Citation Nr: 21042835 Decision Date: 07/14/21 Archive Date: 07/14/21 DOCKET NO. 16-01 924 DATE: July 14, 2021 REMANDED Entitlement to an initial rating in excess of 10 percent for a right knee disability manifested by limitation of flexion is remanded. Entitlement to an initial compensable rating for a right knee disability manifested by limitation of extension is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Army from October 1988 to July 1996. This matter comes before the Board of Veterans' Appeals (Board) on appeal from an August 2009 rating decision issued by a Department of Veterans Affairs (VA) Regional Office (RO), which granted service connection for a right knee strain and assigned a noncompensable rating, effective August 11, 2008. In January 2015, the Board remanded the appeal for further development. In a May 2015 rating decision, the RO increased the rating for the Veteran's right knee limited flexion rating to 10 percent, effective May 2, 2015. In October 2014 and January 2019, the Veteran testified during Board hearings before the undersigned Veterans Law Judge. In November 2019, the Board again remanded the appeal for further development. In an October 2020 rating decision, the RO extended the 10 percent rating for right knee strain with limitation of flexion to August 11, 2008, and granted service connection for right knee strain with limitation of extension and assigned a noncompensable rating, effective October 6, 2020. In a May 2021 Appellate Brief, the Veteran's representative argued that the effective date for both flexion and extension should cover the entirety of the applicable appeal period, or from August 11, 2008. The Board agrees. Unfortunately, another remand is required. Pursuant to the Board's November 2019 remand directives, the Veteran was afforded a VA knee examination in October 2020. The Board asked the examiner to: (i) Please comment as to whether the Veteran's right knee disability is manifested by ankylosis, considering the contradictory findings in this regard in the May 2015 VA examination report. If there is ankylosis, the examiner should comment on its nature and severity consistent with the criteria set forth in 38 C.F.R. § 4.71a, Diagnostic Code (DC) 5256. (ii) Please provide an opinion as to the full range of motion of the Veteran's right knee in (1) active motion, (2) passive motion, (3) in weight-bearing (4) in nonweight-bearing, and (5) with range of motion of the opposite undamaged joint. Please specify range of motion measurements in all areas outlined above. If the examiner cannot provide an opinion without resorting to speculation, he/she should explain why an opinion cannot be provided (e.g. lack of sufficient information/evidence, the limits of medical knowledge, etc.). However, the examiner indicated no ankylosis was present upon current examination, but did not comment on the issue with regard to the contradictory findings in the May 2015 VA examination report. Moreover, the examiner indicated "weakened movement due to muscle injury or peripheral nerves injury, but did not identify the same. Thus, on remand, an addendum opinion is warranted to ensure substantial compliance with the Board's November 2019 remand instructions. Stegall v. West, 11 Vet. App. 268 (1998). Any outstanding treatment records should also be secured. The matters are REMANDED for the following action: 1. Obtain any outstanding VA treatment records. 2. With any necessary assistance from the Veteran, obtain any outstanding private treatment records. 3. Then obtain an addendum opinion from an examiner other than the October 2020 VA examiner, preferably a physician. The claims file should be made available to and reviewed by the examiner. No additional examination is needed, unless the examiner determines otherwise. (a) Please comment on whether the Veteran's right knee disability has been manifested by ankylosis at any point since August 2008, specifically considering the contradictory findings in this regard in the May 2015 VA examination report. If there is ankylosis, the examiner should comment on its nature and severity consistent with the criteria set forth in 38 C.F.R. § 4.71a, Diagnostic Code (DC) 5256. (b) Determine whether the Veteran has a separate diagnosis for a muscle injury and/or peripheral nerve injury in his right knee, given the findings of the October 2020 VA examination report noting reduced muscle strength in the right knee. See October 2020 VA examination report indicating a "weakened movement due to muscle injury or peripheral nerves injury, etc." and loss of muscle strength. If no such injury is present, please explain these contradictory findings. A complete rationale shall be given for all opinions and conclusions expressed. If unable to opine without resorting to speculation, please provide a basis for reaching this conclusion. S. BUSH Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Asante, Ruby 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.