## Facts

- Larry E. English, a U.S. Army veteran, was service-connected for right knee patellofemoral syndrome and assigned a 10% initial disability rating.
- English sought a higher initial rating for the period January 15, 2008, to April 14, 2010, including: (a) a separate rating for recurrent subluxation or lateral instability under 38 C.F.R. § 4.71a, DC 5257; and (b) higher ratings for limitation of flexion and extension under DCs 5260 and 5261.
- English repeatedly reported right-knee instability (including “giving way”) in lay statements.
- Multiple VA examinations recorded negative clinical stability testing and found no objective instability.
- The Board of Veterans’ Appeals denied a separate rating under DC 5257, emphasizing the medical findings and concluding the absence of objective instability precluded a separate evaluation.
- The Board also denied higher ratings under DCs 5260 and 5261, largely relying on range-of-motion measurements without adequately explaining how pain, repeated use, and related functional loss affected the rating.
- English appealed, challenging the Board’s treatment of lay evidence on instability and the adequacy of its functional-loss discussion for limitation-of-motion ratings.

## Issues

1. Whether the Board erred under DC 5257 by discounting lay evidence of knee instability and effectively requiring objective medical evidence or giving it categorical preference.
2. Whether the Board provided an adequate statement of reasons or bases when denying higher ratings under DCs 5260 and 5261, including consideration of functional loss under 38 C.F.R. §§ 4.40 and 4.45.

## Decision

- The Court held that DC 5257 does not require objective medical evidence to establish lateral knee instability.
- The Court held that the Board erred by treating the absence of objective instability as effectively dispositive and by giving categorical preference to objective testing over lay reports without an adequate explanation.
- The Court held that the Board failed to provide an adequate statement of reasons or bases for denying higher ratings under DCs 5260 and 5261 because it did not sufficiently address functional loss under 38 C.F.R. §§ 4.40 and 4.45.
- The Court set aside the Board’s decision and remanded for readjudication consistent with these holdings.

## Legal Principles

- When a diagnostic code is silent on the type of evidence required, adjudicators may not impose an “objective evidence” requirement by interpretation.
- For DC 5257, knee instability may be established by lay evidence, medical evidence, or both; objective medical evidence is not legally required.
- The Board may weigh lay and medical evidence, but it may not categorically deem objective medical evidence more probative than lay testimony on DC 5257 instability without case-specific reasons and an adequate statement of reasons or bases.
- For musculoskeletal ratings under DCs 5260 and 5261, the Board must explain how it considered functional loss due to pain and related factors under 38 C.F.R. §§ 4.40 and 4.45, including how such loss affects the rating determination.

## Conclusion

The Court vacated and remanded because the Board improperly treated objective testing as required or categorically superior for DC 5257 instability and failed to adequately explain its functional-loss analysis when denying higher limitation-of-motion ratings under DCs 5260 and 5261.


English v. Wilkie, 30 Vet. App. 347 (Vet. App. 2018)