Citation Nr: 21014622 Decision Date: 03/15/21 Archive Date: 03/15/21 DOCKET NO. 13-23 279 DATE: March 15, 2021 REMANDED Entitlement to a compensable rating for limitation of extension due to patellofemoral syndrome of the left knee is remanded. Entitlement to an initial compensable rating prior to May 12, 2012, and in excess of 10 percent for limitation of extension due to patellofemoral syndrome of the right knee is remanded. Entitlement to a rating in excess of 10 percent for limitation of flexion due to patellofemoral syndrome of the right knee is remanded. Entitlement to a rating in excess of 10 percent for limitation of flexion due to patellofemoral syndrome of the left knee is remanded. Entitlement to a total disability based on individual unemployability (TDIU) is remanded. REASONS FOR REMAND The Veteran had active service from June 1975 to December 1988. These matters come before the Board of Veterans’ Appeals (Board) on an appeal from a July 2012 rating decision from a Department of Veterans Affairs (VA) Regional Office (RO). The Veteran appeared at a hearing before the undersigned Veterans Law Judge at the Regional Office (RO) in May 2018. A transcript is in the electronic record. In September 2020, the Court of Appeals for Veterans Claims (the Court) issued a Joint Motion for Partial Remand (JMPR) vacating and remanding the parts of the November 2019 decision that dealt with the Veteran’s knee disabilities and the reasonably raised issued of a total disability based on individual unemployability (TDIU). 1. Entitlement to a compensable rating for limitation of extension due to patellofemoral syndrome of the left knee is remanded. 2. Entitlement to an initial compensable rating prior to May 12, 2012, and in excess of 10 percent for limitation of extension due to patellofemoral syndrome of the right knee is remanded. 3. Entitlement to a rating in excess of 10 percent for limitation of flexion due to patellofemoral syndrome of the right knee is remanded. 4. Entitlement to a rating in excess of 10 percent for limitation of flexion due to patellofemoral syndrome of the left knee is remanded. The Board finds that a remand of the abovementioned claims is warranted given the Veteran’s representative’s statements of worsening and increased severity of his left knee disabilities since his June 2019 VA examination. See Appellate Brief received 2/23/2021 at page 2. The VA must provide a new examination with consideration of all pertinent evidence when there is an indication that the record does not adequately reveal the current state of the claimed disability. Palczewski v. Nicholson, 21 Vet. App. 174, 181-82 (2007). Accordingly, the bilateral knee disability claims are remanded for a new VA examination as outlined below. 5. Entitlement to a TDIU is remanded. Finally, because a change of the evaluation regarding the remanded issues above could significantly impact a decision on the issue of a TDIU, the issues are inextricably intertwined. A remand of TDIU is required. These matters are REMANDED for the following actions: 1. Schedule the Veteran for a VA examination to assess the current nature and severity of his service-connected patellofemoral syndrome of the left and right knees. Range of motion should be reported, including whether and the extent to which such motion is affected by pain, weakness, fatigue, lack of endurance, incoordination or other symptoms resulting in functional loss. a. Based upon a review of the medical records, lay statements submitted in support of the claim, and/or statements elicited from the Veteran during the examination, state whether the Veteran experiences flare ups of his service-connected knee disability, and how he characterizes the additional functional loss during a flare. b. If the Veteran describes experiencing flare ups, identify the: o frequency; o duration; o precipitating factors; and o alleviating factors. c. Based upon the information elicited as a result of the foregoing, state whether it is at least as likely as not (50 percent probability or greater) that during a flare up range of motion (extension) is additionally limited to 15 degrees. Please explain why or why not.   d. Based upon the information elicited as a result of the foregoing, state whether it is at least as likely as not (50 percent probability or greater) that during a flare up the disability is manifested by effusion and/or locking. The examiner must provide a complete rationale for his or her opinions in the examination report. If the examiner cannot provide the requested opinions without resorting to speculation, he/she should explain why an opinion cannot be provided (e.g. lack of sufficient information/evidence in this case, or a lack of knowledge among the medical community at large, and not the insufficient knowledge of the individual examiner). If the inability to provide an opinion without resorting to speculation is due to a deficiency in the record (additional facts are required), the AOJ should develop the claim to the extent it is necessary to cure any such deficiency. If the inability to provide an opinion is due to the examiner’s lack of requisite knowledge or training, then the AOJ should obtain an opinion from a medical professional who has the knowledge and training needed to render such an opinion. (Continued on the next page)   2. Take appropriate action to develop the TDIU matter, to include asking the Veteran to submit a formal TDIU application, VA 21-8940 Veterans Application for Increased Compensation Based on Unemployability, to include completing the needed information about his educational background and work history. Paul Sorisio Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board S. Dixon, 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.