Citation Nr: 22018312 Decision Date: 03/28/22 Archive Date: 03/28/22 DOCKET NO. 14-09 181 DATE: March 28, 2022 REMANDED A rating higher than 20 percent for left knee degenerative joint disease (DJD) status post anterior cruciate ligament and medial collateral ligament repair (left knee disability) from April 13, 2011, to March 14, 2018, is remanded. A rating higher than 10 percent for a left knee disability from October 1, 2018, is remanded. A rating higher than 20 percent for right knee chondromalacia patella with degenerative changes (right knee disability) from April 13, 2011, to January 10, 2018, is remanded. A rating higher than 10 percent for a right knee disability from August 1, 2018, is remanded. A total disability rating based on individual unemployability (TDIU) is remanded. REASONS FOR REMAND The Veteran served on active duty from January 1986 to June 1986 and from August 1988 to October 1992. This case comes before the Board of Veterans' Appeals (Board) on appeal from an October 2011 rating decision of the Department of Veteran Affairs (VA) Regional Office (RO). 1. Increased rating for bilateral knee disabilities Remand is required to comply with the March 2021 remand directives. The Board is required by law to ensure that the RO complies with its directives and this compliance is not optional or discretionary. Stegall v. West, 11 Vet. App. 268, 271 (1998). The issues were remanded in March 2021 for private treatment records and an adequate VA examination consistent with the August 2020 United States Court of Appeals for Veterans Claims (Veterans Court) Joint Motion for Partial Remand (JMPR). The Veteran received a June 2021 VA examination. First, the examination was incomplete. The examiner determined abnormal range of motion contributed to functional loss in both knees. The disability benefits questionnaire (DBQ) then asks the examiner to explain. The examiner did not provide a response for either knee. Additionally, in July 2021, the RO requested clarification because the range of motion testing was extremely different from a recent VA treatment record. An August 2021 clarification was provided, however, the clarification itself is unclear. First, the examiner stated: "I agree with 'your findings' however, the range of motion measurements are what the Veteran demonstrated." This is confusing because the request does not make a "finding" and only asked for clarification. Then, the examiner proceeded to give different ranges of motion for flexion and extension for both knees and stated that this type of range of motion is difficult to accurately document on the DBQ. Lastly, the examiner does not make clear if the new measurements were weight bearing, non-weight bearing, active, or passive. Because the June 2021 VA examination is incomplete, and the August 2021 clarification is confusing, remand is required for an adequate VA examination. TDIU Remand is required because entitlement to TDIU is inextricably interwined with the pending increased rating claims. See Harris v. Derwinski, 1 Vet. App. 180, 183 (1991) (holding that issues are inextricably intertwined and must be considered together when a decision concerning one could have a significant impact on the other). The matters are REMANDED for the following action: 1. Obtain the Veteran's VA treatment records for the period from September 2022 to present. 2. Schedule the Veteran for an examination by an appropriate clinician to determine the current severity of his service- connected bilateral knee disabilities. The examiner should 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. 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 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 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). 3. The AOJ must ensure compliance with the directives of this remand. By law, if the report is incomplete or deficient in any manner, the AOJ must implement corrective procedures. VICTORIA MOSHIASHWILI Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Whipple, C 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.