Citation Nr: 20043333 Decision Date: 06/26/20 Archive Date: 06/26/20 DOCKET NO. 13-01 100 DATE: June 26, 2020 REMANDED Entitlement to service connection for a left hip disability, to include as due to his service-connected posttraumatic arthropathy of the left foot and postoperative resection of the left knee medial plica is remanded. REASONS FOR REMAND The Veteran had active duty service in the United States Marine Corps from July 1981 to July 1984, and from November 1986 to May 1989. This matter originally came before the Board of Veterans’ Appeals (Board) on appeal from a March 2010 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO). The Board remanded the matter in April 2016 to obtain a VA examination. Thereafter, a December 2017 supplemental statement of the case denied service connection. In April 2018 the Board remanded the matter to obtain outstanding treatment and social security records. Thereafter, an April 2020 supplemental statement of the case denied service connection. Entitlement to service connection for a left hip disability, to include as due to his service-connected posttraumatic arthropathy of the left foot and postoperative resection of the left knee medial plica. Regrettably, this issue must be remanded again to provide an adequate VA examination. Once VA has provided a VA examination, it is required to provide an adequate one, regardless of whether it was legally obligated to provide an examination in the first place. Barr v. Nicholson, 21 Vet. App. 303 (2007). A VA examiner must consider the Veteran’s lay statements regarding the incurrence of a disorder, and his statements regarding the continuity of symptomatology. Dalton v. Nicholson, 21 Vet. App. 23, 39-40. A Veteran is competent to report symptoms that are capable of lay witness observation. See Layno v. Brown, 6 Vet. App. 465, 469 (1994). Service treatment records show the Veteran complained of left hip pain in 1988. There are no additional complaints relating to his hip during service. In 2009, the Veteran sought treatment for chronic left hip pain. He was diagnosed with a left hip labrum tear in June 2009 and trochanteric bursitis in November 2009. The Veteran was afforded a VA examination in January 2010. However, the Board found this opinion inadequate in an April 2016 decision. The Veteran was afforded a new examination in December 2016. The December 2016 examiner opined that the Veteran’s left hip disability is less likely than not related to service. He reasoned that in his review of the Veteran’s medical history, including service treatment records, he was “unable to find any medical care for chronic recurrent left hip pain or condition while in service.” He also noted the Veteran was not diagnosed with any left hip condition in service. Additionally, the examiner opined that the Veteran’s left hip disability is less likely than not caused or aggravated by his service-connected posttraumatic arthropathy of the left foot or postoperative resection of the left knee medial plica. He reasoned that “there is no objective medical evidence in the medical literature establishing a direct cause and effect relationship, including aggravation beyond its natural progression” between his service-connected disabilities and his left hip labrum tear. However, the examiner did not discuss the Veteran’s trochanteric bursitis. There is no opinion as to whether this condition is related to service, or caused or aggravated by his service-connected posttraumatic arthropathy of the left foot or postoperative resection of the left knee medial plica. Additionally, the examiner did not take into consideration the Veteran’s lay statements. In March 2010 correspondence, the Veteran stated why he believed his current left hip disability was related to his service connected posttraumatic arthropathy of the left foot or postoperative resection of the left knee medial plica. “Due to the severity of my left lower extremity I have to compensate my weight and movement. By doing this it has damaged my left hip and consequently it led to surgery.” The examiner did not address the Veteran’s lay statements regarding the incurrence of his left hip disorder, therefore this medical opinion is inadequate. Dalton v. Nicholson, 21 Vet. App. 23, 39-40. A new opinion based on a full review of the record, consideration of the Veteran’s contentions, and supported by stated rationale is needed to fairly resolve the Veteran’s claim. See 38 U.S.C. § 5103A; 38 C.F.R. § 3.159; Nieves-Rodriguez v. Peake, 22 Vet. App. 295; Dalton v. Nicholson, 21 Vet. App. 23. The matters are REMANDED for the following action: 1. Obtain an addendum opinion to the December 2016 VA examination report and medical opinion for the Veteran’s left hip disability from an orthopedic surgeon or internist (M.D.). The examiner should opine as to whether it is at least as likely as not (50 percent probability or greater) that the Veteran’s left hip condition, including labrum tear AND trochanteric bursitis of the left hip: i. Had its onset in service, ii. Is otherwise related to an in-service injury, event, or disease, iii. Is caused by the Veteran’s service-connected posttraumatic arthropathy of the left foot or postoperative resection of the left knee medial plica, or iv. Is aggravated beyond its natural progression by the Veteran’s service-connected posttraumatic arthropathy of the left foot or postoperative resection of the left knee medial plica. In rendering this opinion, the examiner must consider and address the Veteran’s lay statement from his March 2010 correspondence, wherein he explains that his service-connected disabilities caused him to compensate his weight and movement, which therefore caused his left hip disability. The examiner must also consider the November 18, 2009 letter from B.M., DC (uploaded as “Buddy/Lay Statement” dated 6/11/09) and December 31, 2009 letter from Dr. H.G. (uploaded as “Third Party Correspondence” dated 1/4/10). The examiner is requested to provide a clear rationale and explain in detail the underlying reasoning for any opinions expressed. A discussion of the facts and medical principles involved would be of considerable assistance to the Board. If the examiner cannot provide the requested opinion without resorting to speculation, he or she should expressly indicate this and provide a supporting rationale as to why an opinion cannot be made without resorting to speculation. TANYA SMITH Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board A. Papacalos, 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.