Citation Nr: 21021132 Decision Date: 04/09/21 Archive Date: 04/09/21 DOCKET NO. 20-00 152A DATE: April 9, 2021 REMANDED Entitlement to a rating in excess of 10 percent for impairment of the right knee is remanded. Entitlement to a rating in excess of 10 percent for impairment of the left knee is remanded. REASONS FOR REMAND The Veteran served on active duty from October 1961 to October 1969. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a November 2018 rating decision issued by a Department of Veterans Affairs (VA) Regional Office (RO). In March 2021, the Veteran testified, sitting in California, before the undersigned. A transcript of the hearing has been associated with the virtual file and reviewed. The Board notes that the Veteran filed a claim for entitlement a temporary total evaluation for his right knee disability under 38 C.F.R. § 4.30 based on the need for convalescence following surgery. 01/24/2020, VA 21-526EZ. This claim is pending the issuance of a rating decision and is not before the Board at this time.   1. Entitlement to a rating in excess of 10 percent for impairment of the right knee is remanded. 2. Entitlement to a rating in excess of 10 percent for impairment of the left knee is remanded. The Veteran last underwent a VA examination in July 2018. The examiner noted mid joint line tenderness during range of motion (ROM) testing and that the Veteran’s abnormal ROM did not contribute to a functional loss. The examination was not conducted following repeated use over time nor during a flareup. The examiner did not provide an opinion as to whether flareups or repeated use over time limit the functional ability of the bilateral knees. 08/01/2018, C&P Exam. However, the record suggests that the Veteran’s symptoms has since worsened. The treatment records reveal that the Veteran underwent a total knee replacement of the right knee in July 2019. 02/06/2020, Medical Treatment Record – Non-Government Facility, page 10. And, during the March 2021 Board hearing, the Veteran testified that the pain in his bilateral knees has worsened since the October 2018 VA examination and that he experiences daily flareups. Additionally, the Veteran indicated that a total knee replacement for his left knee has been recommended by his medical provider. The Veteran reported that his knees are not straight and that there is a visible curve to his legs. The Veteran manages his bilateral knee pain with medication and uses assistive devices to ambulate. 03/16/2021, Hearing Transcript. Accordingly, the Board finds that an additional VA examination is warranted to assess the current severity of the Veteran’s right knee and left knee disabilities. 38 C.F.R. § 3.327(a). These matters are REMANDED for the following actions: 1. Obtain any outstanding VA treatment records. Additionally, request the Veteran to submit any relevant private treatment reports or provide VA with authorization to obtain any such records. 2. After completing directive # 1, schedule the Veteran for an examination of the current severity of his right knee and left knee disabilities. 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. The examiner must test the Veteran’s active motion, passive motion, and pain with weight-bearing and without weight-bearing. The examiner must also attempt to elicit information from the Veteran regarding the severity, frequency, and duration of any flare-ups, and the degree of functional loss during flare-ups. 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 is additionally limited to 30 degrees. Please explain why or why not. Additionally, to the extent possible, the examiner should identify any symptoms and functional impairments due to the right and left knee disabilities alone and discuss the effect of the Veteran’s right and left knee disabilities on any occupational functioning and activities of daily living. If it is not possible to provide a specific measurement, or an opinion regarding flare-ups, symptoms, or functional impairment without speculation, the examiner must state whether the need to speculate is due to a deficiency in the state of general medical knowledge (no one could respond given medical science and the known facts), a deficiency in the record (additional facts are required), or the examiner (does not have the knowledge or training). Paul Sorisio Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board David Han 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.