Citation Nr: 22017596 Decision Date: 03/25/22 Archive Date: 03/25/22 DOCKET NO. 06-02 333 DATE: March 25, 2022 REMANDED Entitlement to an initial disability rating in excess of 20 percent for degenerative joint disease, right ankle is remanded. Entitlement to an initial disability rating in excess of 10 percent prior to October 26, 2004, for degenerative arthritis, left ankle, and in excess of 20 percent thereafter is remanded. Entitlement to an initial disability rating in excess of 10 percent prior to August 1, 2018, for left total knee replacement, in excess of 30 percent prior to August 26, 2021, and in excess of 60 percent thereafter is remanded. INTRODUCTION The Veteran had active service from February 1978 to September 1984 and April 1985 to April 1988. When this case was before the Board in November 2018, April 2020, October 2020, July 2021, and November 2021 the above-noted issues were remanded for additional development. The case has since been returned for further appellate review. REASONS FOR REMAND Though the Board is both cognizant and empathetic of the Veteran's frustrations with respect to the unreasonable delays that have transpired in this case, this matter must again be remanded in order to achieve compliance with a remand instruction that has been repeatedly issued since November 2018. On numerous occasions the Board has indicated that to be considered adequate, a musculoskeletal examination must include an assessment of the veteran's flare-ups, as well as range of motion measurements in weight bearing, non-weight bearing, and in passive motion. See Sharp v. Shulkin, 29 Vet. App. 26 (2017); see also Correia v. McDonald, 28 Vet. App. 158 (2016). Following the Board's November 2021 remand, the Veteran underwent VA ankle and knee examinations in December 2021. However, the examiner again failed to provide weight-bearing and non weight-bearing range of motion assessments as directed. As such, a remand is again required. Further, the Board also previously requested a comprehensive assessment of the Veteran's functional limitations in the November 2021 remand. In particular, the Board asked the examiner to comment on how long the Veteran can sit or stand, how far he can walk, and how much weight he is able to bear given his bilateral lower extremity impairments. Though the examiner addressed how long the Veteran can stand/walk, she did not comment on how much weight he could bear, or how far he could walk. Accordingly, the case is REMANDED for the following action: Afford the Veteran a VA examination by an examiner with sufficient expertise to fully assess the severity of the Veteran's service-connected bilateral ankle and left knee disabilities. All pertinent evidence of record should be made available to and reviewed by the examiner. Any indicated studies should be performed. Ensure the examiner provides all information required for rating purposes, to specifically include both active and passive range of motion testing, as well as weight-bearing and nonweight-bearing range of motion assessments. In addition, the examiner must consider and discuss all procurable and assembled data such as the frequency, duration, characteristics, precipitating and alleviating factors, and the severity of any flare-ups, and then provide an assessment of the functional loss during flares, if possible in degrees of motion lost. If the examiner is unable to conduct the required testing or concludes that the required testing is not necessary, he or she should be directed to clearly explain why that is so. Finally, the examiner is also asked to provide concrete examples of functional impairments caused by the Veteran's service-connected bilateral ankle and left knee disabilities. The types of impairments the examiner should address include, but are not limited to, walking, sitting, lifting and standing limitations. If possible, the examiner should expound on how long the Veteran can sit or stand, how far he can walk, and how much weight he is able to bear given his bilateral lower extremity impairments. The examiner must discuss and consider the Veteran's competent lay statements. T. REYNOLDS Veterans Law Judge Board of Veterans' Appeals Attorney for the Board G. Fraser, 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.