Citation Nr: 18149856 Decision Date: 11/13/18 Archive Date: 11/13/18 DOCKET NO. 16-38 456 DATE: November 13, 2018 ORDER Entitlement to service connection for a right hip condition with osteoarthritis, secondary to service-connected lumbar spine disability is denied. Entitlement to service connection for a right knee condition with osteoarthritis, secondary to service-connected lumbar spine disability is denied. FINDINGS OF FACT 1. The Veteran’s right hip disability is neither proximately due to nor aggravated beyond its natural progression by his service-connected lumbar spine disability, and is not otherwise related to an in-service injury, event, or disease. 2. The Veteran’s right knee disability is neither proximately due to nor aggravated beyond its natural progression by his service-connected lumbar spine disability, and is not otherwise related to an in-service injury, event, or disease. CONCLUSIONS OF LAW 1. The criteria for service connection for a right hip disability are not met. 38 U.S.C. §§ 1110, 1131, 5107(b); 38 C.F.R. §§ 3.102, 3.310(a). 2. The criteria for service connection for a right knee disability are not met. 38 U.S.C. §§ 1110, 1131, 5107(b); 38 C.F.R. §§ 3.102, 3.310(a). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty in the United States Marine Corps from September 1964 to February 1966. This matter comes to the Board of Veterans’ Appeals (Board) on appeal from a September 2015 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO) in Reno, Nevada. Service Connection 1. Entitlement to service connection for a right hip condition with osteoarthritis, secondary to service-connected lumbar spine disability The Veteran contends that he has a right hip disability as a result of his service-connected lumbar spine disability. A disability which is proximately due to or the result of a service-connected disease or injury shall be service connected. 38 C.F.R. § 3.310 (a). Moreover, any increase in severity of a nonservice-connected disease or injury that is proximately due to or the result of a service-connected disease or injury, and not due to the natural progress of the nonservice-connected disease, will be service connected. 38 C.F.R. § 3.310 (b). The question for the Board is whether the Veteran has a current disability that is proximately due to or the result of, or was aggravated beyond its natural progress by his service-connected lumbar spine disability. The Board concludes that, while the Veteran has a current diagnosis of osteoarthritis of the right hip, the preponderance of the evidence is against finding that the Veteran’s right hip disability is proximately due to or the result of, or aggravated beyond its natural progression by service-connected disability. 38 U.S.C. §§ 1110, 1131; Allen v. Brown, 7 Vet. App. 439 (1995) (en banc); 38 C.F.R. § 3.310(a). A September 2015 VA examiner opined that the Veteran’s right hip disability is instead more likely due to natural aging and wear and tear process, and was not aggravated beyond its normal progress by the service-connected lumbar spine disability. The rationale was that there was no history of trauma and that multiple joints had developed radiographic degenerative changes more consistent with risk factors of aging and wear and tear process of the aging population. The Veteran’s representative alluded to private treatment records documenting irregularities of the hips and knees, which could be attributed to the back condition. The private treatment records referred to by the Veteran’s representative, however, do not refer to any medical opinion relating the Veteran’s right hip to the back. Rather, the report documents moderate degenerative changes of both hips and degenerative changes of the lumbar spine. While the Veteran believes his right hip disability is proximately due to or the result of his service-connected lumbar spine disability, he is not competent to provide a nexus opinion in this case. The issue is medically complex, as it requires knowledge of interpretation of complicated diagnostic medical testing. Jandreau v. Nicholson, 492 F.3d 1372, 1377 n.4 (Fed. Cir. 2007). Consequently, the Board gives more probative weight to the September 2015 VA medical opinion. Service connection may also be granted on a direct basis, but the preponderance of the evidence is also against finding that the Veteran’s right hip disability is related to 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). 2. Entitlement to service connection for a right knee condition with osteoarthritis, secondary to service-connected lumbar spine disability The Veteran contends that he has a right knee disability as a result of his service-connected lumbar spine disability. The question for the Board is whether the Veteran has a current disability that is proximately due to or the result of, or was aggravated beyond its natural progress by his service-connected lumbar spine disability. The Board concludes that, while the Veteran has a current diagnosis of osteoarthritis of the right knee, the preponderance of the evidence is against finding that the Veteran’s right knee disability is proximately due to or the result of, or aggravated beyond its natural progression by service-connected disability. 38 U.S.C. §§ 1110, 1131; Allen v. Brown, 7 Vet. App. 439 (1995) (en banc); 38 C.F.R. § 3.310(a). A September 2015 VA examiner opined that the Veteran’s right knee disability is instead more likely due to natural aging and wear and tear process, and was not aggravated beyond its normal progress by the service-connected lumbar spine disability. The rationale was that there was no history of trauma and that multiple joints had developed radiographic degenerative changes more consistent with risk factors of aging and wear and tear process of the aging population. The Veteran’s representative alluded to private treatment records documenting irregularities of the hips and knees, which could be attributed to the back condition. The private treatment records referred to by the Veteran’s representative, however, do not refer to any medical opinion relating the Veteran’s right hip to the back. Rather, the report documents moderate degenerative changes of both hips and degenerative changes of the lumbar spine. While the Veteran believes his right knee disability is proximately due to or the result of his service-connected lumbar spine disability, he is not competent to provide a nexus opinion in this case. The issue is medically complex, as it requires knowledge of interpretation of complicated diagnostic medical testing. Jandreau v. Nicholson, 492 F.3d 1372, 1377 n.4 (Fed. Cir. 2007). Consequently, the Board gives more probative weight to the September 2015 VA medical opinion. Service connection may also be granted on a direct basis, but the preponderance of the evidence is also against finding that the Veteran’s right knee disability is related to 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). S. L. Kennedy Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD Sarah B. Richmond