Citation Nr: 21023897 Decision Date: 04/21/21 Archive Date: 04/21/21 DOCKET NO. 15-06 858A DATE: April 21, 2021 REMANDED Entitlement to an evaluation greater than 10 percent for chronic synovitis of the left knee is remanded. Entitlement to service connection for hypertension is remanded. Entitlement to service connection for chronic muscular strain of the right shoulder with degenerative arthritis, tendinitis, and rotator cuff impingement is remanded. Entitlement to service connection for chronic muscular strain of the left shoulder with degenerative arthritis, tendinitis, and rotator cuff impingement is remanded. REASONS FOR REMAND The Veteran had active service in the United States Navy from September 1989 to September 1992. He served in the United States Naval Reserve from October 1995 to October 1998. The Veteran also had a period of active service in the United States Army from November 4, 2006, to November 5, 2006. Finally, he had additional service in the Oregon National Guard. These matters are on appeal from a November 2010 rating decision. In June 2018, the Board remanded the appeal to verify the Veteran’s periods of active service and to afford him a contemporaneous knee examination. 1. Entitlement to an evaluation greater than 10 percent for chronic synovitis of the left knee is remanded. In July 2019, the Veteran underwent a VA knee examination to determine the current severity of his left knee disability. The VA examiner indicated that pain caused functional loss but did not indicate at which point pain begins. Additionally, the VA examiner did not disclose passive ranges of motion. Therefore, a remand is required to obtain an adequate VA examination. 2. Entitlement to service connection for hypertension is remanded. In June 2007, the Veteran’s blood pressure was 139/87. He was determined to have borderline high blood pressure. The Veteran’s separation examination in September 1992 was 138/71. His VA treatment records indicate that he has been prescribed blood pressure medication. A remand is required to obtain a medical opinion to determine whether the Veteran’s hypertension is related to his active service. 3. Entitlement to service connection for chronic muscular strain of the right shoulder with degenerative arthritis, tendinitis, and rotator cuff impingement is remanded. 4. Entitlement to service connection for chronic muscular strain of the left shoulder with degenerative arthritis, tendinitis, and rotator cuff impingement is remanded. In March 2018, the Veteran testified that he injured his right shoulder when he fell in-service. He endorsed pain since service and indicated that his left shoulder disability was the result of compensating for his injured right shoulder. A review of the service treatment records indicates that the Veteran sustained a right arm fracture in March 1990, which is a period of active service. A remand is required to afford the Veteran a VA examination to determine whether the Veteran’s right shoulder disability is at least as likely as not related to his March 1990 right arm fracture. An opinion is also needed to address whether the Veteran’s left shoulder is disability is at least as likely as not caused or aggravated by the right shoulder disability. The matters are REMANDED for the following actions: 1. Schedule the Veteran for an examination by an appropriate clinician to determine the current severity of his service-connected left 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. 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 at all 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). Furthermore, the VA examiner is asked to provide ranges of motion for passive and active ranges of motion and to indicate at which degree pain begins. 2. Obtain an addendum opinion from an appropriate clinician regarding whether the Veteran’s hypertension is at least as likely as not related to his active service. In rendering the opinion, the VA examiner is asked to comment on his September 1992 separation examination that showed his blood pressure was 138/71. A rationale must be provided for the opinion. 3. Schedule the Veteran for a VA examination for his bilateral shoulder disabilities. The examiner must review the claims file. If a diagnosis cannot be provided but the Veteran’s condition manifests in symptoms that cause functional impairment, then the examiner should consider them a “disability” for the purpose of providing the requested opinions below. The examiner is asked to provide a response to the following: Is the Veteran’s right shoulder disability at least as likely as not related to service, including the March 1990 right arm fracture? Is the Veteran’s left shoulder disability at least as likely as not proximately due to the right shoulder disability? Is left shoulder disability at least as likely as not aggravated, i.e., worsened beyond its natural progression, by the right shoulder disability Provide a rationale to support the opinions. 4. After the above development, and any additionally indicated development, has been completed, readjudicate the issues on appeal. If the benefits sought are not granted to the Veteran’s satisfaction, send the Veteran and his representative a Supplemental Statement of the Case   and provide an opportunity to respond. If necessary, return the case to the Board for further appellate review. DAVID L. WIGHT Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board R.R. Watkins, 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.