Citation Nr: 21027694 Decision Date: 05/06/21 Archive Date: 05/06/21 DOCKET NO. 14-09 359 DATE: May 6, 2021 REMANDED Entitlement to a rating in excess of 20 percent for residuals, left knee injury with patellar subluxation is remanded. Propriety of the assignment of a separate 40 percent rating for patellofemoral pain syndrome, meniscal tear, and patellar realignment, with limited extension, as of February 5, 2019, is remanded. REASONS FOR REMAND The Veteran served on active duty from August 1989 to February 1990. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a rating decision issued in October 2012. In April 2017, the Veteran testified at a Board hearing before the undersigned Veterans Law Judge. A transcript of the hearing is associated with the record. In April 2018 and April 2020, the Board remanded the case for additional development and it now returns for further appellate review. 1. Entitlement to a rating in excess of 20 percent for residuals of a left knee injury with patellar subluxation. 2. Propriety of the assignment of a separate 40 percent rating for patellofemoral pain syndrome, meniscal tear, and patellar realignment, with limited extension of the left knee, as of February 5, 2019. In April 2020, the Board found a February 2019 VA examiner failed to provide certain opinions requested in the April 2018 Remand. In particular, the VA examiner did not offer an opinion as to the range of motion findings for pain on active and passive motion and on weight-bearing and nonweight-bearing for the Veteran's left knee disability on examination in October 2012 and June 2013. Thus, the Board remanded the case to ensure compliance with the prior Remand directives by obtaining an addendum opinion addressing such matter. In January 2021, the Veteran underwent another VA examination, and in February 2021, the VA examiner provided an addendum opinion; however, it appears that he may not have understand the specific requests. Instead of providing estimations with respect to the range of motion findings for pain on passive range of motion, the VA clinician merely indicated that such testing was not conducted and attempted to opine as to why the active range of motion findings differed between the 2012 and 2013 VA examinations. Moreover, the VA examiner did not provide an opinion with respect to the range of motion findings for pain on weight-bearing and nonweight-bearing during such VA examinations. Thus, the Board finds the February 2021 addendum opinion did not substantially comply with the Remand directives. Stegall v. West, 11 Vet. App. 268, 271 (1998). Thus, an additional remand is necessary to obtain an adequate medical opinion. The matters are REMANDED for the following action: Forward the Veteran's record, to include a copy of this Remand, to the VA examiner who provided the February 2021 opinion, or an appropriate clinician if he is unavailable, for an addendum opinion concerning the range of motion findings for the Veteran's service-connected left knee disability from past examinations. Following a review the VA examination reports containing range of motion findings pertinent to the Veteran's left knee that were conducted in October 2012 and June 2013, the clinician should estimate, preferably in terms of degrees, the range of motion findings rendered during such examinations for pain on passive motion and on weight-bearing and nonweight-bearing. A rationale for any opinion offered should be provided. If the examiner cannot provide an opinion without resorting to mere speculation, s/he must make clear that s/he has considered all procurable data, but any member of the medical community at large could not provide such an opinion without resorting to speculation. A. JAEGER Veterans Law Judge Board of Veterans' Appeals Attorney for the Board M. M. Celli, 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.