Citation Nr: 18151570 Decision Date: 11/19/18 Archive Date: 11/19/18 DOCKET NO. 10-01 583 DATE: November 19, 2018 REMANDED Entitlement to service connection for a right hip disability, including as secondary to service-connected lumbar spine disorder, is remanded. REASONS FOR REMAND The Veteran served on active duty from March 1958 to February 1960 and from January 1991 to June 1991, with subsequent service in the Army National Guard. This matter comes before the Board of Veterans’ Appeals (Board) from a December 2008 rating decision of a Regional Office (RO) of the Department of Veterans Affairs (VA). This matter was previously by the Board in November 2014, May 2015, and in January 2017. In August 2017, the Board denied service connection for the right hip disability. The Veteran appealed the decision to the Court of Appeals for Veterans’ Claims (the Court) and, in May 2018, the Court vacated the Board’s August 2017 decision and returned the claim to the Board for action consistent with the Joint Motion for Remand (JMR).   1. Entitlement to service connection for a right hip disability, including as secondary to service-connected lumbar spine disorder, is remanded. The Veteran contends that he incurred a right hip disability from jumping about 8 feet off a 2-and-a-half-ton truck onto a dune in Saudi Arabia in 1991. The Veteran underwent VA medical examinations in January 2015, July 2016, and February 2017. In a February 2017 supplemental opinion, the examiner who conducted the earlier examinations opined that the Veteran’s current right hip disability was less likely than not incurred in or caused by the claimed in-service injury, event or illness. The examiner’s rationale, in pertinent part, was that ‘there is no evidence showing continuous and chronic right hip pain or treatments after service to account for a permanent impairment related to service and affecting only his right hip joint.’ The examiner additionally noted that X-rays showing bilateral degenerative joint disease first appeared in 2007, years after service. As noted in the JMR, the examiner’s opinion reflects reliance on an inaccurate factual premise. Indeed, both the Veteran and his wife have asserted that the Veteran experienced continuous right hip pain following service and the Board has previously found them competent and credible in this regard. The February 2017 opinion appears to discount this competent and credible lay contentions regarding continuity of symptomatology. The JMR also highlighted another factual inaccuracy in the February 2017 opinion. In the rationale for the unfavorable finding, the examiner stated, ‘X-rays showing bilateral degenerative joint disease first appeared in 2007, years after service.’ The Board, however, observes that available treatment records show an April 2003 diagnosis of osteoarthritis of the right hip and a July 2004 diagnosis of degenerative joint disease of the right hip – although the records did not indicate whether those diagnoses were made on the basis of right hip imaging studies. The VA examiner failed to address these earlier diagnoses of osteoarthritis, and instead focused on the 2007 diagnosis of degenerative joint disease, which contained the first imaging study of record. Accordingly, the Board finds that a remand is necessary to obtain yet another addendum opinion. The matter is REMANDED for the following action: Obtain an addendum opinion from the February 2017 VA examiner, if available. If unavailable, the opinion must be provided by an equally suitable examiner. The examiner must review the entire claims file and a copy of this remand. If the examiner determines that a physical examination is necessary to render the opinion, then one should be scheduled and all necessary testing should be conducted. The examiner is to provide an opinion as to whether it is at least as likely as not that any current right hip disability, to include degenerative joint disease, had onset in service or is otherwise related to service. In doing so, the examiner must address the Veteran’s competent and credible lay statements that he has suffered continuous right hip pain since service. With regard to the right hip pain since service, the physician should indicate whether it is at least as likely as not that this pain was an early manifestation of the subsequently diagnosed arthritis – first shown in April 2003 and July 2004 (although the records did not indicate whether those diagnoses were made on the basis of right hip imaging studies) and later confirmed on imaging studies in 2007. If the examiner believes the 2003 and/or 2004 findings are not sufficient to establish the presence of degenerative joint disease (prior to the imaging studies in 2007), then this must be sufficiently explained. The examination report must include a thorough rationale for all opinions expressed. If the examiner feels that a requested opinion cannot be rendered without resorting to speculation, the examiner must explain why this is so. D. JOHNSON Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD M. Aoughsten, Associate Counsel