Citation Nr: 21013823 Decision Date: 03/10/21 Archive Date: 03/10/21 DOCKET NO. 10-14 797 DATE: March 10, 2021 REMANDED Entitlement to a separate rating for right knee semilunar cartilage dislocation is remanded. Entitlement to a separate rating for left knee semilunar cartilage dislocation is remanded. REASONS FOR REMAND The Veteran served on active duty from December 1980 to August 2001. This case originally came before the Board of Veterans’ Appeals (Board) on appeal from an April 2009 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO) that continued 10 percent ratings for right knee instability, degenerative joint disease (DJD) of the right knee with crepitation, and DJD of the left knee with crepitation. The claims were before the Board in December 2018. At that time, the Board denied a rating in excess of 10 percent prior to November 13, 2013; and increased the rating to 20 percent, but no higher, thereafter for DJD of the right knee with crepitation. The Board denied a rating in excess of 10 percent for right knee instability, and granted a separate rating of 20 percent, but no higher, for right knee limitation of extension from April 3, 2018. It also denied a rating in excess of 10 percent prior to November 28, 2012; in excess of 10 percent from January 1, 2013, to September 9, 2014; and in excess of 20 percent from November 1, 2014, to February 23, 2018, for DJD of the left knee with crepitation. A separate rating of 10 percent, but no higher, was granted for left knee instability. The Veteran appealed the December 2018 Board decision to the United States Court of Appeals for Veterans Claims (Court), specifically regarding the denial of separate ratings under Diagnostic Code (DC) 5258 for both knees. In September 2019, the Court granted a Joint Motion for Partial Remand, and vacated the December 2018 Board decision to the extent that it denied higher ratings for the right and left knees under DC 5258 for dislocated semilunar cartilage with frequent episodes of “locking,” pain, and effusion into the joints. The issues were returned to the Board, and remanded by the Board for further development in April 2020. Issues 1-2: Entitlement to separate ratings for right and left knee semilunar cartilage dislocations is remanded. In April 2020, the Board remanded these issues for a VA examination to determine whether the semilunar cartilage dislocation was attributable to service or service-connected disabilities, the resultant symptoms associated with the semilunar cartilage dislocation in each knee, and the frequency and severity of any such symptoms. The Veteran was provided a VA examination in September 2020, at which time he was diagnosed with bilateral knee strain, bilateral patellofemoral pain syndrome, and bilateral degenerative arthritis. The examiner also found a meniscal tear with frequent episodes of joint locking in the left knee. The examiner did not check off any meniscal conditions in the right knee, but also did not mark that the Veteran had no current symptoms of a right knee meniscal condition. Furthermore, even if the examiner was indicating that the Veteran had no meniscal conditions in the right knee, he did not at any point address other conflicting evidence. Specifically, the October 2009 VA examination report reflects a diagnosis of a small tear at the posterior horn of the medial meniscus, a November 2013 VA examination report reflects a meniscal tear of the right knee as of November 2007, and an April 2018 VA examination report notes a meniscus condition of the right knee. Therefore, there is conflicting evidence regarding whether the Veteran has a right knee meniscal condition. As such, a new VA examination is required to confirm the presence of a right knee meniscal condition and, if so, the symptoms associated with such. The left knee semilunar cartilage claim is also remanded as the VA examination for the right knee may provide new evidence regarding the severity of the left knee. The matters are REMANDED for the following action: 1. Schedule the Veteran for a VA examination to determine the nature and etiology of the Veteran’s claimed right and left knee semilunar cartilage disorders. The claims file, and a copy of this remand, will be available to and reviewed by the examiner. Although a complete review of the record is imperative, attention is called to the following: *A March 1993 service treatment record (STR) reflecting a 12-year history of DJD of the left knee and assessment of DJD of the left knee with probable meniscal tear. *A September 2003 VA examination report reflecting no meniscal issues noted on examination. *A November 2007 private MRI of the right knee demonstrating osteoarthritis of the right knee with cartilage defect and small tear at the posterior horn of the medial meniscus. *An October 2009 VA examination report reflecting diagnoses of osteoarthritis of the bilateral knees and a small tear at the posterior horn of the medial meniscus in the right knee. *An October 2012 MRI of the left knee revealing a horizontal tear at the posterior horn of the medial meniscus. *A November 2013 VA examination report reflecting diagnoses of bilateral meniscal tears with frequent episodes of joint pain and effusion bilaterally. *A September 2014 private operative report reflecting a diagnosis of both medial and lateral meniscal tears and chondromalacia patella. *An April 2018 VA examination report reflecting that the Veteran had a meniscus condition with frequent episodes of joint locking, pain, and effusion in the right knee and frequent episodes of joint pain and effusion in the left knee. *A September 2020 VA examination report reflecting that the Veteran had a meniscal tear with frequent episodes of joint locking in the left knee that was at least as likely as not incurred in or caused by service, although the current symptoms were residuals of the total knee replacement and not the meniscal condition. After reviewing the claims file in its entirety and examining the Veteran, if possible, the examiner is asked to address the following with complete rationale: a) Confirm whether the Veteran has semilunar cartilage dislocation in the RIGHT KNEE. i) If so, provide an opinion as to whether it is attributable to service or any service-connected disability. ii) If attributable to service or to a service-connected disability, address whether the semilunar cartilage dislocation in the right knee results in frequent episodes of locking, pain, and effusion in the joint, distinct from or in addition to any frequent episodes of locking, pain, and effusion in the joint due to the Veteran’s service-connected arthritis, instability, and crepitation. Describe the frequency and severity of such distinct of additional episodes of locking, pain, and effusion attributable to semilunar cartilage dislocation. The examiner should try to identify intervals, with specific dates, of greater or lesser severity of semilunar cartilage dislocation over the claim period. b) Describe the symptoms associated with the LEFT knee semilunar cartilage dislocation, including whether it results in frequent episodes of locking, pain, and effusion in the joint, distinct from or in addition to any frequent episodes of locking, pain, and effusion in the joint due to the Veteran’s service-connected arthritis, instability, and crepitation. Describe the frequency and severity of such distinct of additional episodes of locking, pain, and effusion attributable to semilunar cartilage dislocation. The examiner should try to identify intervals, with specific dates, of greater or lesser severity of semilunar cartilage dislocation over the claim period. A complete rationale should be provided for any opinion provided. 2. Thereafter, readjudicate the remanded claims on appeal. S. B. MAYS Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board J. Lee, 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.