Citation Nr: 18154885 Decision Date: 12/04/18 Archive Date: 11/30/18 DOCKET NO. 15-15 477 DATE: December 4, 2018 REMANDED Entitlement to service connection for a right hip disability, to include as secondary to a right knee disability is remanded. Entitlement to service connection for a right ankle disability, to include as secondary to a right knee disability is remanded. Entitlement to service connection for hearing loss is remanded. REASONS FOR REMAND The Veteran served on active duty from December 1979 to January 1983. These matters come before the Board of Veterans’ Appeals (Board) on appeal from an August 2012 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO) which denied service connection for a hearing loss disability, a right ankle disability, to include as secondary to a right knee disability, and a right hip disability, to include as secondary to a right knee disability. 1. Entitlement to service connection for a right hip disability, to include as secondary to a right knee disability, is remanded. The Board cannot make a fully-informed decision on the issue of service connection for a right hip disability because no VA examiner has opined whether the Veteran has a right hip disability related to his service-connected right knee disability. The Veteran last underwent a VA examination for his claimed right hip disability in July 2017. However, the July 2017 VA examiner did not issue a nexus opinion related to the Veteran’s claimed right hip disability. Furthermore, a statement from B.S., D.C. noted that based upon examination and evaluation he felt the hip pain was referred pain from sacroiliitis versus true hip involvement. During the pendency of this appeal, service connection was granted for the thoracolumbar spine. Accordingly, on remand, the RO should seek an addendum opinion regarding whether the Veteran has a right hip disability proximally related to any service-connected disability. 2. Entitlement to service connection for a right ankle disability, to include as secondary to a right knee disability, is remanded. The Veteran last underwent a VA examination on his right ankle in October 2011. Since that time, the Veteran has undergone a total knee replacement of his right knee, and the Veteran has indicated that his service-connected right knee disability has caused a right ankle disability. Significantly, a report from B.S., D.C. noted an unequal leg length, most likely from the surgical repair of the right knee and indicated it was “quite possible” that this caused the ankle pain. No further rationale was provided. On remand, the RO should schedule the Veteran for a VA examination regarding whether the Veteran has a right ankle disability proximally related to his service-connected right knee disability. 3. Entitlement to service connection for hearing loss is remanded. The Veteran claims that he has hearing loss due to noise exposure during his active duty service. The Veteran last underwent a VA examination for his claimed hearing loss disability in November 2011. At that time, the VA examiner diagnosed the Veteran with hearing loss, but opined that the Veteran’s hearing loss was less likely than not related to his service. The examiner based this opinion predominantly on the normal examination at separation. The examiner indicated there was no significant threshold shifts from enlistment to separation. However, service treatment records include a audiogram from September 1981 that included several left ear findings that were 20 decibels or greater. The examiner did not discuss this record. Accordingly, another examination is necessary. The matters are REMANDED for the following action: 1. Obtain an addendum opinion from an appropriate clinician (or schedule another VA examination, if deemed necessary) regarding the nature and etiology of the right hip disability. The examiner must opine whether it is at least as likely as not (1) proximately due to his service-connected right knee disability or thoracolumbar spine disability, or (2) aggravated beyond its natural progression by service-connected right knee or thoracolumbar spine disability. The examiner must comment on the 2013 opinion of B.S., D.C and the May 2012 VA examination that noted a gait abnormality. 2. Schedule the Veteran for an examination by an appropriate clinician to determine the nature and etiology of any right ankle disability. The examiner must opine whether it is at least as likely as not (1) proximately due to his service-connected right knee disability or (2) aggravated beyond its natural progression by service-connected right knee disability. The examiner must comment on the 2013 opinion of B.S., D.C. and the May 2012 VA examination that noted a gait abnormality 3. Schedule the Veteran for an examination by an appropriate clinician to determine the nature and etiology of any hearing loss disability. The examiner must opine: a) whether any hearing loss disability is at least as likely as not related to an in-service injury, event, or disease, including noise exposure to include airplane noises and noise from grenade launchers; b) whether any hearing loss disability at least as likely as not (1) began during active service, (2) manifested within one year after discharge from service, or (3) was noted during service with continuity of the same symptomatology since service. The examiner must discuss the September 1981 audiogram. H. SEESEL Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD A. Boal, Associate Counsel