Citation Nr: 22010583 Decision Date: 02/24/22 Archive Date: 02/24/22 DOCKET NO. 16-43 421 DATE: February 24, 2022 REMAND The issue of a disability rating greater than 20 percent for a service-connected right knee disability is remanded The issue of a disability rating greater than 10 percent for a service-connected left knee disability is remanded. REASONS FOR REMAND The Veteran served on active duty from 1967 to October 1981; April 1988 to February 1994; and July 1999 to March 2002. These matters come before the Board of Veterans' Appeals (Board) from a November 2014 rating decision from a Department of Veterans Affairs (VA) regional office (RO). The Board remanded these matters in June 2021 for additional development. A supplemental statement of the case (SSOC) was issued in December 2021. 1. Disability rating greater than 20 percent for a service-connected right knee disability 2. Disability rating greater than 10 percent for a service-connected left knee disability. The matters are REMANDED for the following action: 1. BACKGROUND FOR THE ADJUDICATOR: This matter is remanded to obtain a complete VA examination for the Veteran's bilateral knee disabilities to comply with the June 2021 remand order and VA's duty to assist. Stegall v. West, 11 Vet. App. 268, 271 (1998). The June 2021 remand order directed the RO to obtain a new examination for the Veteran's bilateral knee disabilities. The examiner was instructed to "attempt to elicit information regarding the severity, frequency, and duration of any flare-ups, and the degree of functional loss during flare-ups." The October 2021 examiner commented on the Veteran's inability to provide a specific frequency of flare-ups but did not address the severity or duration of the flare-ups. The sections of the examination report for flare-ups were not completed. The examiner may attempt to determine an approximation of the frequency of knee symptoms from other sources, (including the electronic or treatment files) or from the severity of the disorders themselves. A remand is necessary to obtain a complete examination that addresses the severity, frequency, and duration of the Veteran's flare-ups. Additionally, the record is incomplete and does not contain treatment records from the Las Vegas, Nevada VA. A July 2021 note from the Miami VAMC states the Veteran relocated to Las Vegas and established care there. No records were uploaded to the claims folder from the Las Vegas VA. A remand is necessary to obtain Las Vegas VA treatment records. THE REMAND DIRECTIVES FOLLOW. 2. Obtain the Veteran's outstanding VA treatment records, to include records from the Las Vegas, Nevada VA from July 2021 to present. 3. Schedule the Veteran for an examination by an appropriate clinician to determine the current severity of his service-connected right and left knee disabilities. THE EXAMINER MUST PROVIDE A FULL DESCRIPTION OF THE DISABILITY AND REPORT ALL SIGNS AND SYMPTOMS NECESSARY FOR EVALUATING THE VETERAN'S DISABILITY UNDER THE RATING CRITERIA. The examiner must test the Veteran's active motion, passive motion, and pain with weight-bearing and without weight-bearing. 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 must 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 review the record as found in VA treatment reports and the electronic file. However, the record in substance indicates the following: In May 2014, the Veteran reported he experienced more pain after kneeling or using stairs. In November 2014, the Veteran reported flare-ups in his knees that last one to two days after certain activities. In August 2015, he reported that he experiences instability when rising from a kneeled position. He also stated he has increased pain after kneeling and using stairs. In January 2020, the Veteran testified that he had painful flare-ups when bending, placing weight on his knees, and climbing stairs. He also indicated that if he sits for more than ten minutes, he needs assistance standing up. Finally, he stated that his knee collapses from front to back when using stairs. In February 2020, the Veteran reported painful flare-ups after bending, prolonged sitting, repetitive lifting, running, and climbing. He reported the flare-ups usually last several hours but can last up to two days. In May 2020, he reported pain after using stairs and kneeling. 4. Readjudicate the issues on appeal, specifically addressing Diagnostic Codes 5257-59. If any of the benefits sought on appeal remain denied, provide the Veteran with a SSOC. Vito A. Clementi Veterans Law Judge Board of Veterans' Appeals Attorney for the Board S. Reed, Counsel The Board's action is binding only in this case. This decision is not precedential and does not establish VA policies or interpretations of general applicability. 38 C.F.R. § 20.1303.