Citation Nr: 21042845 Decision Date: 07/14/21 Archive Date: 07/14/21 DOCKET NO. 19-21 725 DATE: July 14, 2021 REMANDED Service connection for a low back disability is remanded. A disability rating greater than 10 percent for patellofemoral syndrome of the right knee is remanded. REASONS FOR REMAND The Veteran served in the United States Marine Corps with active duty service from January 1998 to September 2002. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a September 2018 rating decision. The Board initially denied the claims for service connection for a low back disability and a rating greater than 10 percent for patellofemoral syndrome of the right knee in a February 2020 decision. The Veteran appealed this decision to the Court of Appeals for Veterans Claims (Court). The Court vacated the Board's denial in a February 2021 Joint Motion for Remand. Specifically, the Court held that the Board did not provide adequate reasons and basis for its denial of the Veteran's claims. The Court found the Board relied on an October 2018 VA examination that failed to consider lay statements from the Veteran regarding how her back disability was incurred in service and continued to affect her daily life thereafter. The Board finds remand is required for an addendum opinion addressing these lay statements. Regarding the Veteran's increased rating claim, the Court found the Board relied on an inadequate opinion in denying the Veteran's claim. The August 2018 VA examination the Board relied upon provided an inadequate rationale for not providing an opinion on the functional impact of flare-ups. Therefore, remand is required to address the impact of flare-ups on the Veteran's functional limitations. The matters are REMANDED for the following action: 1. Obtain an addendum opinion regarding whether the Veteran's low back disability is at least as likely as not (50 percent or greater) related to the Veteran's service. The examiner is to consider the Veteran's lay assertions, including the lay statements included in the December 2018 Notice of Disagreement. The rationale for the opinion must be provided 2. Schedule the Veteran for an examination by an appropriate clinician to determine the current severity of his service-connected right knee disability. All indicated tests and studies should be conducted and all findings reported in detail, including range of motion measurements. 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). JOHN Z. JONES Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Jorge Barroso, 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.