Citation Nr: 21041844 Decision Date: 07/10/21 Archive Date: 07/10/21 DOCKET NO. 17-64 239 DATE: July 10, 2021 REMANDED Entitlement to a rating in excess of 30 percent for status post total knee replacement, right knee (right knee condition) is remanded. Service connection for left knee condition as secondary to the service-connected right knee condition is remanded. REASONS FOR REMAND The Veteran had active duty in the Marine Corps from June 1971 to March 1973. The issues are on appeal from a July 2014 rating decision. In a February 2017 rating decision, the regional office (RO) granted a 100 percent evaluation for status post total knee replacement from January 12, 217 to February 28, 2018 and then a subsequent 30 percent rating for the right knee condition. As a claim for an increased rating will be presumed to be for the maximum available benefit allowed by law, a claim remains in controversy when less than the maximum available benefit has been awarded. See AB v. Brown, 6 Vet. App. 35, 38 (1993). The Veteran testified before the undersigned in a December 2020 hearing. A copy of the transcript is associated with the claims file. 1. Entitlement to a rating in excess of 30 percent for right knee condition is remanded. 2. Service connection for left knee is remanded. The Veteran was last afforded a VA examination to evaluate his knees in June 2014. The Board finds that a new VA examination is needed to assess the current manifestations and severity of his service-connected right knee condition as the Veteran has undergone right knee surgery since that date and has reported worsening of his right knee symptoms. Furthermore, in June 2014 and an addendum medical opinion in October 2017, a VA examiner opined that the Veteran's left knee degenerative joint disease was a product of aging, normal wear and tear, and his weight. Therefore, the examiner found that the left knee degenerative joint disease was less likely than not proximately due to or the result of the service-connected right knee condition. While the examiner offered a nexus opinion regarding the causation prong of secondary service connection, she did not provide an opinion regarding aggravation, another prong of secondary service connection. Thus, on remand, the Veteran's left knee should be examined along with his right knee in the ordered VA examination above, and an etiology opinion regarding secondary service connection should be obtained. Regarding both knees, the examiner must consider the Veteran's testimony explaining that he required a cane for walking up steps and ramps, and after prolonged standing and walking. He experienced instability and buckling sensations in each knee, and often used a wall or chair to stabilize himself. Finally, the Veteran testified that he had continued to receive treatment at the Tenth Street VA Medical Center since undergoing right knee surgery in January 2017. The most recent VA medical record is dated January 26, 2017. Therefore, any updated records since January 2017 should be obtained. The matters are REMANDED for the following action: 1. Obtain the Veteran's VA treatment records for the period from January 2017 to the Present. 2. Schedule the Veteran for a VA examination to assess the current nature and manifestations of the right and left knees. 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 of the right knee. 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). The examiner must note and consider the Veteran's testimony that he required a cane for walking up steps and ramps, and after prolonged standing and walking. He experienced instability and buckling sensations in each knee, and often used a wall or chair to stabilize himself. The examiner is also asked to opine whether the Veteran's left knee degenerative joint disease is at least as likely as not (i.e. 50 percent or greater) proximately due to his service-connected right knee condition OR aggravated beyond its natural progression by his service-connected right knee condition. (a) If aggravation is found, please identify to the extent possible the baseline level of disability prior to the aggravation. Again, the examiner should note and consider the Veteran's explanation that he required a cane for walking up steps and ramps, and after prolonged standing and walking. He experienced instability and buckling sensations in each knee, and often used a wall or chair to stabilize himself. Any opinions offered should contain sufficient and thorough rationale. 3. Readjudicate the appeals. L. M. BARNARD Veterans Law Judge Board of Veterans' Appeals Attorney for the Board J. Lee 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.