Citation Nr: 21014024 Decision Date: 03/11/21 Archive Date: 03/11/21 DOCKET NO. 14-30 153 DATE: March 11, 2021 REMANDED Entitlement to a rating in excess of 10 percent for a right knee disability is remanded. Entitlement to a total disability rating based on individual unemployability due to service-connected disability(TDIU) is remanded. REASONS FOR REMAND The Veteran served on active duty from April 1971 to April 1973, February 2002 to December 2002, and February 2003 to February 2004. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from an April 2014 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO). In April 2016, the Veteran testified before the undersigned Veterans Law Judge. The Board remanded this matter in November 2016 and April 2020 for additional development. 1. Entitlement to a rating in excess of 10 percent for a right knee disability is remanded. The Veteran was last afforded a VA knee examination in February 2017. VA treatment records indicate that the Veteran was advised to have knee replacement surgery, which he refused. See May 2019 VA treatment record. In March 2021, the Veteran’s representative requested a new VA examination to assess the current severity of the Veteran’s right knee disability. The Board finds that, given the potential worsening of his condition in May 2019, a new examination should be provided in order to assess the current nature and severity of his service-connected right knee disability. See Snuffer v. Gober, 10 Vet. App. 400, 403 (1997). Any outstanding records should also be secured. 2. Entitlement to a TDIU is remanded. As a decision on the increased rating claim could significantly impact a decision on the TDIU claim, the issues are inextricably intertwined; thus, consideration of this matter must be deferred pending resolution of the increased rating claim. See Harris v. Derwinski, 1 Vet. App. 180, 183 (1991). The matters are REMANDED for the following action: 1. Obtain any outstanding VA treatment records. 2. With any necessary assistance from the Veteran, obtain all outstanding private orthopedic treatment records. If any records are unavailable, notify the Veteran pursuant to 38 C.F.R. § 3.159(e). 3. Then schedule the Veteran for a VA examination to determine the current nature and severity of his right knee disability. The claims file, to include a copy of this remand must be made available to and be reviewed by the examiner. All findings should be reported in detail. The examiner is asked to address the following: Full range of motion testing must be performed where possible. The joints involved should be tested in (1) active motion, (2) passive motion, (3) in weight-bearing, (4) in nonweight-bearing, and (5) the opposite undamaged joint. 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. Considering the Veteran’s reported history, please also provide an opinion describing functional impairment of the Veteran’s right knee due to flare-ups, accounting for pain, incoordination, weakened movement, and excess fatigability on use, and, to the extent possible, report such impairment in terms of additional degrees of limitation of motion. If the examiner is unable to provide such an opinion without resort to speculation, the examiner must provide a rationale for this conclusion, with specific consideration of the instructions in the VA Clinician’s Guide to estimate, “per [the] veteran,” what extent, if any, flare-ups affect functional impairment. The examiner must include a discussion of any specific facts that cannot be determined if unable to opine without speculation. A complete rationale shall be given for all opinions and conclusions expressed. 4. If following the above directives, the schedular requirements for a TDIU are not met, refer to the Director of Compensation Service the matter of whether a TDIU is warranted on an extraschedular basis pursuant to 38 C.F.R. § 4.16(b). The Director’s attention is drawn to the May 2020 VA medical opinion indicating that the Veteran would not be able to return to his position in building and lawn maintenance at this time due to his right knee disability. S. BUSH Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board K. Forde, 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.