Citation Nr: 21028292 Decision Date: 05/10/21 Archive Date: 05/10/21 DOCKET NO. 15-35 187A DATE: May 10, 2021 REMANDED Entitlement to a rating in excess of 20 percent for right knee limitation of motion prior to January 11, 2019, is remanded. REASONS FOR REMAND The Veteran served on active duty from January 1967 to December 1969. In a December 2019 decision, the Board declined to grant an increased rating for right knee limitation of motion prior to January 11, 2019. A December 2020 Court of Appeals for Veterans Claims (CAVC) order vacated the Board's decision regarding this issue, and adopted a Joint Motion for Remand (JMR) for reconsideration of the Veteran's claim. This issue is once again before the Board for further adjudication The December 2020 JMR indicates that the Board relied on an inadequate examination that did not comply with Sharp v. Shulkin, 29 Vet. App. 26, 34-36 (2017). In Sharp v. Shulkin 29 Vet. App. 26 (2017), a CAVC decision addressed what constitutes an adequate explanation for an examiner's inability to estimate motion loss in terms of degrees during periods of flare-ups. CAVC held that a VA examiner must attempt to elicit information from the record and the Veteran regarding the severity, frequency, duration, or functional loss manifestations during flare-ups before determining that an estimate of motion loss in terms of degrees could not be given. It also held that any inability to furnish such an estimate must be predicated on a lack of medical knowledge among the medical community at large, rather than insufficient knowledge by the individual examiner. Id. The December 2020 JMR indicates that the October 2014 VA examiner failed to state the severity, frequency, and duration of flare ups or name precipitating or alleviating factors, and estimate to what extent they affect functional impairment. The December 2020 JMR also indicates the October 2014 VA examination did not satisfy the requirements of Correia v. McDonald, 28 Vet. App. 158, 168 (2016). As noted in the December 2019 Board decision, the October 2014 VA examiner, after examining and interviewing the Veteran, opined that the Veteran would experience an additional 10 degrees loss of flexion during flare-ups, but no additional loss of extension, amounting to a limitation of 20 degrees of flexion during flare-ups. In addition to estimating the range-of-motion limitations during flare-ups, the October 2014 VA examiner also noted contributing factors of pain, weakness, fatigability, and/or incoordination during flare-ups or repeated use over time. Based on the December 2020 JMR, a remand is needed to comply with Sharp and Correia to determine the appropriate rating for the Veteran's right knee limitation of motion prior to January 11, 2019. The Board notes that the Veteran's rating of 100 percent disabled for status post right knee total arthoplasty effective January 11, 2019; a separate rating of 10 percent disabled for right knee instability prior to January 11, 2019; and a separate rating of 10 percent disabled for symptomatic removal of right knee cartilage prior to January 11, 2019, are not currently before the Board. See December 2020 JMR. The matters are REMANDED for the following action: 1. Obtain VA treatment records since November 2020 and associate them with the claims file. 2. Schedule the Veteran for an examination of the current severity of his right knee limitation of motion. In order to comply with Sharp v. Shulkin, 29 Vet. App. 26, 33 (2017), the examiner is asked to describe whether pain, weakness, fatigue and/or incoordination significantly limits functional ability during flares or repetitive use, and if so, the examiner must estimate range of motion during flares or repetitive use. The examiner should have the Veteran describe and/or demonstrate the extent of motion loss during flares or repetitive use and provide the extent of motion loss described in terms of degrees. If there is no pain and/or no limitation of function, such facts must be noted in the report. The examiner should comment as to whether there is any medical reason to accept or reject the Veteran's description of reduced range of motion during flares or repetitive use. The examiner should also accomplish the following: Determine whether there is any medical reason to accept or reject the October 2014 VA examiner's estimation that the Veteran would experience an additional 10 degrees loss of flexion during flare-ups, but no additional loss of extension, amounting to a limitation of 20 degrees of flexion during flare-ups, and whether there is sufficient lay and medical evidence to determine whether the Veteran would experience greater limitation of motion during flares; and state the severity, frequency, and duration of flare ups; and name precipitating and alleviating factors; and estimate to what extent all of these affect functional impairment. Also, in order to comply with the Court's decision in Correia v. McDonald, 28 Vet. App. 158 (2016), the VA examination must include range of motion testing of both the right and left knees in the following areas: active motion; passive motion; weight-bearing; and nonweight-bearing. The examiner is asked to explain whether and why these measurements of the right and left knees would have changed since January 11, 2019, and estimate what these measurements would have been if they have changed. A complete medical rationale for all opinions expressed must be provided. T. MAINELLI Veterans Law Judge Board of Veterans' Appeals Attorney for the Board C. Howell, 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.