Citation Nr: 18157846 Decision Date: 12/14/18 Archive Date: 12/13/18 DOCKET NO. 16-60 399 DATE: December 14, 2018 ORDER Entitlement to service connection for a left hip disability is denied. REMANDED Entitlement to service connection for a low back disability is remanded. FINDING OF FACT It is not shown that the Veteran has a left hip disability (or that any such disability might be related to his service). CONCLUSION OF LAW Service connection for a left hip disability is not warranted. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.304. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran is an appellant who served on active duty from July 1969 to July 1973. This matter is before the Board of Veterans’ Appeals (Board) on appeal from a December 2015 rating decision which denied service connection for a left hip disability and for a lower back disability. Legal Criteria Service connection may be granted for disability due to disease or injury incurred in or aggravated by active military service. 38 U.S.C. § 1110; 38 C.F.R. § 3.303. To substantiate a claim of service connection, there must be evidence of: a present disability (for which service connection is sought); incurrence or aggravation of a disease or injury in service; and a causal relationship between the claimed disability and the disease or injury incurred or aggravated during service. Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004). The threshold matter that must be addressed in any claim seeking service connection is whether there is competent evidence that the Veteran actually has (or during the pendency of the claim has had) the disability for which service connection is sought. In the absence of proof of current disability there is no valid claim for service connection. See Brammer v. Derwinski, 3 Vet. App. 223, 225 (1992). Service connection for a left hip disability is denied. The Veteran’s service treatment records (STRs) are silent for complaints, findings, diagnosis, or treatment of a left hip disability. His June 1973 service separation examination report is silent regarding left hip disability or injury. A February 2017 private treatment record notes the Veteran’s complaint of left hip pain. In a November 2016 statement (on VA Form 9), the Veteran related that he injured his left hip while serving on the USS Midway when he fell from an escape ladder after a steam line broke, and the engine room was evacuated. He stated that a superior denied him opportunity to seek medical treatment at the time. VA treatment records through November 2016 do not show a diagnosis of, or treatment for, a left hip disability. The threshold requirement in substantiating a claim of service connection is that there must be competent evidence of the disability for which service connection is sought. Whether there is an underlying disability for reports of pain in an anatomical area is a medical question. Here, there is no medical evidence that the Veteran has, or during the pendency of the instant claim has had a left hip disability. The Veteran has not identified any health care provider who has treated him for, or diagnosed such disability. While he has reported left hip pain, he has not presented any evidence of pathology underlying such complaint. He has not described a disability capable of diagnosis by a layperson (such as a fracture), and his own opinion that he has an insidious left hip disability has no probative value. The Board has considered whether an examination is necessary, and finds one is not. Without documentation of a left hip injury or disease in service, there would be no basis for a medical provider to relate a current left hip disability to service. [The Veteran’s reports of an acute undocumented and untreated injury in service are too tenuous to establish that a left hip injury resulting in chronic disability occurred therein.] As there is no competent evidence that the Veteran had, a left hip disability (and no evidence that any such disability might be related to his service), he has not presented A valid claims of service connection for such disability. See 38 U.S.C. § 1110. REASONS FOR REMAND Service connection for a low back disability is remanded. The Veteran alleges that he injured his back while serving on the USS Midway when he fell from a ladder; he states that he was not afforded opportunity to seek treatment when the injury occurred. His STRs, including his June 1973 service separation examination report are silent regarding a back injury or back disability. Private treatment records from February 2017 note a chronic and persistent low back pain, but do not show a clear diagnosis. The private treatment record notes that the back pain has been present for many years and resulted from a fall during service in the Vietnam era. The Veteran has not been afforded a VA examination to determine the nature and etiology of any back disability. Considering his reports and the private treatment record and the possibility that pertinent medical evidence may be outstanding, as well as the low threshold standard for determining that a disability may be related to service, the Board finds that a medical examination is necessary. See McLendon v. Nicholson, 20 Vet. App. 79 (2006). The matter is REMANDED for the following: 1. Ask the Veteran to identify all providers of evaluations or treatment he has received for his back since his discharge from service (records of which are not already associated with his record), and to submit authorizations for VA to secure records from any private providers identified. Obtain for the record complete clinical records of the evaluations and treatment from all providers identified. 2. Then arrange for an orthopedic examination of the Veteran to determine the nature and likely etiology of his claimed back disability. The Veteran’s claims file must be reviewed by the examiner in conjunction with the examination. The examiner should: (a) Identify (by diagnosis) each low back disability entity found/shown by the record. (b) Identify the likely etiology of each low back disability entity diagnosed. Is it at least as likely as not (a 50 percent or better probability) that it is etiologically related to his active duty service and his reported (untreated) injury in a fall therein? The examiner must specifically consider and address. The examiner must include rationale with all opinions. GEORGE R. SENYK Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD E. Robert Cordingley, Associate Counsel