11-27 275, 11-27 275

Veteran served multiple active-duty periods (1986–1992; 1998–1999; 2006–2007; 2008–2009) and appealed VA rating decisions from the Pittsburgh RO.
Claims on appeal: initial ratings in excess of 10% for degenerative arthritis of the lumbar spine and for patellofemoral syndrome/arthritis of both knees.
Board previously denied these higher-rating claims in February 2016; Veteran appealed to the Court and a Joint Motion for Remand (JMR) resulted in an August 2016 remand to the Board.
Veteran testified at an April 2015 hearing; most recent VA examinations for spine and knees were from June 2015.
The Board found the June 2015 examinations inadequate because they did not comply with 38 C.F.R. § 4.59 requirements (e.g., active vs. passive ROM, weight-bearing vs. nonweight-bearing, flare-up quantification) and therefore ordered new VA spine and bilateral knee exams.
The Board remanded the claims for new exams addressing active/passive ROM, weight-bearing status, flare-ups/repeated-use loss (with, if feasible, degrees of additional ROM loss), and any neurological findings, then instructed the AOJ to readjudicate and provide SSOC if denial remains.

Issue	Plaintiff's Argument	Defendant's Argument	Held
Whether veteran is entitled to >10% for degenerative arthritis of the lumbar spine	Veteran contends ROM loss, pain, and flare-ups produce greater functional limitation and warrant a higher rating	Prior VA rating based on existing exams; RO/Board had denied higher rating	Remanded for new VA spine exam per §4.59 requirements and reassessment of rating and neurological signs
Whether veteran is entitled to >10% for right knee patellofemoral syndrome/arthritis	Veteran contends pain, limited ROM, and flare-ups cause greater disability than currently rated	Prior exams/decision found rating 10% adequate	Remanded for new right knee exam including active/passive ROM, weight-bearing testing, flare-up impact, and re-adjudication
Whether veteran is entitled to >10% for left knee patellofemoral syndrome/arthritis	Same as right knee claim	Same as right knee	Remanded for new left knee exam and re-adjudication
Whether existing examinations complied with applicable VA exam standards (e.g., active vs passive ROM, weight-bearing, flare-ups)	Veteran (and Court via JMR) argued prior exams were inadequate to resolve symptomatology	VA relied on June 2015 exams that lacked required detail (no passive vs active ROM discussion for knees; no differentiation for lumbar ROM)	Board found exams inadequate under §4.59 and ordered new, comprehensive musculoskeletal examinations and readjudication

Kutscherousky v. West, 12 Vet. App. 369 (1999) (appellant may submit additional evidence and argument after remand; remand requires further development and opportunity to respond)