Citation Nr: 20021847
Decision Date: 03/27/20	Archive Date: 03/27/20

DOCKET NO. 16-35 827
DATE: March 27, 2020

REMANDED

Entitlement to service connection for a left hip disability, to include as secondary to a service-connected herniated disc, lumbar spondylosis, and bilateral knee disabilities, is remanded.

REASONS FOR REMAND

This appeal comes to the Board of Veterans’ Appeals (Board) from a March 2016 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO). 

In November 2018, the Board remanded this case for additional development. Specifically, it was found that the February 2016 VA examiner did not satisfactorily address the Veteran’s contentions with respect to the etiology of his left hip disability and did not provide an adequate analysis or explanation for the cause of the Veteran’s left hip osteoarthritis. 

Although the Veteran was afforded another VA examination in February 2019, with medical opinions rendered in April 2019 and October 2019, the Board finds that another addendum medical opinion is necessary. In this regard, the VA examiner stated in October 2019 that the MRI study demonstrated findings of mild bilateral hip degenerative changes that were consistent with the age of the Veteran and not something that represented a significant pathology. The examiner then opined that since this finding was bilateral and mild it was less likely than not, less than 50 percent probability that the Veteran’s left hip condition was related to or aggravated by his service-connected back and knee disabilities. The examiner also stated that due to the finding of mild and bilateral hip degenerative changes it was less likely than not that the Veteran’s left hip was proximate to or aggravated by favoring his left side and adjusting his gait while walking. However, the Board notes that the Veteran is service-connected for a right hip disability and that the basis for that award was a July 2015 VA examination where an examiner opined that the Veteran’s right hip disability was secondary to his low back disability, and specifically the altered gait and overcompensation that resulted from the service-connected disability. As it does not appear the VA examiner considered this finding in the rendering of his medical opinion, the Board must remand this claim again.

The matter is REMANDED for the following action:

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Obtain an addendum opinion from the February 2019 VA examiner (who also rendered the April 2019 and October 2019 medical opinions in this case) regarding whether the Veteran’s left hip osteoarthritis is at least as likely as not proximately due to his service-connected herniated disc, lumbar spondylosis and/or bilateral knee disabilities, or whether the claimed disability is aggravated beyond its natural progression by those service-connected disabilities.  In addressing the foregoing questions the examiner is asked to specifically consider and address the fact that the Veteran’s right hip disability has been awarded service connection as secondary to his service-connected herniated disc, lumbar spondylosis. 

If the February 2019 VA examiner is no longer available, the claims file should be forwarded to another appropriate clinician for a medical opinion. If a physical examination is deemed necessary to provide the requested opinion, arrangements should be made for that to be completed.

 

 

A. ISHIZAWAR

Veterans Law Judge

Board of Veterans’ Appeals

Attorney for the Board	E. Kilbride, Law Clerk

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.