Citation Nr: 21023584 Decision Date: 04/21/21 Archive Date: 04/21/21 DOCKET NO. 13-03 619 DATE: April 21, 2021 ORDER Service connection for left total knee replacement is granted. REMANDED The issue of an increased rating of more than 10 percent for right knee osteoarthritis is remanded. FINDING OF FACT Resolving reasonable doubt in the Veteran’s favor, his left knee disability is related to active service. CONCLUSION OF LAW The criteria to establish service connection for left knee osteoarthritis have been met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from September 1976 to September 1980, and from March 1982 to April 2002. These matters come before the Board of Veterans’ Appeals (Board) on appeal from an August 2010 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO). In August 2016, the Veteran testified at a Board videoconference hearing before the undersigned Veterans Law Judge. A copy of the hearing transcript is associated with the claims file. The Veteran’s claims were last before the Board in June 2017 and remanded for additional development. The claims have since been returned for further appellate review. The Board finds substantial compliance with remand directives. The issue of service connection for left total knee replacement. The Veteran contends his left knee disability is related to trauma to the knee during service. Alternatively, he contends that his left knee disability is aggravated by his service-connected right knee disability. Certain chronic diseases will be presumed related to service if they were shown as chronic in service; or, if they manifested to a compensable degree within a presumptive period following separation from service; or, if they were noted in service, with continuity of symptomatology since service that is attributable to the chronic disease. 38 U.S.C. §§ 1101, 1112, 1113, 1137; 38 C.F.R. §§ 3.303, 3.307, 3.309. Walker v. Shinseki, 708 F.3d 1331, 1338 (Fed. Cir. 2013). The Veteran has a current diagnosis of left total knee replacement as evidenced by the February 2018 VA examination. The Veteran was also previously diagnosed with osteoarthritis of the left knee prior to his total knee replacement by his private physician in 2016. Arthritis is an enumerated condition under 38 C.F.R. § 3.309(a); Walker, 708 F.3d 1331. Service treatment records show the Veteran complained of knee trouble and was diagnosed with degenerative joint disease of the knees, during active service. March 2009 post-service, private treatment records show that the Veteran continued to complain of knee pain and it was noted that this pain had persisted for several years. July 2013 VA medical treatment records reflect the Veteran’s reports of bilateral knee pain for 12 years. In June 2017, the Veteran underwent a left total knee replacement. The surgeon noted the Veteran had osteoarthritis and failed conservative treatment which included injections, physical therapy and medication, led to the election of a total knee replacement. The Veteran continued to experience the same symptoms of left knee pain during and since service. The Veteran is competent to report that he experienced symptoms of left knee pain. His reports are credible and entitled to probative weight, as they are internally consistent and consistent with other evidence of record, which shows the Veteran’s left knee pain was attributable to the Veteran’s osteoarthritis which led to his total knee replacement. The claim is granted. The RO will assign an appropriate disability rating on receipt of this decision. Ferenc v. Nicholson, 20 Vet. App. 58 (2006) (discussing the distinction in the terms “compensation,” “rating,” and “service connection” as although related, each having a distinct meaning as specified by Congress). REASONS FOR REMAND The issue of an increased rating greater than 10 percent for right knee osteoarthritis is remanded. The matter is REMANDED for the following action: 1. BACKGROUND FOR THE RO ADJUDICATOR: Remand of the issue of an increased rating for right knee osteoarthritis is necessary because the Veteran has not been afforded a VA examination since February 2018. In statements submitted in October 2020, the Veteran noted that he needed a total right knee replacement. VA treatment records from 2019 and 2020 reflect the Veteran may soon require a total knee replacement and noted the Veteran suffered from a limp and the right knee was swelling and hurting more. This evidence indicates that there has been a worsening of the Veteran’s right knee since his last examination. Thus, the Board finds a new VA examination is required to determine the current severity of the Veteran’s right knee disability. The remand directives follow. 2. Schedule the Veteran for an examination by an appropriate clinician to determine the current severity of his service-connected right knee disability. The examiner should provide a full description of the disability and report all signs and symptoms necessary for evaluating the Veteran’s disability under the rating criteria. In so doing, the examiner must test the Veteran’s active motion, passive motion, and pain with weight-bearing and without weight-bearing. If it is not possible to provide a specific measurement 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). The examiner must also attempt to elicit information regarding the severity, frequency, and duration of any flare-ups, and the degree of functional loss during flare-ups. If it is not possible to provide a specific measurement based on direct observation, the examiner should provide an estimate, if possible, of the additional impairment due to flare-ups based on the other evidence of record and the Veteran’s statements. If it is not possible to provide a specific measurement 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). 3. Readjudicate the issue on appeal. If any benefit sought on appeal remains denied, the Veteran and his representative should be provided a supplemental statement of the case (SSOC). An appropriate period should be allowed for response before the case is returned to the Board. Vito A. Clementi Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board K. McDuffie, 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.