Citation Nr: 21027782 Decision Date: 05/06/21 Archive Date: 05/06/21 DOCKET NO. 14-31 175 DATE: May 6, 2021 REMANDED Entitlement to a compensable evaluation prior to March 29, 2019, and an evaluation greater than 10 percent thereafter for patellofemoral pain syndrome of the right knee status post arthroscopic surgery with knee fracture, instability, synovial cysts, and degenerative arthritis is remanded. Entitlement to a compensable evaluation prior to March 29, 2019, and a 10 percent evaluation thereafter for left knee patellofemoral syndrome is remanded. REASONS FOR REMAND The Veteran served on active duty from July 1984 to November 1984 and from January 1986 to April 1994. These matters are on appeal from a June 1998 rating decision. In September 2014, the Board remanded the appeal to schedule the Veteran for a Board hearing. The Veteran appeared before the undersigned Veterans Law Judge at a videoconference hearing in June 2017. A hearing transcript is associated with the record. In March 2018, the Board remanded the appeal to afford the Veteran a contemporaneous VA knee examination. In December 2020, the Veteran testified at another Board hearing before the undersigned. 1. Entitlement to a compensable evaluation prior to March 29, 2019, and an evaluation greater than 10 percent thereafter for patellofemoral pain syndrome of the right knee status post arthroscopic surgery with knee fracture, instability, synovial cysts, and degenerative arthritis is remanded. 2. Entitlement to a compensable evaluation prior to March 29, 2019, and a 10 percent evaluation thereafter for left knee patellofemoral syndrome is remanded. Pursuant to the Board's March 2018 remand directives, the Veteran was afforded another VA examination in March 2019. The VA examiner noted bilateral pain that caused functional loss on flexion and extension. However, the VA examiner did not indicate the additional loss of range of motion due to pain. As the VA examiner did not address whether functional loss caused additional range of motion limitations, the Board finds that the June 2019 VA knee examination is inadequate. See Mitchell v. Shinseki, 25 Vet. App. 32, 43-44 (2011) (explaining that the Board should determine the amount of additional range of motion loss a veteran experiences when pain causes functional loss); DeLuca v. Brown, 8 Vet. App. 202, 206-07 (1995). Therefore, a remand is necessary to obtain another VA knee examination to determine the nature and current severity of the Veteran's bilateral knee disabilities. 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 bilateral knee disabilities. 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). If the VA examiner finds that pain causes functional loss, the VA examiner should determine the amount of additional range of motion loss. 2. 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.