Citation Nr: 21028967 Decision Date: 05/12/21 Archive Date: 05/12/21 DOCKET NO. 18-41 596 DATE: May 12, 2021 REMANDED A rating higher than 40 percent left total knee replacement status post revision (hereinafter left knee disability) is remanded. Service connection for right ankle sprain status post fusion (hereinafter right ankle disability) is remanded. REASONS FOR REMAND The Veteran served honorably on active duty in the United States Army from July 1977 to August 1983. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a May 2016 rating decision issued by a Department of Veterans Affairs (VA) Regional Office (RO). The Veteran attended a virtual hearing before the undersigned in May 2021. Left Knee Disability At his May 2021 hearing, the Veteran asserted that his left knee disability has increased in severity since he was last examined by VA. The Veteran should be provided an opportunity to report for a VA examination to ascertain the current severity and manifestations of left knee disability Right Ankle Disability The Board cannot make a fully-informed decision on the issue of service connection for right ankle disability. In May 2016, the Veteran underwent a VA examination for his claim. The examiner opined that it was less likely than not that that the Veteran's right ankle disability was due to an in-service ankle injury. In August 2016, the Veteran raised a contention that his right ankle disability was caused by his service connected left knee disability. No examiner has opined on whether the Veteran's left knee disability caused or aggravated beyond normal progression the Veteran's right ankle disability. As such, a remand is necessary to obtain an adendum opinion. Furthermore, the examiner based their opinion on the Veteran injuring his ankle in a road march. A review of service records indicate the Veteran injured his right ankle playing basketball. As such, a remand is necessary to obtain an adendum opinion. The matters are REMANDED for the following actions: 1. Obtain the Veteran's VA treatment records for the period from July 2018 to the Present. 2. 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. In so doing, the examiner must test the Veteran's active motion, passive motion, and pain with weight-bearing and without weight-bearing. 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). In so doing, the examiner must 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). 3. Obtain an addendum opinion from an appropriate clinician regarding whether the Veteran's right ankle disability is at least as likely as not (50 percent or greater) related to an in-service basketball injury. The claims file must be provided to the clinician for review. The clinician's attention is directed to the Veteran's service treatment records which show that he incurred a right ankle injury in August 1978 while playing basketball. The rational for the opinion must be provided. If the clinician feels that a physical examination is necessary to provide the requested opinion one should be scheduled. 4. Obtain an addendum opinion from an appropriate clinician regarding whether the Veteran's right ankle disability is at least as likely as not (50 percent or greater probability) proximately due to his service-connected left knee disability or aggravated beyond its natural progression by his service-connected left knee disability. The claims file must be provided to the clinician for review. The rational for the opinion must be provided. If the clinician feels that a physical examination is necessary to provide the requested opinion one should be scheduled. JOHN Z. JONES Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Michael Chandeck, Associate 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.