Citation Nr: 20043552 Decision Date: 06/29/20 Archive Date: 06/29/20 DOCKET NO. 10-33 855 DATE: June 29, 2020 REMANDED Entitlement to service connection for a right hip disorder, to include as secondary to service-connected patellofemoral pain syndrome of the right knee and/or chronic back strain, is remanded. REASONS FOR REMAND The Veteran served on active duty from July 1987 to August 1990. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a December 2009 rating decision issued by a Department of Veterans Affairs (VA) Regional Office. In September 2014, the claim was remanded for additional development and, in April 2015, the Veteran testified at a Board hearing before the undersigned Veterans Law Judge. A transcript of the hearing is associated with the record. In June 2015 and November 2016, the Board again remanded the case for additional development and, in July 2017, denied the Veteran’s claim for service connection for a right hip disorder. He subsequently appealed such decision to the United States Court of Appeals for Veterans Claims (Court), which, in June 2018, on the basis of a Joint Motion for Partial Remand (JMPR), vacated the July 2017 decision and remanded the matter to the Board for further consideration. In January 2019, the Board remanded the case for additional development and it now returns for further appellate review. Entitlement to service connection for a right hip disorder, to include as secondary to service-connected patellofemoral pain syndrome of the right knee and/or chronic back strain. As noted above, this matter was remanded by the Board in January 2019. However, there has not been substantial compliance with the Board’s previous remand directives and, as such, another remand is required. Stegall v. West, 11 Vet. App. 268, 271 (1998). In this regard, the January 2019 remand directed that an addendum opinion addressing the nature and etiology of the Veteran’s claimed right hip disorder be obtained. Specifically, the examiner was requested to determine whether the Veteran has a diagnosis of a right hip disability at any time since July 2009 and, if not, reconcile such a finding with the evidence of record showing that he has a current diagnosis of right sacroiliac joint arthralgia and arthropathy. Here, the Board requested that the examiner should explain why such diagnosis was not considered a right hip disability as the hips formed part of the pelvis. Further, if such is not considered a right hip disability, the examiner was requested to determine if such diagnosis is separate and distinct from the Veteran’s service-connected back strain in light of the fact that such is manifested by hip pain. Upon remand, the Veteran was afforded a VA examination in October 2019, at which time the examiner found that the Veteran did not have a current right hip disability as such was not shown on clinical examination and no functional impairment was associated with his reported symptoms. In a February 2020 addendum opinion, he reported that, with respect to whether the Veteran had a right hip disability at any time since July 2009, such question, although relevant from a layperson’s perspective, did not pertain to the key question about his current disability. Here, the examiner noted that, as an example, a patient’s knee contusion injury may be etiology for temporary disability during convalescent period – then the temporary disability could be removed due to healing of the knee contusion. He further observed that the Veteran’s available medical records, as well as September 2015 and October 2019 VA examinations, were silent for a current right hip disability. Further, while he had limited hip range of motion during the October 2019 VA examination, such was attributed to the Veteran’s body habitus and right knee discomfort. The Board finds that the February 2020 VA addendum opinion does not substantially comply with the January 2019 remand directives. Specifically, he did not reconcile his finding that the Veteran did not have a current right hip disability at any time since July 2009 with the evidence of record showing that the Veteran had a current diagnosis of right sacroiliac joint arthralgia and arthropathy, to include explaining why such diagnosis was not considered a right hip disability as the hips formed part of the pelvis, and whether such diagnosis is separate and distinct from the Veteran’s service-connected back strain in light of the fact that such is manifested by hip pain. Therefore, a remand for an addendum opinion addressing such matter is necessary. The matter is REMANDED for the following action: Forward the record, to include a copy of this remand, to an appropriate examiner to offer an opinion regarding the nature and etiology of the Veteran’s claimed right hip disorder. Following a review of the record, the examiner should address the following inquiries: (A) The examiner should determine whether the Veteran has a diagnosis of a right hip disability at any time since July 2009, the date of receipt of his claim, even if such is asymptomatic or has resolved. In this regard, the examiner is advised that the term “disability” for VA compensation purposes refers to the functional impairment of earning capacity, not the underlying cause of said disability. In this regard, pain alone can serve as a functional impairment and therefore qualify as a disability. If the examiner finds that the Veteran does not have a right hip disability at any time since July 2009, he or she should reconcile such a finding with the evidence of record showing that the Veteran has a current diagnosis of right sacroiliac joint arthralgia and arthropathy. In this regard, the examiner should explain why such diagnosis is not considered a right hip disability other than that the “sacroiliac joint is a structure of the posterior pelvis” as the hips form part of the pelvis. If the examiner finds that the Veteran’s current diagnosis of right sacroiliac joint arthralgia and arthropathy is not considered a right hip disability, he or she should also determine if such diagnosis is separate and distinct from the Veteran’s service-connected back strain in light of the fact that such is manifested by hip pain. (B) For each right hip disability, the examiner should offer an opinion as to whether it is at least as likely as not (50 percent or greater probability) that such is caused OR aggravated by the Veteran’s service-connected right knee disability and/or his back disability. For any aggravation found, the examiner should state, to the best of their ability, the baseline of symptomatology and the amount, quantified if possible, of aggravation beyond the baseline symptomatology. A rationale for any opinion offered should be provided. A. JAEGER Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Koria B. Stanton, 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.