Citation Nr: 20009627 Decision Date: 02/06/20 Archive Date: 02/05/20 DOCKET NO. 15-38 477 DATE: February 6, 2020 REMANDED Entitlement to service connection for a bilateral hip disorder, to include as secondary to service-connected left knee disability and/or claimed right knee and lumbar spine disorders, is remanded. REASONS FOR REMAND The Veteran had active duty service from September 1973 to August 1975. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a September 2010 rating decision by a Department of Veterans Affairs (VA) Regional Office (RO). This case was last before the Board in October 2018, at which time the Board reopened claims of service connection for right knee, left wrist, and lumbar spine disorders; the Board remanded those claims for additional development, as well as clear and unmistakable error claims with regards to adjudication of those issues in a final January 2009 rating decision. The Board also remanded an increased evaluation claim for his left knee disability and a claim of entitlement to a total disability rating based on individual unemployability due to service-connected disabilities (TDIU) for additional development. Those claims are still pending at the Agency of Original Jurisdiction (AOJ) and the Board will not address those issues further at this time. In the October 2018 decision, however, the Board denied service connection for a bilateral hip disorder. The Veteran timely appealed that decision to the United States Court of Appeals for Veterans Claims (Court). During the pendency of the appeal, the parties agreed to joint vacate and remand that claim to the Board for additional clarification and/or development. The case has been returned to the Board at this time in compliance with the August 2019 Joint Motion for Remand and Court order. In the Joint Motion for Remand, the parties indicated that the Board needed to clarify its reasons and bases for finding that April and May 2010 statements from the Veteran’s treating chiropractor, Dr. D.E., did not have adequate rationales and to also consider whether a VA medical opinion regarding secondary aggravation due to the Veteran’s left knee disability was needed. With regards to Dr. D.E.’s statements, the Board reflects they are imprecise, referring to the Veteran’s knees and back as causing the Veteran’s bilateral hip problems. The Board notes that the Veteran is solely service connected for his left knee and is not currently service connected for his lumbar spine and right knee disabilities. Dr. D.E.’s statements do not appear to differentiate between service-connected and nonservice-connected disabilities and therefore the probative value of those statements is, at best, minimal. However, after review of the claims file, including the April and May 2010 statements from Dr. D.E. as well as the July 2010 VA examination and medical opinion, the Board finds that a remand is necessary in order to obtain a new VA examination that adequately addresses all aspects of the bilateral hip claim. See Barr v. Nicholson, 21 Vet. App. 303, 311 (2007); Kowalski v. Nicholson, 19 Vet. App. 171, 179 (2005) (a VA examination must be based on an accurate factual premise). The Board also notes that the bilateral hip claim is intertwined with the remanded right knee and lumbar spine claims. See Henderson v. West, 12 Vet. App. 11, 20 (1998); Harris v. Derwinski, 1 Vet. App. 180, 183 (1991). On remand, the Board also finds that any outstanding VA treatment records should also be obtained. See 38 U.S.C. § 5103A(b), (c); 38 C.F.R. § 3.159(b); see also Sullivan v. McDonald, 815 F.3d 786 (Fed. Cir. 2016); Bell v. Derwinski, 2 Vet. App. 611 (1992). The matters are REMANDED for the following action: 1. Obtain any and all VA treatment records and associate those documents with the claims file. 2. Schedule the Veteran for a VA examination with an appropriate examiner in order to determine whether any bilateral hip disorders are related to service or secondary to his service-connected left knee disability. The claims folder must be made available to and be reviewed by the examiner. All tests deemed necessary should be conducted and the results reported in detail. Following examination of the Veteran and review of the claims file, the examiner is asked to specifically state all bilateral hip disorders found. Then, the examiner is asked to opine whether such least as likely as not (50 percent or greater probability) began in or are otherwise related to his miliary service. For any bilateral hip disorders found above that are not found to be directly related to military service, the examiner must opine whether such at least as likely as not is (a) caused by; or, (b) aggravated by the Veteran’s service-connected left knee disability and total replacement, to include any abnormal weightbearing or gait as a result of that disability. The examiner is asked to provide an opinion as to both causation and aggravation. The examiner is reminded that merely because the left knee disability did not cause the bilateral hip disorders such is not an adequate rationale for why that disability does not aggravate the bilateral hip disorders and an independent inquiry into that theory of entitlement must be undertaken by the examiner. Further, if the examiner does not find that the bilateral hip disorders are related to military service or to his service-connected left knee disability, the Board further requests that the VA examiner address whether the Veteran’s nonservice-connected right knee and/or lumbar spine disorders likewise either cause or aggravate the Veteran’s bilateral hip disabilities. In addressing the above, the examiner should consider any of the Veteran’s lay statements regarding symptomatology during service and any continuity of symptomatology since discharge and/or since onset. The examiner should specifically consider and discuss the April and May 2010 statements from Dr. D.E. and the July 2010 VA examiner’s findings and conclusions. The examiner should also consider any other pertinent evidence of record, as appropriate. All findings should be reported in detail and all opinions must be accompanied by a clear rationale. L. M. BARNARD Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board M. Peters, Senior 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.