did not constitute a full grant of the benefits sought for the entire appeal period, the claim for an increased rating remains before the Board. See AB v. Brown, 6 Vet. App. 35, 38 (1993). Upon review of the record, the Board finds that the claims must be remanded. The Board sincerely regrets the additional delay caused by this remand but wishes to assure the Veteran that it is necessary for a full and fair adjudication of his claims. Increased rating for right shoulder disability The Veteran last underwent a VA examination for his right shoulder in October 2020. Since that time, the record reflects that his symptoms may have worsened. Specifically, the Veteran underwent another shoulder surgery in November 2020. See January 2021 CAPRI, p. 43. Accordingly, the Board finds that an updated VA examination is necessary. See Snuffer v. Gober, 10 Vet. App. 400 (1997) (noting that a claimant is entitled to a new VA examination where there is evidence that the condition has worsened since that last examination). Service connection for bilateral knee condition The Veteran last underwent a VA examination for his bilateral knee condition in April 2007, with an etiological opinion provided in July 2007. Since that time, the Veteran has asserted that his bilateral knee condition is due to his duties onboard ships during his service, including climbing ladders, running, doing physical training (PT), and climbing through numerous ships to check shipping containers, as well as due to being hit by a car while in service. See November 2007 VA 21-4138 Statement in Support of Claim. Moreover, a November 2007 lay statement from the Veteran’s spouse and updated medical records were also associated with the claims file after the April 2007 examination and July 2007 opinion. The April 2007 examiner was unable to consider this evidence. Accordingly, remand for a new examination and etiological opinion is warranted. The matters are REMANDED for the following action: 1. Assist the Veteran in associating with the claims file updated treatment records. 2. Schedule the Veteran for an examination to determine the severity of his right shoulder condition. The examiner should report all signs and symptoms necessary for evaluation of the Veteran’s right shoulder condition under the rating criteria. In particular, the examiner should provide range of motion test results (in degrees) for the Veteran’s right shoulder on active motion, passive motion, weight-bearing, and nonweight-bearing. The examiner should offer an opinion as to whether pain could significantly limit functional ability during flare-ups or when the right shoulder is used repeatedly over a period of time. The examiner should specifically indicate whether the Veteran experiences any limitation of motion that is attributable to pain and at what point during the range of motion. 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 is asked to describe whether pain significantly limits functional ability during flare-ups and, if so, the examiner must estimate the range of motion during flares. IF THE EXAMINATION DOES NOT TAKE PLACE DURING A FLARE, THE EXAMINER MUST GLEAN INFORMATION REGARDING THE FLARES’ SEVERITY, FREQUENCY, DURATION, AND FUNCTIONAL LOSS MANIFESTATIONS FROM THE VETERAN, MEDICAL RECORDS, AND OTHER AVAILABLE SOURCES. EFFORTS TO OBTAIN SUCH INFORMATION MUST BE DOCUMENTED. If there is no pain and/or no limitation of function, such facts must be noted in the report. The examiner is advised that the Veteran is competent to report his symptoms and history and such reports must be considered. If the examiner rejects the Veteran’s reports, the examiner must provide a reason for doing so. The Board recognizes the practical difficulties of scheduling an examination in view of the COVID-19 epidemic and requests flexibility and understanding in affording the Veteran an opportunity for an examination. If an in-person examination cannot be provided, consider other appropriate alternatives, such as a telehealth examination. 3. Schedule the Veteran for a VA examination to determine the nature and etiology of the Veteran’s bilateral knee condition.  The claims file should be made available to the examiner for review in connection with the examination.  Based on review of the record and conducting an examination of the Veteran, the examiner should respond to the following:  (a.) Obtain a detailed history of the Veteran’s bilateral knee condition, to include any and all symptomology.  (b.) Determine whether it is at least as likely as not (i.e., at least a 50 percent probability) that the Veteran’s bilateral knee condition had its onset in or is related to service.  The examiner must specifically discuss: • The Veteran’s contention that his due to his duties onboard ships during his service, including climbing ladders, running, doing PT, and climbing through numerous ships to check shipping containers, as well as due to being hit by a car while in service; • The November 2007 buddy statement from the Veteran’s spouse. The examiner is advised that the Veteran is competent to report symptoms, treatment, and injuries, and that his reports must be taken into account in formulating the requested opinions.  The Board recognizes the practical difficulties of scheduling an examination in view of the COVID-19 epidemic and requests flexibility and understanding in affording the Veteran an opportunity for an examination.  If an in-person examination cannot be provided, consider other appropriate alternatives, such as a telehealth examination.  The examiner must provide the rationale for all proffered opinions.  If the examiner is unable to provide any required opinion, he or she should explain why.  If the examiner cannot provide an opinion without resorting to mere speculation, he or she shall provide a complete explanation as to why this is so.  If the inability to provide a more definitive opinion is the result of a need for additional information, the examiner should identify the additional information that is needed. JOHN Z. JONES Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board T. L. Park, 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.