Citation Nr: 21003008 Decision Date: 01/19/21 Archive Date: 01/19/21 DOCKET NO. 16-05 244 DATE: January 19, 2021 ORDER Service connection for right hip osteoarthritis is granted. Service connection for lumbar spondylosis and intervertebral disc syndrome is granted. FINDINGS OF FACT 1. Resolving all doubt in the Veteran’s favor, her current right hip disorder, diagnosed as osteoarthritis, is related to her military service. 2. Resolving all doubt in the Veteran’s favor, her current back disorder, diagnosed as lumbar spondylosis and intervertebral disc syndrome, is related to her military service. CONCLUSIONS OF LAW 1. The criteria for service connection for right hip osteoarthritis have been met. 38 U.S.C. §§ 1131, 5107; 38 C.F.R. §§ 3.102, 3.303. 2. The criteria for service connection for lumbar spondylosis and intervertebral disc syndrome have been met. 38 U.S.C. §§ 1131, 5107; 38 C.F.R. §§ 3.102, 3.303. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from June 1979 to November 1983. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a rating decision issued in December 2013 by a Department of Veterans Affairs (VA) Regional Office. In February 2019, the Veteran and her daughter testified at a Board hearing before the undersigned Veterans Law Judge. A transcript of the hearing is of record. In August 2019, the Board remanded the case for additional development it now returns for further appellate review. Following the issuance of the most recent supplemental statement in April 2020, the Veteran submitted additional evidence in support of her appeal in June 2020. 1. Entitlement to service connection for a right hip disorder. 2. Entitlement to service connection for a back disorder. Service connection may be granted for a disability resulting from disease or injury incurred in or aggravated by service. 38 U.S.C. § 1131; 38 C.F.R. § 3.303(a). Service connection may also be granted for any disease diagnosed after discharge, when all of the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303(d). Direct service connection may not be granted without evidence of a current disability; in-service incurrence or aggravation of a disease or injury; and a nexus between the claimed in-service disease or injury and the present disease or injury. Id.; see also Caluza v. Brown, 7 Vet. App. 498, 506 (1995) aff’d, 78 F.3d 604 (Fed. Cir. 1996) [(table)]. The Veteran contends that she has right hip and back disorders that had their onset during service, or are otherwise the result of an injury incurred therein. In this regard, at her February 2019 Board hearing, she reported that she injured her right hip and back when lifting and transferring a patient from a stretcher to a gurney while performing her duties as a hospital corpsman in 1981. She further indicates that she has experienced right hip and back pain since service. Consequently, the Veteran claims that service connection for such disorders is warranted. As an initial matter, the Board notes that the record reflects current diagnoses of right hip osteoarthritis as well as lumbar spondylosis and intervertebral disc syndrome. Additionally, the Veteran’s service treatment records reflect that, on July 10, 1981, she was referred for an orthopedic consultation. In requesting such, it was noted that she had right hip pain since March 1981 and X-rays indicated roughening of both hip joint surfaces. Upon examination, the Veteran reported right hip pain with a gradual onset in March 1981 and, since such time, the pain radiated down the right leg, knee, and foot, and currently included low back pain. Upon review of the X-rays, the physician noted irregular surfaces. A whole body bone scan was ordered, and in August 1981, such was noted to be normal. On July 13, 1981, the Veteran reported increased pain in the right hip that had been present since March 1981. The examiner noted X-rays showed possible early osteoarthritis. On July 20 and 24, 1981, the Veteran again reported right hip pain. An undated service treatment record reflects complaints of right hip and low back pain since July 5, 1981, at which time she was diagnosed with arthritis by a private physician. It was further noted that a military physician also thought it was arthritis. Another undated service treatment record reflects the Veteran’s report of recurring right hip pain and a diagnosis of possible early osteoarthritis on July 13, 1981. The assessment was rule out early osteoarthritis of the right hip. In September 1981, the Veteran reported a right hip injury. The impression was right hip pain of unknown etiology and tendonitis. In November 1981, the Veteran reported experiencing right hip pain for six month. An August 1983 Report of Medical History, completed at the time of the Veteran’s separation examination, reflects prior treatment at Jones County Community Hospital emergency room in Laurel, Mississippi, for right hip pain in November 1981. She reported that she was not suffering from such pain at the time of the examination; however, she did stated that she suffered from and had been treated for arthritis. The examiner stated that the history of arthritis was unknown, and such symptoms could be transient and/or related to her pregnancy. In light of evidence of a current right hip disorder and in-service complaints, the Veteran was afforded a VA examination in November 2013 so as to determine the etiology of such disorder. At such time, the examiner opined that her right hip disorder was less likely than not incurred in or caused by the claimed in-service injury, event, or illness. In this regard, she noted that the Veteran was treated for a right hip disorder on several occasions