Citation Nr: 20008328 Decision Date: 01/31/20 Archive Date: 01/31/20 DOCKET NO. 18-03 150 DATE: January 31, 2020 ORDER Service connection for a left hip disability, claimed as secondary to the service-connected degenerative disc disease of the thoracolumbar spine, is denied. Service connection for a right hip disability, claimed as secondary to the service-connected degenerative disc disease of the thoracolumbar spine, is denied. FINDINGS OF FACT 1. The Veteran’s left hip disability is not secondary to his service-connected degenerative disc disease of the thoracolumbar spine, and is not otherwise related to an in-service injury or disease. 2. The Veteran’s right hip disability is not secondary to his service-connected degenerative disc disease of the thoracolumbar spine, and is not otherwise related to an in-service injury or disease. CONCLUSIONS OF LAW 1. The criteria for service connection for a left hip disability due to service or due to the service-connected degenerative disc disease of the thoracolumbar spine are not met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.310. 2. The criteria for service connection for a right hip disability due to service or due to the service-connected degenerative disc disease of the thoracolumbar spine are not met. 38 U.S.C. §§ 1110, 1131, 5107 (2012); 38 C.F.R. §§ 3.102, 3.303, 3.310 (2019). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from November 1967 to July 1970 and from November 1988 to May 1991. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a September 2015 rating decision. The claims on appeal were remanded by the Board in April 2019. The Regional Office (RO) having substantially complied with the remand directives, the matters are now again before the Board for review. Service Connection The Veteran contends that he has disabilities in his right and left hips that were caused by his already service-connected thoracolumbar spine (back) disability. Because the Veteran has not raised, and the record does not reasonably raise, entitlement to direct service connection, the Board’s adjudication will consider only entitlement to secondary service connection. Service connection may be granted for a disability that is proximately due to, or aggravated by, service-connected disease or injury. 38 C.F.R. § 3.310. The question for the Board is whether the Veteran has a current left and/or right hip disability that is proximately due to or the result of, or aggravated beyond its natural progress by his service-connected back disability. A March 2015 VA examination shows the diagnosis of degenerative joint disease in both hips. The x-ray reports confirming this were attached to the report. This examiner indicated that it is not evident that the bilateral hip complaints are due to the lower back arthritis. The examiner did indicate that the Veteran had an EMG coming up the following month to determine whether any lower extremity discomfort was radiculopathy associated with the low back disability. The Board observes that the Veteran does receive compensable ratings for right and left lower extremity radiculopathy associated with the back disability. Most recently, in response to the Board’s remand, a VA examiner submitted an opinion as to the etiology of the left and right hip disabilities in October 2019. The medical opinion was based upon review of the claims file, including the Veteran’s clinical records. The examiner who completed this report also confirmed that the Veteran has degenerative joint disease in both hips. Based upon the review of the clinical records, the examiner noted that there was no evidence in the file that any symptom of the back caused or aggravated the Veteran’s left or right hip disability. The examiner also noted that arthritis in one joint does not cause arthritis in another joint and that there is no medical literature to support this. The examiner concluded that the Veteran’s degenerative joint disease of his spine did not cause the degenerative joint disease of his hips. The clinical records and the Veteran’s statements also give no indication of any aggravating factors. Moreover, the examiner noted that the diagnosis of the hip disability was more than twenty years after the Veteran’s active service, such that there is also no basis for finding any direct causal connection to his active service. Based upon the foregoing, the Board concludes that, while the Veteran has a current disability in both his left and right hip, the preponderance of the evidence is against finding that the Veteran’s left and right hip disabilities are proximately due to or the result of, or aggravated beyond its natural progression by his service-connected back disability. 38 U.S.C. §§ 1110, 1131; Allen v. Brown, 7 Vet. App. 439 (1995) (en banc); 38 C.F.R. § 3.310(a). To the extent that the Veteran believes his left and right hip degenerative joint disease is proximately due to or the result of, or aggravated beyond its natural progression by his service-connected back disability, the Veteran is not competent to provide a nexus opinion regarding this issue. The issue is medically complex, as it requires knowledge of anatomical relationships and interpretation of complicated diagnostic medical testing. Therefore, it is outside the competence of the Veteran in this case because the record does not show that he has the skills or medical training to make such a determination. Jandreau v. Nicholson, 492 F.3d 1372, 1377 n.4 (Fed. Cir. 2007); see also Kahana v. Shinseki, 24. Vet. App. 428 (2011). Consequently, the Board gives more probative weight to the VA opinions in this case. Accordingly, these claims must be denied. The Board has duly considered the benefit-of-the-doubt doctrine. However, the preponderance of the evidence is against the Veteran’s claims, so that doctrine is not applicable. M.J. COLICELLI Acting Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board A. Adamson, 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.