Citation Nr: 18151444 Decision Date: 11/20/18 Archive Date: 11/19/18 DOCKET NO. 16-30 775 DATE: November 20, 2018 REMANDED Entitlement to service connection for degenerative left hip replacement, to include as secondary to service-connected disability of the lumbar degenerative disc disease is remanded. Entitlement to service connection for degenerative right hip replacement, to include as secondary to service-connected disability of the lumbar degenerative disc disease is remanded. REASONS FOR REMAND The Veteran served on active duty from June 1973 to June 1993. The case is before the Board of Veterans’ Appeals (Board) on appeal from an August 2015 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO) in Winston-Salem, North Carolina. Secondary service connection for right and left hip disorders Although the Board regrets the additional delay, a remand is necessary to ensure that due process is followed and that there is a complete record upon which to decide the Veteran’s claim so that he is afforded every possible consideration. 38 U.S.C. § 5103A (2012); 38 C.F.R. § 3.159 (2017). At the outset, the Veteran has been diagnosed with right and left hip degenerative joint disease (DJD). See March 2016 private treatment record. The Veteran underwent a total hip arthroplasty in February 2015. Moreover, the Board notes that the Veteran is service-connected for lumbar degenerative disc disease (DDD) with spondylolisthesis L-5/S-1 and degenerative osteoarthritis. In the August 2015 VA examination, the VA examiner opined that the Veteran’s right and left hip DJD were less likely as not proximately due to or the result of his service-connected DDD. The VA examiner reasoned that, due to the Veteran’s bilateral hip replacement, his arthritis was alleviated. The VA examiner further reasoned that the Veteran’s hip arthritis was not due to the service-connected DDD and, rather, due to sciatic pain that was improved with the bilateral hip replacement. The Board notes, however, that the VA physician only opined on causation and did not provide an opinion on aggravation. Specifically, there is no opinion addressing whether the Veteran’s right and left hip DJD were aggravated by his service-connected DDD. The Board adds that in Allen v. Brown, 7 Vet. App. 439 (1995), the Court of Appeals for Veterans Claims interpreted the language of 38 C.F.R. § 3.310(b) to mean that an additional disability may be entitled to secondary service connection if it is caused by or aggravated by a service-connected disability. Thus, when determining secondary service connection, both causation and aggravation must be addressed. See El-Amin v. Shinseki, 26 Vet. App. 136 (2012). Therefore, a remand is necessary to obtain an addendum opinion to determine whether the Veteran’s current left and right hip DJD were aggravated by his service-connected DDD. The matters are REMANDED for the following action: 1. Obtain and associate with the record all relevant outstanding VA and private treatment records. All records/responses received must be associated with the electronic claims file. 2. After the foregoing, return the claims file including a copy of this remand to the August 2015 VA physician, or a qualified examiner if the 2015 VA physician is no longer available. The record and this remand should be reviewed by the examiner and he/she should note that the record has been reviewed. The physician is asked to address the following: (a.) Whether it is at least as likely as not (i.e., a 50 percent or greater probability) that the Veteran’s right and left hip DJD were proximately caused by his service-connected DDD. (b.) Whether it is at least as likely as not (i.e., a 50 percent or greater probability) that the Veteran’s right and left hip DJD were aggravated (i.e., worsened beyond normal progression) by his service-connected DDD. For the purposes of secondary service connection, the examiner is advised that aggravation is defined as “any increase in disability.” See Allen v. Brown, 7 Vet. App. 439, 448 (1995). If it is determined that the Veteran’s right and left hip DJD were aggravated beyond the natural progression by his service-connected DDD, please discuss whether the baseline level of severity of the peripheral vascular disease is established by medical evidence created before the onset of aggravation or by the earliest medical evidence created at any time between the onset of aggravation and the receipt of medical evidence establishing the current level of severity. The examiner should cite to the medical and competent lay evidence of record and explain the rationale for all opinions given. If after consideration of all pertinent factors it remains that the opinion sought cannot be given without resort to speculation, it should be so stated and the provider must (to comply with governing legal guidelines) explain why the opinion sought cannot be offered without resort to speculation. 3. After completing all actions set forth above and any further action needed because of the above development, readjudicate the service connection claim on appeal, to include service connection on a secondary basis. If any benefit on appeal remains denied, the RO should furnish to the Veteran and his representative an appropriate Supplemental Statement of the Case (SSOC) and allow the appropriate time for response. Then return the case to the Board for further appellate review. KRISTI L. GUNN Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD A. C. Slaughter, Associate Counsel