Citation Nr: 21004167 Decision Date: 01/26/21 Archive Date: 01/26/21 DOCKET NO. 15-12 592 DATE: January 26, 2021 REMANDED The claim of entitlement to service connection right hip disability is remanded. REASONS FOR REMAND The Veteran served on active duty from November 1968 to June 1971. This appeal is from an April 2014 rating decision. In July 2019, the Board remanded this claim for additional development, along with the issues of entitlement to service connection for the right knee and right ankle. Subsequent to that development, service connection for the right knee and right ankle were granted, and those matters are no longer on appeal before the Board. The claim of entitlement to service connection for a right hip disability is remanded. The Veteran argues that medical opinions regarding whether his newly service-connected right knee and right ankle caused or aggravated his right hip disability should be obtained, and the Board agrees. He also argues that the examiner should more adequately consider whether the Veteran’s trochanteric pain syndrome led to hip arthritis. The examiner appears to rely on the Veteran’s treating physician’s opinion that it is most likely genetic, without discussing the symptoms throughout the years or whether symptoms in the greater trochanter could as likely as not result in hip arthritis. The matters are REMANDED for the following action: 1. Associate updated VA treatment records with the claims file. 2. After completion of directive 1, schedule the Veteran for an appropriate examination for a report on whether it is as likely as not (50/50 probability or greater) that current right hip disability is related to service or caused or aggravated by service-connected right knee and/or right ankle disability. The examiner is asked to review the record prior to the examination and to conduct a search of the relevant literature prior to opining. The Veteran asserts that he has had trouble with the greater trochanteric (which he identified as his right hip) since service and that it has led to hip arthritis and hip replacement. He reports that he jumped from helicopters, which caused hip pain. The examiner is asked to elicit from the Veteran a detailed history of his right hip/greater trochanter pain, and how he treated it over the years. He asserts that his greater trochanter was not treated properly, leading to the arthritis in the hip. His STRs show that he complained of right hip pain in March 1969. He had not had any trauma, but had pain, and pain on external rotation and abduction. In July 1969, he was still having pain. The X-rays were negative, but a FABER diagnostic test was positive, which suggests pathology. A July 1969 consultation report show that he had reduced external rotation of the right hip, 30 degrees. He was noted to have tenderness of the greater trochanteric. X-rays showed no pathology, and he was given a cortisone injection. He still had pain in September 1969, and diagnosed with musculoskeletal pain. He separated from service without any chronic diagnoses. He claimed service connection for right hip disability in 1972. At the VA examination, he complained on ongoing pain due to prolonged exercise and mounting stairs. He had a normal examination and was diagnosed with musculoskeletal pain. In November 1996, he complained of having longstanding problems with his hips, and that he had at one point had a cortisone shot in his right hip. An August 2002 treatment record notes that he was diagnosed with right hip arthritis in July 1996, and that the Veteran had consistently reported having rotational problems with his right leg since he was a teenager. In April 2006, his private physician indicated that it was possible that the right hip arthritis was from service, that traumatic arthritis took time to manifest, given the number of parachute jumps he did, but that he could not absolutely declare this was the case. In May 2007, his private doctor indicated that, because of a lack of documentation, he would not be able to provide an opinion, but the examiner is advised that a lack of documentation is not dispositive of the question. To reiterate, the examiner is asked whether right greater trochanter and hip pain that started in service, and which the Veteran reports has persisted since service, is related to current right hip disability. The Veteran has recently been service connected for the right knee and the right ankle. The examiner is asked whether these disabilities, singularly or together, caused or aggravated the right hip. “Aggravated” means to have caused any increase in severity beyond the normal progression of the disability, and it need not be permanent in nature. The examiner is advised that attributing his hip arthritis to genetics or other causes does not adequately answer the question of whether the current disability is related to service. All opinions are to be supported with explanation. Nathaniel J. Doan Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board A. Gibson 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.