Citation Nr: 18141050 Decision Date: 10/09/18 Archive Date: 10/09/18 DOCKET NO. 08-19 137 DATE: October 9, 2018 ORDER Entitlement to service connection for bilateral hip disability is denied. Entitlement to service connection for residuals of a head injury is denied. FINDINGS OF FACT 1. The Veteran’s bilateral hip arthritis did not manifest to a compensable degree within the applicable presumptive period; continuity of symptomatology is not established; and the Veteran’s bilateral hip disability is not otherwise etiologically related to an in-service injury, event, or disease. 2. The preponderance of the evidence of record is against finding that the Veteran has, or has had at any time during the appeal, a current diagnosis of residuals of a head injury. CONCLUSIONS OF LAW 1. The criteria for service connection for bilateral hip disability are not met. 38 U.S.C. §§ 1131, 1137, 5107(b); 38 C.F.R. §§ 3.102, 3.303(a)-(b), (d), 3.307, 3.309(a). 2. The criteria for service connection for residuals of a head injury are not met. 38 U.S.C. §§ 1131, 5107(b); 38 C.F.R. §§ 3.102, 3.303(a). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from July 1975 to July 1978. The Board remanded the case for additional development in August 2009, July 2010 and March 2016. The case has now been returned to the Board for further appellate action. The Board finds that there has been substantial compliance with its prior remand directives. See Stegall v. West, 11 Vet. App. 268, 271 (1998). A hearing was held on June 8, 2010, in Montgomery, Alabama, before the undersigned Veterans Law Judge. A transcript of the testimony is of record. Service Connection Service connection will be granted if the evidence demonstrates that a current disability resulted from an injury or disease incurred in or aggravated by active service, even if the disability was initially diagnosed after service. 38 U.S.C. § 1131; 38 C.F.R. § 3.303. 1. Entitlement to service connection for bilateral hip disability The Veteran contends that he experiences on-going medical problems with his hips as a result of injuries he sustained in service, to include running and pounding on hard surfaces as well as falling off a balcony while stationed in Germany. During his Board hearing, when the Veteran was asked if he experienced difficulty with his hips between 1978 and the early nineties he responded that as the years passed, his pain continued to grow worse. Certain chronic diseases will be presumed related to service if they were noted as chronic in service; or, if they manifested to a compensable degree within a presumptive period following separation from service; or, if continuity of the same symptomatology has existed since service, with no intervening cause. 38 U.S.C. §§ 1101, 1112, 1113, 1137; Walker v. Shinseki, 708 F.3d 1331, 1338 (Fed. Cir. 2012); Fountain v. McDonald, 27 Vet. App. 258 (2015); 38 C.F.R. §§ 3.303(b), 3.307, 3.309(a). The question for the Board is whether the Veteran has a chronic disease that manifested to a compensable degree in service or within the applicable presumptive period, or whether continuity of symptomatology has existed since service. The Board concludes that, while the Veteran has arthritis of both hips, which is a chronic disease under [38 U.S.C. § 1101(3)/38 C.F.R. § 3.309(a)], it was not chronic in service or manifest to a compensable degree in service or within a presumptive period, and continuity of symptomatology is not established. VA clinical records show that the Veteran did not report hip pain until approximately October 2005. Importantly, contemporaneous x-rays of the hips were normal. VA treatment records show the Veteran was not diagnosed with arthritis until an October 2006 x-ray, over 28 years after his separation from service and 27 years outside of the applicable presumptive period. While the Veteran is competent to report experiencing symptoms of pain since service, the Board finds the reports of continuity of symptomatology not credible. The Veteran’s reports are internally inconsistent with his reports in contemporaneous treatment records, which show no complaints of hip pain until October 2005, outside of the presumptive period. Significantly, in a March 1978 Report of Medical History, although reporting other problems, the Veteran was silent with respect to any reports of hip pain. Likewise, post-service, a January 1979 VA examination was also silent with respect to any complaints pertaining to the hips. Buchanan v. Nicholson, 451 F.3d 1331, 1336-37 (Fed. Cir. 2006). Further, while the Veteran asserts that the