Citation Nr: 18147240 Decision Date: 11/02/18 Archive Date: 11/02/18 DOCKET NO. 16-50 791 DATE: November 2, 2018 ORDER Entitlement to service connection for status post right hip replacement with osteoarthritis, as secondary to the service-connected degenerative joint disease of the bilateral knees, is granted. Entitlement to service connection for status post left hip replacement with osteoarthritis, as secondary to the service-connected degenerative joint disease of the bilateral knees is granted. FINDINGS OF FACT 1. On balance, the record evidence is sufficient to establish that the Veteran’s status post right replacement with osteoarthritis is proximately due to or the result of his service-connected degenerative joint disease of the right and left knees. 2. On balance, the record evidence is sufficient to establish that the Veteran’s status post left knee replacement with osteoarthritis is proximately due to or the result of his service-connected degenerative joint disease of the right and left knees. CONCLUSIONS OF LAW 1. The criteria for service connection for status post right knee replacement with osteoarthritis on a secondary basis have been meet. 38 U.S.C. §§ 1110, 1131, 5107(b) (2012); 38 C.F.R. §§ 3.102, 3.303, 3.310 (2018). 2. The criteria for service connection for status post left knee replacement with osteoarthritis on a secondary basis have been meet. 38 U.S.C. §§ 1110, 1131, 5107(b) (2012); 38 C.F.R. §§ 3.102, 3.303, 3.310 (2018). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from January 1986 to December 1994. This appeal to the Board of Veterans’ Appeals (Board) arose from a rating decision issued in August 2015 by the Department of Veterans Affairs (VA) Regional Office (RO). A Notice of Disagreement was received in September 2015. In July 2016, a Statement of the Case was issued. In September 2016, the Veteran filed his substantive appeal (via a VA Form 9). Entitlement to service connection for status post right replacement and status post left knee replacement, as secondary to the service-connected degenerative joint disease of the bilateral knees. The Veteran contends that his right and left hip disorders are secondary to his service-connected bilateral knee disorders. Importantly, the Veteran limited his appeal for his hip conditions as secondary to his bilateral knee disabilities. Service connection may be established for a disability resulting from a disease or injury incurred in or aggravated by active service. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303. Service connection may be established on a secondary basis for a disability that is proximately due to or the result of a service-connected disease or injury. 38 C.F.R. § 3.310(a). To prevail on the issue of secondary service connection, there must be evidence of (1) a current disability, (2) a service-connected disability, and (3) medical evidence of a nexus, or link, between the current disability and the service-connected disability. Wallin v. West, 11 Vet. App. 509, 512 (1998). When there is an approximate balance of positive and negative evidence regarding any issue material to the determination of the matter, the benefit of the doubt will be given to the claimant. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102. The Veteran was afforded a VA examination in July 2015. The examiner also noted that the Veteran had a left knee replacement in 2008 and a right knee replacement in 2009, as well as diagnoses of bilateral hip osteoarthritis. Further, the examiner noted degenerative arthritis of the bilateral hips with an onset date of 2015. In the medical history section of the report, the Veteran reported that the date of onset of his symptoms was June 2006, and that his pain began while he was walking at work. He also reported that his pain had gotten progressively worse. The examiner opined that it was less likely than not that the Veteran’s bilateral hip disorder was proximately related to his service-connected bilateral knee disorder. The rationale provided for the opinion included the fact that the Veteran’s examination findings and medical records did not show the hip being a direct or indirect result of his hip disorder. The examiner also cited that the Veteran stated that his hips began hurting without provocation and that both had been replaced unrelated to his knee issues. The Veteran has submitted a private opinion dated in July 2015. The Veteran reported that he had bilateral hip pain, with the pain being worse in the right hip. The physician noted that the Veteran underwent a bilateral hip replacement due to symptomatic osteoarthritis of the right and left hips. The left total hip arthroplasty was performed in December 2007 and the right hip arthroplasty was performed in January 2009. After reviewing the Veteran’s x-rays, the physician noted that there was an obvious loosening, rotation, and progressive thinning of the acetabular cup, stating that the Veteran’s knees more likely than not contributed to the condition of his hips. In viewing the totality of the evidence, including the July 2015 VA and private reports, the Board determines that with the resolution of all reasonable doubt in the Veteran’s favor, service connection for the right and left hip disorders is warranted. In this regard, the Veteran’s contention that his right and left hip disorders were caused by his service-connected bilateral knee disorders is supported by the private medical diagnoses and opinion entered in July 2015, and is opposed by the VA medical opinion entered in July 2015. However, the Veteran’s medical record as a whole, in effect, lends support to both the foregoing opinions. In such cases, where the evidentiary record is so evenly balanced, the benefit of the doubt must be resolved in favor of the Veteran. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102. Therefore, the Board determines that the Veteran’s status post right hip replacement with osteoarthritis and his status post left hip replacement with osteoarthritis were caused by the service-connected degenerative joint disease of the bilateral knees. 38 C.F.R. § 3.310(a). Accordingly, the appeal is granted. DEBORAH W. SINGLETON Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD Tiffany N. Hanson, Associate Counsel