Citation Nr: 21022490 Decision Date: 04/15/21 Archive Date: 04/15/21 DOCKET NO. 15-26 773 DATE: April 15, 2021 REMANDED The issue of entitlement to an initial disability rating in excess of 10 percent for left knee strain is remanded. REASONS FOR REMAND The Veteran served on active duty from June 1985 to August 1985, January 1986 to January 1990, December 1990 to September 1991, and from September 1991 to October 1992. This matter comes to the Board of Veterans' Appeals (Board) on appeal from a December 2014 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO) in Philadelphia, Pennsylvania. The Veteran testified at a hearing before the undersigned Veterans Law Judge (VLJ) via videoconference in November 2018 and a transcript of the hearing has been associated with the claims file. This matter was previously before the Board in April 2019 at which time it was remanded for further development. Entitlement to an initial disability rating in excess of 10 percent for left knee strain is remanded. A December 2019 VA examiner indicated that during his assessment the Veteran did not report, VBMS medical treatment records on review did not consistently document an ongoing history of, and physical examination did not demonstrate objective findings consistent with flare-ups, clinical exacerbation with repetitive use over time, and/or knee joint effusion or locking. The examiner therefore concluded that description of any putatively associated factors, including further limited range of motion and provision of relevant medical opinions as originally requested in the BVA remand were rendered moot. The Board finds the December 2019 VA opinion inadequate to decide the Veteran’s claim for an initial disability rating in excess of 10 percent for left knee strain. As noted in the April 2019 Board remand, the Veteran testified during the November 2018 Board hearing that he experiences flare-ups once a month resulting in pain, swelling, knee buckling, inability to run or stand for long periods of time, and difficulty climbing and descending stairs. As there is evidence that the Veteran experienced flare-ups during the period on appeal, the December 2019 VA examiner should have attempted to estimate the Veteran's functional loss during a flare-up in terms of limitation of motion based on the information procured from relevant sources, including the Veteran's lay statements. The April 2019 Board remand directives specifically asked the examiner to give an opinion regarding the functional effects of flare-ups of the Veteran's service-connected left knee strain. When VA undertakes to provide a VA examination or obtain a VA opinion, it must ensure that the examination or opinion is adequate. Barr v. Nicholson, 21 Vet. App. 303, 312 (2007). A remand by the Board also confers on a claimant, as a matter of law, the right to compliance with remand requests. Stegall v. West, 11 Vet. App. 268 (1998). Therefore, the Board finds that an addendum opinion is required in order to comply with the April 2019 Board remand directives. The matters are REMANDED for the following action: 1. Request that the Veteran provide or authorize VA to obtain records of his relevant treatment that have not yet been associated with the claims file, and associate with the claims file any outstanding VA treatment records. 2. Forward a copy of this remand to a qualified examiner for the purpose of obtaining an opinion based on file review. (a.) 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 (for flexion) (the measurement required for the next higher rating). Please explain why or why not. Please estimate functional loss that occurred during flare-ups, using information procured from relevant sources of record in addition to examination reports, including lay statements from Veteran. The Veteran testified during the November 2018 Board hearing that he experiences flare-ups about once a month. Symptoms of flare-ups include pain, swelling, and knee buckling. The Veteran further testified that he cannot run or stand for long periods of time; and he has difficulty climbing and descending stairs. The flare-ups require rest, elevation, and medication for alleviation. (b.) State whether it is at least as likely as not (50 percent probability or greater) that repetitive use over time additionally limits motion to 30 degrees or less (for flexion) or 10 degrees or more (for extension). Please explain why or why not. (c.) 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. 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. S.C. Krembs Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board J. Smith-Jennings, 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.