reported symptoms were manifestations of arthritis, he is not competent to determine that these symptoms were manifestations of arthritis. The issue is medically complex, as it requires specialized medical knowledge. Jandreau v. Nicholson, 492 F.3d 1372, 1377, 1377 n.4 (Fed. Cir. 2007). The Board gives more probative weight to competent medical evidence, which establishes that these symptoms did not have their onset in service. The June 2018 VA examiner determined that the evidence failed to support the claim that the Veteran’s bilateral hip disability had its onset in service given the 30-plus years-time lapse without complaint of hip pain or hip pathology on record. Service connection for bilateral hip disability may still be granted on a direct basis; however, the preponderance of the evidence is against finding that a medical nexus exists between the Veteran’s bilateral hip disability and an in-service injury, event or disease. 38 U.S.C. §§ 1110, 1131; Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009); 38 C.F.R. § 3.303(a), (d). Again, the June 2018 VA examiner opined that the Veteran’s bilateral hip disability is not at least as likely as not related to an in-service injury, event, or disease. The rationale was that it was difficult to opine with certainty that the Veteran’s hip conditions were not a result of post-military trauma, particularly given the 30-plus years-time lapse without complaints of hip pain or evidence of hip pathology. While the Veteran believes his bilateral hip disability is related to an in-service injury, event, or disease, he is not competent to provide a nexus opinion in this case. This issue is also medically complex, as it requires specialized medical knowledge. Jandreau v. Nicholson, 492 F.3d 1372, 1377, 1377 n.4 (Fed. Cir. 2007). Consequently, the Board gives more probative weight to the competent medical evidence. In conclusion, the Board finds that the preponderance of the evidence is against the Veteran’s claim for service connection for bilateral hip disability. In denying such a rating, the Board finds the benefit of the doubt doctrine is not applicable. 38 U.S.C. § 5107; 38 C.F.R. §§ 4.3, 4.7. 2. Entitlement to service connection for residuals of head injury The Veteran contends that he sustained trauma to his head after falling off the balcony while in service and that he experiences continuous medical problems as a result. Specifically, he maintains that he suffers from daily headaches and feels dizzy at times when moving too fast. The question for the Board is whether the Veteran has a current disability that began during service or is at least as likely as not related to an in-service injury, event, or disease. The Board concludes that the Veteran does not have a current diagnosis of any residuals of head injury and has not had one at any time during the pendency of the claim or recent to the filing of the claim. 38 U.S.C. §§ 1110, 1131, 5107(b); Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009); Romanowsky v. Shinseki, 26 Vet. App. 289, 294 (2013); McClain v. Nicholson, 21 Vet. App. 319, 321 (2007); 38 C.F.R. § 3.303(a), (d). The June 2018 VA examiner evaluated the Veteran and found that the Veteran never had a traumatic brain injury (TBI) or any residuals of TBI. The examiner determined that there was no medical evidence indicating any TBI or any residuals of head trauma related to any in-service event or occurrence. Further, despite consistent VA treatment for many years, treatment records do not contain a diagnosis of any residuals of head trauma. Moreover, a June 2018 VA psychiatric examination also found that the Veteran did not appear to have a TBI based on examination, review of records and previous mental status examination. The examiner concluded that there did not appear to be any residual effect from his fall. While the Veteran believes he has current residuals from an in-service head injury, he is not competent to provide a diagnosis in this case. The issue is medically complex, as it requires specialized medical knowledge. Jandreau v. Nicholson, 492 F.3d 1372, 1377, 1377 n.4 (Fed. Cir. 2007). Consequently, the Board gives more probative weight to the competent medical evidence.   In conclusion, the Board finds that the preponderance of the evidence is against the Veteran’s claim for service connection for residuals of a head injury. In denying such a rating, the Board finds the benefit of the doubt doctrine is not applicable. 38 U.S.C. § 5107; 38 C.F.R. §§ 4.3, 4.7. L. M. BARNARD Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD J.N. Moats