Citation Nr: 18152013 Decision Date: 11/20/18 Archive Date: 11/20/18 DOCKET NO. 09-14 808 DATE: November 20, 2018 ORDER Entitlement to service connection for a bilateral hip condition, is denied. Entitlement to service connection for a bilateral knee condition, is denied. Entitlement to service connection for a bilateral ankle condition, is denied. FINDINGS OF FACT 1. The Veteran failed without good cause to report for a scheduled VA examination in July 2018. 2. A bilateral hip condition is not shown to be related to active service. 3. A bilateral knee condition is not shown to be related to active service. 4. A bilateral ankle condition is not shown to be related to active service CONCLUSIONS OF LAW 1. The criteria for service connection for a bilateral hip disability are not met. 38 U.S.C. §§ 1110, 5103, 5103A, 5107; 38 C.F.R. §§ 3.102, 3.159, 3.303. 2. The criteria for service connection for a bilateral knee disability have not been met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.159, 3.303. 3. The criteria for service connection for a bilateral ankle disability have not been met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. § 3.303. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from March 1997 to August 1997, and April 2001 to September 2001. He also had a period of inactive duty training from October 1999 to November 1999, and other Reserve service. This matter is before the Board of Veterans’ Appeals (Board) on appeal of June 2007 and February 2009 rating decisions of the Cleveland, Ohio, and Montgomery, Alabama, Regional Offices (ROs) of the Department of Veterans Affairs (VA). In December 2014, the Board again remanded the case to the RO for further evidentiary development. Following the requested development, an SSOC was issued in September 2018. A review of the claims file shows that there has been substantial compliance with the Board’s remand directives. See Stegall v. West, 11 Vet. App. 268 (1998); see also Dyment v. West, 13 Vet. App. 141 (1999) (holding that another remand is not required under Stegall where the Board’s remand instructions were substantially complied with), aff’d, Dyment v. Principi, 287 F.3d 1377 (2002). The Veteran was scheduled for a VA examination in July 2018 in conjunction with his claims of service connection for the issues on appeal and the Veteran was notified at his address on record. The Veteran failed to appear for his examinations and has yet to provide any explanation for that failure to attend. Under 38 C.F.R. § 3.655, when a claimant fails to report for an examination scheduled in conjunction with an original compensation claim, the claim shall be rated based on the evidence of record. The Court of Appeals for Veterans Claims (Court) has held that when developing evidence pertinent to a claim, the Veteran also has a duty to cooperate with VA in developing the required evidence; the duty to assist is not a one-way street. Hayes v. Brown, 5 Vet. App. 60, 68 (1993) (if a veteran wishes help, he cannot passively wait for it in those circumstances where his/her own actions are essential in obtaining the putative evidence). Because the Veteran has not provided an explanation or cause for missing this appointment, the Board will move forward with a decision absent the evidence requested by its prior remand. Service Connection A veteran is entitled to VA disability compensation if there is a disability resulting from personal injury suffered or disease contracted in line of duty in active service, or for aggravation of a preexisting injury suffered or disease contracted in line of duty in active service. 38 U.S.C. §§ 1110, 1131. To establish a right to compensation for a present disability, a Veteran must show: “(1) the existence of a present disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the present disability and the disease or injury incurred or aggravated during service” - the so-called “nexus” requirement. Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004). Service connection may also be granted for a disease shown after service, when all of the evidence, including that pertinent to service, shows that it was incurred in-service. 38 C.F.R. § 3.303 (d). Service connection for chronic disease may be granted if manifest to a compensable degree within one year of separation from service. 38 U.S.C. §§ 1101, 1112, 1113, 1137; 38 C.F.R. §§ 3.307, 3.309. 1. Entitlement to service connection for a bilateral hip condition, a bilateral knee condition and a bilateral ankle condition. The Veteran is seeking entitlement to service connection for a bilateral hip condition, a bilateral knee condition, and a bilateral ankle condition. In his claim the Veteran asserted that he suffers from hip, knee, and ankle conditions as a result of service. The Board acknowledges that the Veteran has a current diagnosis for bilateral hip, knee, and ankle conditions and therefore the first criterion for establishing service connection has been met. The question, then, is whether his conditions arose in or are related to military service. Service treatment records show no evidence of complaints, treatment, or diagnosis of a bilateral hip, knee, or ankle condition while the Veteran was on active duty. The Veteran was afforded a VA examination in September 2008. The examiner opined it is less likely as not that the Veteran’s claimed condition is due to parachute jumps. The examiner indicated after a review of the Veteran’s records there were no complaints of, examination for, or treatment for any hip or ankle conditions. He also noted the Veteran did have some evaluations of his knees in 2007. The examiner indicated that the Veteran was treated for severe low back pain following a parachute jump in 2002 where the Veteran landed on his back. He noted there were no notations of landing on his extremities. He also noted that the records do not indicate any joint pain in the hip, knees, or ankles following any other parachute jumps. The examiner also noted that the Veteran’s x-ray results were essentially normal. In its December 2014 remand, the Board noted private treatment records from Dr. D. R. S. that indicated the Veteran’s ankle, knee, and hip pains were related to an in-service parachuting accident; however, he did not provide a diagnosis beyond pain. The Board also noted that in the October 2009 general VA examination, the examiner confirmed the diagnosis of ankle, knee, and hip strains. The VA examiners did not indicate whether these diagnoses were related to the Veteran’s in-service parachuting accident. The Board found the evidence of record was insufficient to decide the claims and remanded the case for a VA examination to determine the nature and cause of the Veteran’s disabilities. As noted above, the Board remanded the case in December 2014 for additional development which included affording the Veteran an additional VA examination to determine the etiology of his bilateral hip, knee, and ankle conditions. However, the Veteran failed to report for the examination. Consequently, the record is absent evidence of a bilateral hip, knee, or ankle condition during service, and medical evidence of a nexus between service and the Veteran’s bilateral hip, knee, or ankle conditions. The Board also notes that the September 2008 VA medical examiner indicated the Veteran’s bilateral hip, knee and ankle conditions are not related to service, including any parachute jumps while in service. The Board acknowledges the Veteran’s contentions that he currently suffers from a bilateral hip, knee or ankle condition a result of a parachute jump in service. Although lay persons are competent to provide opinions on some medical issues, see Kahana v. Shinseki, 24 Vet. App. 428, 435 (2011), as to the specific issue in this case, etiology of a bilateral hip, knee, or ankle condition falls outside the realm of common knowledge of a lay person. See Jandreau v. Nicholson, 492 F.3d 1372, 1377 n.4 (Fed. Cir. 2007) (lay persons not competent to diagnose cancer).” Accordingly, the Board finds that the statements as to medical causation are not competent evidence to establish service connection for bilateral knee, hip, and ankle conditions. Based on the foregoing, the Board finds that the preponderance of the evidence is against a grant of service connection for a bilateral hip, knee, or ankle condition. In reaching this conclusion, the Board has considered the benefit-of-the-doubt doctrine. However, as the preponderance of the evidence is against the Veteran’s claims, that doctrine is not applicable, and service connection must be denied. L. M. BARNARD Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD J. Whitley, Associate Counsel