Citation Nr: 21025254 Decision Date: 04/27/21 Archive Date: 04/27/21 DOCKET NO. 16-40 377 DATE: April 27, 2021 REMANDED Entitlement to an initial rating in excess of 10 percent for right knee tricompartmental osteoarthritis with complete medial meniscal posterior horn and body degeneration under 38 C.F.R. § 4.71a, Diagnostic Codes 5003, 5260 is remanded. Entitlement to an initial compensable rating for right knee tricompartmental osteoarthritis with complete medial meniscal posterior horn and body degeneration under 38 C.F.R. § 4.71a, Diagnostic Codes 5003, 5261 is remanded. Entitlement to an initial rating in excess of 10 percent for right knee tricompartmental osteoarthritis with complete medial meniscal posterior horn and body degeneration under 38 C.F.R. § 4.71a, Diagnostic Code 5257 is remanded. REASONS FOR REMAND The Veteran had active service from August 1963 to August 1965. Entitlement to an initial rating in excess of 10 percent under 38 C.F.R. § 4.71a, Diagnostic Codes 5003, 5260; an initial compensable rating under 38 C.F.R. § 4.71a, Diagnostic Codes 5003, 5261; and an initial rating in excess of 10 percent under 38 C.F.R. § 4.71a, Diagnostic Code 5257for right knee tricompartmental osteoarthritis with complete medial meniscal posterior horn and body degeneration is remanded. The report of a December 2020 knee examination conducted for the Department of Veterans Affairs (VA) states that the Veteran exhibited a right knee range of motion of 0 to 60 degrees with pain on flexion and pain with weight bearing. The examiner commented that: “pain noted on examination and causes functional loss;” “pain after standing less than a few minutes, after sitting 5 minutes, after walking a few steps, if lifting/carrying more than 2 pounds, and with getting in and out of a vehicle;” “unable to climb stairs due to pain;” “there is objective evidence of pain on passive range of motion testing of the right knee;” and “there is objective evidence of pain on non weight bearing testing of the right knee.” The nurse practitioner did not indicate the degree at which the Veteran experienced pain on motion of the right knee. Given that deficiency, the Board finds that the functional loss associated with the service connected right knee disability is unclear and the examination report is of limited probative value. VA’s duty to assist includes, in appropriate cases, the duty to conduct a thorough and contemporaneous medical examination which is accurate and fully descriptive. McLendon v. Nicholson, 20 Vet. App. 79 (2006); Green v. Derwinski, 1 Vet. App. 121, 124 (1991). When VA undertakes to obtain an evaluation, it must ensure that the evaluation is adequate. Barr v. Nicholson, 21 Vet. App. 303, 312 (2007). The Board concludes that further VA knee evaluation is needed. The Board observes that the Secretary of VA has recently amended that portion of 38 C.F.R. Part 4 which pertain to musculoskeletal disabilities. On February 7, 2021, the provisions of 38 C.F.R. § 4.71a, Diagnostic Codes 5003, 5257 addressing degenerative arthritis and knee impairment were amended. Schedule for Rating Disabilities: Musculoskeletal System and Muscle Injuries, 85 Fed. Reg. 76453, 76463 (Nov. 30, 2020) (to be codified at 38 C.F.R. § 4.71a, Diagnostic Codes 5003, 5257. Clinical documentation dated after January 2021 is not of record. VA should obtain all relevant VA and private treatment records which could potentially be helpful in resolving the Veteran’s claims. Murphy v. Derwinski, 1 Vet. App. 78 (1990); Bell v. Derwinski, 2 Vet. App. 611 (1992). The matter is REMANDED for the following action: 1. Ask the Veteran to complete a VA Form 21-4142 for each private healthcare provider who has treated the service connected right knee disability. Make two requests for the authorized records from all identified healthcare providers unless it is clear after the first request that a second request would be futile. 2. Obtain any VA treatment records not of record, to include those pertaining to treatment after January 2021. 3. Schedule the Veteran for a VA examination conducted by a medical doctor to assist in determining the current nature and severity of the right knee tricompartmental osteoarthritis with complete medial meniscal posterior horn and body degeneration. The examiner must review the record and should note that review in the report. A rationale for all opinions should be provided. The examiner should: (a) Provide ranges of motion for weight-bearing and nonweight-bearing and passive and active motion of the right knee. The examiner should specifically indicate the degree at which the Veteran experiences pain on motion of the right knee. (b) State whether there is any additional loss of function of the right knee due to painful motion, weakened motion, excess motion, fatigability, incoordination, or on flare up. (c) State whether there is any recurrent lateral instability or subluxation of the right knee and, if so, the severity of any instability or subluxation. (d) Provide an opinion as to the impact of the right knee disability on the Veteran’s vocational pursuits. J. T. HUTCHESON Acting Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Edward G. Lent 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.