Citation Nr: 21003465 Decision Date: 01/21/21 Archive Date: 01/21/21 DOCKET NO. 14-26 638 DATE: January 21, 2021 ORDER Entitlement to service connection for left hip osteoarthritis, status post total left hip replacement, is granted. REMANDED Entitlement to service connection for a right ankle condition is remanded. FINDING OF FACT The Veteran’s left hip osteoarthritis, status post total left hip replacement, is etiologically related to active service. CONCLUSION OF LAW The criteria to establish service connection for left hip osteoarthritis, status post total left hip replacement, have been met. 38 U.S.C. §§ 1110, 1131, 5103, 5103A, 5107; 38 C.F.R. §§ 3.102, 3.303. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from September 1980 to January 2002. The Veteran appeals an August 2013 rating decision by the Agency of Original Jurisdiction (AOJ). A veteran is entitled to the Department of Veteran Affairs (VA) disability compensation if there is a disability resulting from personal injury suffered or disease contracted in the line of duty in active service, or for aggravation of a preexisting injury suffered or disease contracted in the line of duty in active service. 38 U.S.C. §§ 1110, 1131. Generally, to establish a right to compensation for a present disability, a veteran must show: (1) a present disability; (2) an in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the present disability and the disease or injury incurred or aggravated during service, the so-called “nexus” requirement. Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004). Service connection may be granted for any disease diagnosed after discharge, when all of the evidence, including that pertinent to service, establishes that a disease was incurred in service. 38 C.F.R. § 3.303(d). The Veteran was diagnosed with osteoarthritis of the left hip which led to a total left hip replacement on January 30, 2013. See November 2013 Dr. C.T. letter. The Veteran attributed his left hip condition to the rigors of military service. See July 2014 VA Form 9; July 2015 VA Form 646. As to nexus, Dr. M.A. and Dr. C.T., treating physicians of the Veteran, both attributed the Veteran’s left hip condition to the activities and rigors during service. See October 2013 Dr. M.A. letter; November 2013 Dr. C.T. letter. The Board finds these opinions probative since they are based on treatment and history of the Veteran. There is not a medical nexus opinion to the contrary. The Board finds that there is persuasive evidence of record establishing a link between the Veteran’s left hip condition and service. Accordingly, the Board finds that a grant of service connection is warranted for left hip osteoarthritis, status post total left hip replacement. See 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102. REASONS FOR REMAND The Veteran has claimed a right ankle condition and noted in-service injuries and a cyst. See June 2001 VA Form 21-526; July 2015 VA Form 646. Service treatment records (STRs) noted treatment for the right ankle. See, e.g., December 1983 STRs. However, the current nature of the Veteran’s right ankle condition is unclear. Importantly, the Veteran seems to combine his ankle condition with his already service-connected right foot condition. See July 2015 VA Form 646. Therefore, a VA examination is required to determine if the Veteran has a current and separate right ankle condition which may be related to service or his service-connected right foot condition. Additionally, the Board notes the August 2005 VA opinion related the Veteran’s right ankle condition to his in-service cyst removal. However, STRs are inconsistent on which foot actually had a cyst removed. See August 1996 and March 2001 STRs; September 2005 memorandum. As such, another etiology opinion is required. The matter is REMANDED for the following action: 1. Obtain any outstanding VA and/or private treatment records relevant to treatment the Veteran received for his right ankle condition that are not already of record. All obtained records should be associated with the evidentiary record. If any identified records are not obtainable (or none exist), the Veteran and his representative should be notified, and the record clearly documented. 2. Thereafter, schedule the Veteran for an examination to determine the nature and etiology of his right ankle condition. The evidentiary record, including a copy of this remand, must be made available to and reviewed by the examiner. After the record review and examination of the Veteran, if deemed necessary, the examiner should identify all right ankle conditions present that are separate and apart from the Veteran’s service-connected right foot condition. Then, the examiner is asked to respond to the following inquiries: Is it at least as likely as not that the Veteran’s right ankle condition and/or right ankle functional loss, was incurred in, or otherwise related, to his time on active service, to include, but not limited to, his in-service right ankle treatment and cyst removal? Is it at least as likely as not that the Veteran’s right ankle condition was CAUSED by his service-connected right foot condition? Is it at least as likely as not that the Veteran’s right ankle condition was AGGRAVATED by his service-connected right foot condition? In rendering this opinion, the examiner is advised that the Veteran is competent to report his symptoms and history. Such reports must be acknowledged and considered in formulating any opinion. If the examiner rejects the Veteran’s reports, he or she must provide an explanation for such rejection. The examiner is not to improperly discount the Veteran’s lay statements or mistakenly rely on an absence of medical evidence in the record to support his or her conclusions. A complete rationale for all opinions should be set forth and a discussion of the facts and medical principles involved would be of considerable assistance to the Board. If an opinion cannot be provided without resorting to mere speculation, the examiner must provide a complete explanation for why an opinion cannot be rendered. In so doing, the examiner must explain whether the inability to provide a more definitive opinion is the result of a need for additional information, or that he or she has exhausted the limits of current medical knowledge in providing an answer to that particular question(s). 3. After the above development has been completed to the extent possible, readjudicate the claim. If any benefit sought remains denied, provide the Veteran and his representative with a supplemental statement of the case (SSOC), and return the case to the Board, if otherwise in order. DONNIE R. HACHEY Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board A. Zheng, 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.