Citation Nr: 18154446
Decision Date: 11/29/18	Archive Date: 11/29/18

DOCKET NO. 15-04 047A
DATE:	November 29, 2018
REMANDED
Entitlement to service connection for a left hip disability, to include as secondary to a service connected left knee disability is remanded.
REASONS FOR REMAND
The Veteran served on active duty in the U.S. Marine Corps from December 1994 to February 1999 from March 2003 to March 2005 and from December 2005 to September 2010 with service in Southwest Asia. In addition, the Veteran served in the U.S. Marine Corps Reserves.
Service connection for a left hip disability, to include as secondary to a service connected left knee disability 
The Veteran contends that he injured his left hip in service 
The Board cannot make a fully-informed decision on the issue of entitlement to service connection for a left hip disability, to include as secondary to a service connected left knee disability because no VA examiner has fully opined whether the disability was caused or aggravated by service or secondary to a service-connected disability. As such a remand is warranted for a VA examination.  
The matter is REMANDED for the following action:
Schedule the Veteran for an examination by an appropriate clinician to determine the nature and etiology of his left hip disability. The examiner must opine whether: 
(a.) Is it at least as likely as not (a 50 percent probability or greater) that the Veteran’s left hip disability is caused or aggravated by an in-service injury or disease?
(b.) If a diagnosis of arthritis is found, is it at least as likely as not that the Veteran’s arthritis (1) began during active service, (2) manifested within the applicable presumptive period after discharge from service, or (3) was noted during service with continuity of the same symptomatology since service?
(c.) Is it at least as likely as not (a 50 percent probability or greater) that the Veteran’s left hip disability was caused by his service connected left knee disability?
(d.) Is it at least as likely as not (a 50 percent probability or greater) that the Veteran’s left knee disability was aggravated (permanently worsened beyond its natural progression) by his service connected left knee disability?
Review of the entire claims file is required. The examiner must provide a complete rationale for all findings and opinions, and a discussion of the facts and medical principles involved would be of considerable assistance to the Board. Attention is invited to the January 2010 VA examination finding a normal left hip; a November 2010 hip X-ray; the June 2014 VA examination noting the Veteran’s left hip condition is less likely than not proximately due to or the result of his service connected left knee ACL injury. A January 2016 opinion from the Veteran’s treating VA physician noted consistent left hip pain which is as likely as not related to a sports injury sustained in 2003 in-service.  Lastly, attention is invited to the Veteran’s statements noting ongoing left hip pain since his active duty deployments. 
If aggravation is found, identify to the extent possible the baseline level of disability prior to the aggravation and determine what degree of additional impairment is attributable to aggravation of his left hip disability by the service connected disability. 
 
 
Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD	K. Kardian