Citation Nr: 20004377 Decision Date: 01/21/20 Archive Date: 01/17/20 DOCKET NO. 12-04 870 DATE: January 21, 2020 ORDER Entitlement to service connection for right hip disability is denied. FINDING OF FACT The probative evidence of record does not show the Veteran’s right hip disability is related to his active duty service, to include his service-connected bilateral foot disabilities. CONCLUSION OF LAW The criteria for service connection for right hip disability have not been met. 38 U.S.C. §§ 101, 1131; 38 C.F.R. §§ 3.6, 3.303, 3.304, 3.307, 3.309, 3.310. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty in the United States Army from August 1953 to June 1955. The Veteran was provided a hearing in September 2017 with the undersigned Veterans Law Judge and a transcript of the proceeding is of record. The claim was brought before the Board in June 2017 and December 2017 and was remanded for further development. Service Connection Service connection will be granted if the evidence demonstrates that a current disability resulted from an injury or disease incurred in or aggravated by active service. 38 U.S.C. § 1110; 38 C.F.R. § 3.303(a). In order to establish service connection, the record must show competent evidence of three things: (1) a current disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship, i.e., a nexus, between the claimed in-service disease or injury and the current disability. Holton v. Shinseki, 557 F.3d, 1362, 1366 (Fed. Cir. 2009). When considering such a claim for service connection, the Board must consider on a case-by-case basis, the competence and sufficiency of lay evidence offered to support a finding of service connection. See Davidson v. Shinseki, 581 F.3d 1313, 1316 (Fed. Cir. 2009) (quoting Jandreau v. Nicholson, 492 F.3d 1372, 1377 Fed. Cir. 2007)). The mere conclusory or generalized lay statements that a service event or illness caused a current disability are insufficient. Waters v. Shinseki, 601 F.3d 1274, 1278 (2010). Entitlement to service connection for right hip disability The Veteran contends that his right hip condition is related to his active duty service, to include as secondary to his service-connected bilateral foot disabilities. As an initial matter, the Board acknowledges that the Veteran has been diagnosed with degenerative arthritis of the right hip and hip strain. Further, it has already been established that the Veteran suffered cold injuries while in service, and he is service-connected for bilateral foot conditions. Thus, the issue turns upon whether there is evidence of a nexus between the said in-service event or injury and the present diagnosed disability, or a whether the disability is due to or aggravated by the Veteran’s service-connected disabilities. See 38 C.F.R. §§ 3.303, 3.310; Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004). The Board finds there is not. In July 2016, the Veteran received a VA examination. The examiner opined that the claimed condition was less likely than not incurred in or caused by the claimed in-service injury, event, or illness. The examiner rationalized that while the Veteran did sustain some joint stiffness from cold injury during service, there is no documentation of record that there has been continued care and treatment of this injury, to include a 30 plus year gap. The examiner provided that he was unable to confirm the Veteran’s right hip condition was related to the initial in-service injury without resorting to mere speculation and a nexus cannot be established. The examiner then opined that the claimed condition was less likely than not proximately due to or the result of the Veteran’s service-connected condition. The examiner provided the same rationale. In January 2018, the Veteran received another VA examination. The examiner opined that the claimed condition is less likely than not due to or the result of the Veteran’s service-connected condition. The examiner rationalized that the two conditions are not medically related. The examiner further explained that the claimed disorder is a separate entity entirely from the service-connected condition and unrelated to it. The examiner provided that the Veteran’s right hip strain is not due to the service-connected bilateral foot conditions and medical literature does not support a medical relationship. The examiner also provided that hip strain is often due to overuse injury causing stretching of the tendons or ligaments of the hip. The examiner then opined that the Veteran’s right hip condition is not aggravated beyond its natural progression by the service-connected condition. The examiner rationalized the Veteran’s hip strain symptoms are known to vary based upon degree of the strain and most strains are treated with rest, ice, compression, and elevation. The examiner provided that while the Veteran reports continued pain in the hip, it is not beyond the natural progression of the strain. The examiner explained that there was no objective evidence of aggravation of the right hip strain beyond natural progression by his service-connected bilateral foot conditions. The Board notes that VA treatment records do show treatment and complaints regarding the Veteran’s right hip. However, none of the records related the Veteran’s right hip condition to his active duty service, to include his service-connected bilateral foot conditions. Further, the VA treatment records show the Veteran’s report in December 2015 of only having hip pain for the last 4 years, which is over 50 years after his service. Therefore, the Board finds the July 2016 and January 2018 VA opinions to be of significant probative value in determining that the Veteran’s right hip condition is not related to his active service, to include his service-connected bilateral foot conditions. The Board notes that the probative value of medical opinion evidence is based on the medical experts’ personal examination of the patient, their knowledge, and skill in analyzing the data, and their medical conclusion. As is true with any piece of evidence, the credibility and weight to be attached to these opinions are within the province of the adjudicator. Guerrieri v. Brown, 4 Vet. App. 467, 470-71 (1993). Whether a physician provides a basis for his or her medical opinion goes to the weight or credibility of the evidence in the adjudication of the merits. See Hernandez-Toyens v. West, 11 Vet. App. 379, 382 (1998). Here, the reviewing physicians’ opinions were based on review of the Veteran’s lay contentions, his reported medical history, review of the medical evidence of record, and full examination of the Veteran. Further, complete and thorough rationales were provided for the opinions rendered and are consistent with the medical evidence of record. The Board acknowledges the Veteran’s assertions that his right hip condition is related to his active duty service, to include his service-connected bilateral foot conditions. The Board also recognizes that lay persons are competent to provide medical opinions on some medical issues. See Kahana v. Shinseki, 24 Vet. App. 428, 435 (2011). However, although the Veteran is competent to report his symptoms, any opinion regarding whether any right hip disability is related to his service, to include foot disabilities, requires medical expertise that the Veteran has not demonstrated since hip disabilities can have many causes. See Jandreau v. Nicholson, 492 F.3d 1372, 1376 (2007). Further, the Board again notes that the Veteran reported not having hip pain until 2011, over 50 years after his service. Additionally, the Veteran has provided no evidence that his right hip was due to or aggravated by his foot conditions, to include any notations in his treatment records suggesting such. The Board has also considered whether presumptive service connection is warranted for the Veteran’s right hip arthritis. However, the evidence does not show that the Veteran was diagnosed with arthritis within one year after discharge from service, so presumptive service connection is not warranted. Further, the Veteran reported in December 2015 that his right hip pain had started 4 years ago, which was over 50 years after discharge from service, so service connection based on a theory of continuity of symptomatology is also not warranted. 38 C.F.R. §§ 3.307, 3.309. In light of the foregoing, the Board concludes that the preponderance of evidence is against the claim, and the benefit of the doubt doctrine is not for application. See Gilbert v. Derwinski, 1 Vet. App. 49 (1990); Ortiz v. Principi, 274 F.3d 1361 (Fed Cir. 2001). JENNIFER HWA Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board J. Negron, Associate Counsel The Board’s decision in this case is binding only with respect to the instant matter decided. This decision is not precedential, and does not establish VA policies or interpretations of general applicability. 38 C.F.R. § 20.1303.