during service, that the August 1981 bone scan was negative, and that she reported such was not a problem at the time of her August 1983 separation examination. The examiner further observed that post-service treatment records failed to document continued pain and the need for treatment for a right hip disorder. Consequently, she found that a nexus between the Veteran’s in-service right hip pain and her current right hip pain could not be established. However, in light of the diagnosis of possible right hip arthritis in service, the Veteran’s recent report of an in-service injury to the right hip, and her reports of a continuity of right hip symptomatology since service, the Board remanded the claim to obtain an addendum opinion reconciling such evidence. Furthermore, in light of the current diagnosis of a back disorder, in-service complaints of back pain and a report of an injury therein, and the Veteran’s reports of a continuity of back symptomatology, the Board remanded such claim in order to afford her a VA examination so as to determine the etiology of such claimed disorder. In December 2019 and March 2020, the Veteran was afforded VA examinations with opinions addressing the etiology of her back and right hip disorders, respectively. The examiner, who offered both opinions, found that such disorders were less likely than not incurred in or caused by the claimed in-service injury, event, or illness. In support of such opinions, she noted that the Veteran’s service treatment records were negative for chronic right hip and lumbar spine conditions, and her August 1983 separation examination noted no relevant complaints and such systems were normal upon clinical evaluation. The examiner further observed that the Veteran’s claimed disorders were not diagnosed or treated in the immediate post-service treatment records. Rather, the first diagnoses of right hip and back disorders were in 2013 and 2009, respectively. Finally, she found that the Veteran’s documented in-service right hip treatment was acute and the condition resolved, and no diagnosis of arthritis was confirmed upon objective testing. Thus, the examiner determined that the Veteran’s right hip osteoarthritis was due to natural aging and body habitus. However, the examiner did not address the Veteran’s consistent lay statements that she has experienced back and right hip pain since her military service, to include her reported injury therein. Furthermore, in a June 2020 statement, her former spouse recounted the Veteran’s in-service injury, at which time she told her husband she had felt a pop in her lower back while lifting a patient. He also described witnessing her chronic and recurring pain in her right hip and lower back in the years following her injury. Furthermore, in a March 2019 record, which was received in January 2020, the Veteran’s private treatment provider noted that the Veteran reported right hip and low back pain that started while she was serving in the military when she was injured while caring for a patient. Further, she opined that her right hip and back disorders were at least as likely as not had their onset in, or were otherwise, related to her military service. In support of such opinion, the Veteran’s treatment provider noted that the etiology of such disorders include major or minor trauma, frequent lifting of heavy objects (especially bending at the waist and twisting movements), vibration, and degenerative changes. She further indicated that working in patient care requires one to frequently life heavy objects, to include patients, and has to bend at the waist often, which includes twisting movements that may cause trauma to the back. The Veteran’s treatment provider noted that many individuals who experience low back pain have lumbar disc disease and involving surrounding spinal ligaments, muscles, joints, and the skeleton, which, over time, may progress to disc degeneration/herniation and arthritic proliferation of the facet joint. After a review of the record, the Board finds that the evidence of record is at least in equipoise as to whether the Veteran’s current right hip and back disorders are related to her military service, to include her reported in-service injury. In this regard, as noted previously, while the December 2019/March 2020 VA examiner found that the Veteran’s right hip and back disorders were unrelated to her military service, she did not address the Veteran’s lay statements regarding a continuity of symptomatology. Additionally, while the Veteran’s private treatment provider focused the basis of her opinion primarily on the etiology of the Veteran’s back disorder, the Board finds that her opinion addressing both disorders is consistent with the entirety of the evidence of record, to include the Veteran’s service treatment records documenting ongoing complaints of right hip pain, with back pain also noted in July 1981, and a documented injury in September 1981. Furthermore, such opinion is consistent with the Veteran’s and her former spouse’s statements regarding the onset of her disorders in service and a continuity of symptomatology thereafter. Therefore, the Board resolves all doubt in favor of the Veteran and finds that her current right hip and back disorders, diagnosed as right hip osteoarthritis and lumbar spondylosis and intervertebral disc syndrome, are related to her military service. Thus, service connection for such disorders is warranted. 38 U.S.C. § 5107; 38 C.F.R. § 3.102; Gilbert v. Derwinski, 1 Vet. App. 49, 53 (1990). A. JAEGER Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board M. Breckenridge, 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.