Citation Nr: 1317941 Decision Date: 06/03/13 Archive Date: 06/11/13 DOCKET NO. 10-47 115 ) DATE ) ) On appeal from the Department of Veterans Affairs Regional Office in Muskogee, Oklahoma THE ISSUE Entitlement to service connection for a left hip disability, to include as secondary to service-connected degenerative joint disease of the left knee with residual scar. REPRESENTATION Appellant represented by: Disabled American Veterans ATTORNEY FOR THE BOARD Devon Rembert-Carroll, Associate Counsel INTRODUCTION The Veteran had active service in the Navy from August 1962 to July 1965 and from July 1969 to July 1972; and in the Air Force from March 1977 to February 1978. The matter is before the Board of Veterans' Appeals (Board) on appeal from a November 2009 rating decision of the Department of Veteran Affairs (VA) Regional Office (RO) in Muskogee, Oklahoma. The appeal is REMANDED to the RO via the Appeals Management Center (AMC), in Washington, DC. VA will notify the appellant if further action is required. REMAND The Veteran contends that his left hip disability is related to his service-connected left knee disability. In a November 2010 statement the Veteran also contends that his left hip pain may be related to his service-connected lower back disability. Service connection may be granted where a disability is proximately due to or the result of a service-connected disease or injury. 38 C.F.R. § 3.310(a) (2012). Establishing service connection on a secondary basis requires evidence sufficient to show (1) that a current disability exists and (2) that the current disability was either (a) caused by or (b) aggravated by a service-connected disability. Allen v. Brown , 7 Vet. App. 439, 448 (1995). The Veteran underwent a VA examination in March 2010. X-rays revealed stable, mild degenerative changes involving bilateral hip articulations with no acute fractures or dislocations. The examiner diagnosed stable, mild degenerative changes of the bilateral hips. The examiner stated that due to the Veteran's age and the mild and bilateral changes he was unable to determine, without resorting to mere speculation, whether the Veteran's left knee condition was a contributing factor in the degenerative changes to his hips. The Board finds that the March 2010 etiology opinion was incomplete as the examiner did not specifically indicate whether the Veteran's left hip disability was caused by, or aggravated by his service-connected left knee disability. Therefore an addendum opinion addressing this issue is necessary. Further, as noted, the Veteran has also alleged that his left hip disability is secondary to his service-connected low back disability. This theory of causation was not considered by the VA examiner as it was not raised until after the examination. The examiner is asked to include a discussion of whether or not a causal relationship exists between the service connected low back disability and the left hip disability. Once VA undertakes the effort to provide an examination with respect to a claim of entitlement to service connection, whether or not statutorily obligated to do so, the duty to assist requires that it be adequate. Barr v. Nicholson, 21 Vet. App. 303, 311 (2007). Accordingly, the case is REMANDED for the following action: 1. The Veteran should be requested to provide the names, addresses and approximate dates of treatment of all medical care providers, VA and non-VA, who have treated him for the disability on appeal. After the Veteran has signed the appropriate releases, those records should be obtained and associated with the claims folder. Appropriate efforts must be made to obtain all available VA treatment records. All attempts to procure records should be documented in the file. If the AMC/RO cannot obtain records identified by the Veteran, a notation to that effect should be inserted in the file. The Veteran is to be notified of unsuccessful efforts in this regard, in order to allow him the opportunity to obtain and submit those records for VA review. 2. Return the Veteran's claims file to the March 2010 VA examiner (and if that original examiner is no longer available, then send the claims file to another examiner of similar background and experience) to provide an addendum opinion as to whether any current disability of the left hip was either caused by, or aggravated by the service-connected left knee disability. The entire claims file (i.e., both the paper claims file and any electronic medical records) should be made available to and be reviewed by the examiner, and it should be confirmed that such records were available for review. All required testing must be performed. The examiner should also opine as to whether it is at least as likely as not that any current disability of the left hip was caused by, or aggravated by the service-connected low back disability. The examination report must include a complete rationale for all opinions expressed. If the examiner feels that the requested opinion cannot be rendered without resorting to speculation, the examiner must state whether the need to speculate is caused by a deficiency in the state of general medical knowledge (i.e. no one could respond given medical science and the known facts) or by a deficiency in the record or the examiner (i.e. additional facts are required, or the examiner does not have the needed knowledge or training). 3. After the development requested above as well as any additional development deemed necessary has been completed, the record should again be reviewed. If the benefit sought on appeal remains denied, then the Veteran and his representative should be furnished with a supplemental statement of the case and be given the opportunity to respond thereto. The case should then be returned to the Board for further appellate consideration, if in order. The appellant has the right to submit additional evidence and argument on the matter or matters the Board has remanded. Kutscherousky v. West, 12 Vet. App. 369 (1999). This claim must be afforded expeditious treatment. The law requires that all claims that are remanded by the Board of Veterans' Appeals or by the United States Court of Appeals for Veterans Claims for additional development or other appropriate action must be handled in an expeditious manner. See 38 U.S.C.A. §§ 5109B, 7112 (West Supp. 2012). _________________________________________________ WAYNE M. BRAEUER Veterans Law Judge, Board of Veterans' Appeals Under 38 U.S.C.A. § 7252 (West 2002), only a decision of the Board of Veterans' Appeals is appealable to the United States Court of Appeals for Veterans Claims. This remand is in the nature of a preliminary order and does not constitute a decision of the Board on the merits of your appeal. 38 C.F.R. § 20.1100(b) (2012).