Citation Nr: 21014030 Decision Date: 03/11/21 Archive Date: 03/11/21 DOCKET NO. 03-08 282 DATE: March 11, 2021 REMANDED 1. Entitlement to an extraschedular evaluation for limited extension, left knee degenerative joint disease (DJD) with meniscal/anterior cruciate ligament (ACL) tears, is remanded. 2. Entitlement to an extraschedular evaluation for limited flexion, left knee degenerative joint disease with meniscal/anterior cruciate ligament (ACL) tears, is remanded. 3. Entitlement to an extraschedular evaluation for left knee instability is remanded. REASONS FOR REMAND The Veteran served on active duty from March 1987 to July 1990. The claim of entitlement to an extraschedular evaluation for a left knee disability was remanded by the Board in January 2016 and October 2016. In February 2017, the claim was referred to the Director of Compensation Service (Director) for extraschedular consideration under 38 C.F.R. § 3.321(b)(1) by the Appeals Management Center (AMC). In September 2017, the Director denied entitlement to an increased evaluation in excess of 30 percent, for subluxation and lateral instability of the left knee and in excess of 30 percent for limitation of extension of the left knee. In April 2015, the Board remanded the claim of entitlement to a separate evaluation for a left knee disability based upon locking of the knee and/or other manifestations of the semilunar cartilage for further development. In a January 2016 decision, the Board denied entitlement to a separate evaluation. The Veteran appealed the decision to the United States Court of Appeals for Veterans Claims (Court). A November 2017 Panel Decision from the Court reversed the Board’s finding that the Veteran’s pain and swelling associated with his left knee disability were compensated by his 30 percent evaluation under Diagnostic Code (DC) 5257 and remanded the Veteran’s left knee meniscal disability claim. The Court found that the Board did not properly assess whether the Veteran’s pain, swelling, popping, locking, and grinding associated with his left knee meniscal disability would have been compensated by his current left knee evaluation under DC 5261. Specifically, the Court found that a determination as to whether a separate evaluation of a meniscal disability under either DC 5258 or 5259 is warranted on the facts of the case or whether such evaluation would constitute impermissible pyramiding was necessary. In July 2018, the Board remanded the claim for entitlement to a separate evaluation for the left knee disability based upon locking of the knee and/or other manifestations of the semilunar cartilage for further development to comply with the Court’s directives. As it did not appear that the remand directives had been fulfilled, to include updating treatment records and scheduling an examination of the Veteran’s left knee, and the claim for a separate evaluation adjudicated, the claim of entitlement to an extraschedular evaluation for a left knee disability was remanded by the Board in October 2018, pending adjudication of the claim for a separation evaluation of the left knee disability, as these issues are inextricably intertwined. In an August 2020 decision, the Board denied entitlement to a separate evaluation for the left knee disability based upon locking of the knee and/or manifestation of the semilunar cartilage. As such, the Veteran’s claims for extraschedular evaluations for the left knee disability, as listed on the cover page, are back at the Board. During the pendency of the appeal, the rating criteria for evaluating musculoskeletal disabilities under 38 C.F.R. § 4.71a were amended effective February 7, 2021. 85 Fed. Reg. 230 (Nov.30, 2020). In a February 2021 Appellant’s Brief, the Veteran, through his representative, asserted that he has marked interference with his daily activities and that he has ongoing worsening symptoms of painful motion functional loss due to weakness, fatigability, incoordination or pain on movement of a joint, limitation of motion due to pain on use, including use during flare-ups. It was also asserted that the Veteran presented significant deficits with activities of daily living. Because the record does not contain sufficient evidence to rate the Veteran’s left knee disability under the new rating criteria and there is a suggestion of a worsening of the disability, a new examination is warranted to assess the current nature, extent and severity of the service-connected left knee disability on appeal. The matters are REMANDED for the following action: 1. Schedule the Veteran for a VA examination to evaluate the current severity of his service-connected left knee disability. All appropriate tests, studies, and consultations should be accomplished, and all clinical findings should be reported in detail, to include current symptomatology his left knee disability. The Veteran’s claims file should be reviewed by the examiner in conjunction with the examination. 2. The AOJ should take any additional development as deemed necessary and readjudicate the claims on appeal. A. P. SIMPSON Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board D. Cheng, 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.