Citation Nr: 18146605 Decision Date: 10/31/18 Archive Date: 10/31/18 DOCKET NO. 16-23 972 DATE: October 31, 2018 REMANDED Entitlement to service connection for a right hip disability is remanded. Entitlement to service connection for a cervical spine disability is remanded. Entitlement to service connection for a back disability is remanded. Entitlement to service connection for a right shoulder disability is remanded. Entitlement to service connection for a menstrual disability is remanded. REASONS FOR REMAND The Veteran served on active duty from December 2008 to May 2012. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from December 2014 and June 2015 rating decisions issued by the Department of Veterans Affairs (VA) Regional Office (RO) in Winston-Salem, Virginia. The issue of entitlement to service connection for a right hip disability is remanded. The Veteran contends that she has a right hip disability due to service, to specifically include participating in “a twelve-mile ruck march” during her service. See April 2015 Notice of Disagreement. Service treatment records reveal that she had various in-service reports concerning right hip pain. See September 2009 service treatment record (noting a diagnosis of right thigh strain); October 2009 service treatment record (noting right hip pain after a twelve-mile march and increased pain on anterior right hip flexor); November 2009 service treatment record (noting a problem of right thigh strain); February 2012 service treatment record (noting a problem of consistent right thigh strain). A September 2014 Disability Benefits Questionnaire (DBQ) examiner rendered a negative nexus opinion given no diagnosis of a right hip disability. Given that there is ample clinical evidence of in-service right hip complaints and treatments and that the claims file currently does not contain any post-service treatment records that may reveal a current diagnosis, a remand is necessary to obtain any outstanding post-service treatment records, to include VA outpatient treatment records. Further, pertinent to all claims, the Veteran’s enlistment and separation examination records are not associated with the claims file. On remand, the AOJ should obtain the missing reports. See 38 C.F.R. § 3.159(c). The issues of entitlement to service connection for cervical spine, back, and right shoulder disabilities are remanded. The Veteran maintains that she has cervical spine, back, and right shoulder disabilities secondary to a right hip disability, presently on appeal. As favorable action on the right hip disability claim could potentially result in the award of service connection for the cervical spine, back, and right shoulder claims, they are inextricably intertwined with the right hip claim that is being remanded herein. See Parker v. Brown, 7 Vet. App. 116 (1994); Harris v. Derwinski, 2 Vet. App. 180, 183 (1991). Entitlement to service connection for a menstrual disability is remanded. The Veteran contends that she has a menstrual disability due to service, to include insertion and subsequent attempted removal of an intrauterine device (IUD) during her service. See July 2015 Notice of Disagreement. Service treatment records reflect various complaints related to IUD insertion in November 2011. A November 2011 service treatment record indicates that the Veteran has been reporting “spotting” and bleeding since the IUD insertion. A December 2011 service treatment record notes continued complaint of spotting and discharge after the IUD insertion. In a February 2012 service treatment record, the treating physician noted that the Veteran’s IUD could not be removed because the IUD could not be located despite multiple attempts at that time. The Veteran has not undergone a VA examination for the claimed disability. A VA examination is necessary to determine whether there is a current menstrual disability underlying her reports of such disability, and, if so, whether such is due to service, to include the above-noted complaints related to the IUD insertion and failed attempt to remove such device during the Veteran’s service. McLendon v. Nicholson, 20 Vet. App. 79 (2006). The matters are REMANDED for the following action: 1. Obtain the Veteran’s enlistment and separation examination reports for her service from December 2008 to May 2012. All reasonable attempts should be made to obtain such record. If such record cannot be obtained after reasonable efforts have been made, issue a formal determination that such record does not exist or that further efforts to obtain such record would be futile, which should be documented in the claims file. The Veteran must be notified of the attempts made and why further attempts would be futile, and allowed the opportunity to provide such record, as provided in 38 U.S.C. § 5103A(b)(2) and 38 C.F.R. § 3.159(e). 2. Update private and VA clinical records of the Veteran. 3. Schedule the Veteran for an appropriate VA examination to address her claimed menstrual disability. All indicated tests and studies should be undertaken. (A) The examiner should identify all current diagnoses related to the claimed menstrual disability since the date of claim (i.e. since May 2015), even if such diagnosis is currently asymptomatic or resolved during the pendency of the appeal. (B) For each diagnosis, the examiner should opine whether it is at least as likely as not (i.e. a 50 percent or greater probability) that such disability had its onset or is otherwise medically related to service, to include as due to various in-service complaints of bleeding and spotting since IUD insertion. See, e.g., November and December 2011 service treatment records; February 2012 service treatment record. A complete rationale should be given for all opinions and conclusions expressed. (Continued on the next page) 4. After completing the above, and any other development as may be indicated, the AOJ is to readjudicate the claims based on the entirety of the evidence of record. If the claims remain denied, the Veteran should be issued a supplemental statement of the case. An appropriate period should be allowed for response. MARJORIE A. AUER Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD S. Kim, Associate Counsel