Citation Nr: 21004342 Decision Date: 01/26/21 Archive Date: 01/26/21 DOCKET NO. 16-24 576A DATE: January 26, 2021 ORDER Entitlement to a left hip disability is denied. FINDING OF FACT The Veteran’s left hip disability, including osteoarthritis, status post left total hip replacement, was not shown as chronic in service and did not manifest to a compensable degree within the applicable presumptive period; continuity of symptomatology is not established; and the disability is not otherwise etiologically related to an in-service injury or disease. CONCLUSION OF LAW The criteria for service connection for a left hip disability, including arthritis, are not met. 38 U.S.C. §§ 1110, 1112, 1113, 1131, 1137, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from June 1953 to June 1977. On October 7, 2019, the Veteran was scheduled for a video hearing before a Veterans Law Judge. However, he did not report for that hearing and has not requested that it be rescheduled. Accordingly, the Board will make its decision based on the evidence of record. 1. Entitlement to a left hip disability The Veteran contends that his left hip disability was first manifested in service after fell while inspecting an engine on board a submarine. He states that he injured his left shoulder and dislocated his left hip and that he subsequently developed arthritis in the hip. He further states that he underwent a total left hip replacement in 2010 due to the arthritis. Service connection may be granted for disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. § 3.303. The three-element test for service connection requires evidence of: (1) a current disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the current disability and the in-service disease or injury. Shedden v. Principi, 381 F.3d 1163, 1166 -67 (Fed. Cir. 2004). Certain chronic diseases, such as arthritis, will be presumed related to service, if they were shown as chronic in service; or, if they manifested to a compensable degree within a presumptive period following separation from service; or, if they were noted in service (or within an applicable presumptive period) with continuity of symptomatology since service that is attributable to the chronic disease. 38 U.S.C. §§ 1101, 1112, 1113, 1137; 38 C.F.R. §§ 3.303, 3.307, 3.309; Walker v. Shinseki, 708 F.3d 1331, 1338 (Fed. Cir. 2013). The question for the Board is whether the Veteran has a current disability that began during service or is at least as likely as not related to an in-service injury, event, or disease. The Board concludes that, while the Veteran has a diagnosis of osteoarthritis and underwent a total left hip replacement, the preponderance of the evidence is against finding that it began during active service, or is otherwise related to an in-service injury, event, or disease. While the Board understands the Veteran’s assertions that he injured his left hip in service, and there is no reason to doubt that the incident where he hurt his hip occurred, it does not appear that any sort of actual left hip disorder resulted from this incident. Specifically, the Veteran’s service medical records, including the report of his March 1977 retirement examination are negative for any complaints or clinical findings of a left hip disability. Indeed, during his retirement examination, his lower extremities, spine, and other musculoskeletal abnormalities were found to be normal. The Board would add that his service treatment record reflects multiple occasions where he would have been expected to mention left hip symptoms, but no such annotations exist. In fact, a left hip disability was not manifest until April 2007 during treatment at the Bremerton Naval Hospital. On that occasion, the Veteran reported a one-week history of acute left hip pain without an inciting event; and radiographic studies During treatment in March 2011, the Veteran recalled an injury to his left hip he sustained at age 28 while working on a submarine. He reportedly walked away but had left hip and leg pain and stated that he could have dislocated his left hip. These symptoms later resulted in a total left hip replacement at Madigan Army Medical Center in May 2011. Therefore, given the fact that the first objectively observed hip disorder was not until 30 years after he left active duty, there is no finding that he experienced continuous symptoms. Next, the evidence also does not otherwise indicate that the Veteran’s left hip disorder is related to service. Specifically, during a February 2013 VA examination, the diagnoses were - osteoarthrosis of the left hip, status post left hip replacement and post-operative residuals of trophy of left gluteus muscles. The examiner opined that it was less likely than not that the Veteran’s left hip disability had been incurred in or caused by the claimed in-service injury, event, or illness. The examiner noted that there was no medical documentation of a left hip injury or complaint while in the service. However, she contradicted that opinion by stating that an opinion could not be rendered without resorting to speculation. Such a speculative or equivocal medical opinion is considered “non-evidence” and has no probative value. Hood v. Shinseki, 23 Vet. App. 295, 296 (2009); Perman v. Brown, 5 Vet. App. 237, 241 (1993). Following a May 2015 review of the Veteran’s claims file and VA records, the reviewing physician opined that it was less likely than not that the Veteran’s left hip disability had been incurred in or caused by his duties as a diver in service. The physician found no evidence of left hip complaints during service, nor of decompression sickness which would have likely affected his left hip. He further noted that osteoarthritis of the hip has multiple potential risk factors: age, occupation, serious trauma, genetics, etc. Therefore, he concluded that it was most likely that the Veteran’s hip condition was related to those risk factors rather than diving injuries. The normal medical findings at the time of the Veteran’s retirement from service, as well as the absence of any medical records of a diagnosis or treatment for many years after service is probative evidence against the claim. Maxson v. Gober, 230 F.3d 1330, 1333 (Fed. Cir. 2000) (A prolonged period without medical complaint can be considered, along with other factors concerning a claimant's health and medical treatment during and after military service, as evidence of whether an injury or a disease was incurred in service which resulted in any chronic or persistent disability.); Forshey v. West, 12 Vet. App. 71, 74 (1998), aff'd sub nom. Forshey v. Principi, 284 F.3d 1335, 1358 (Fed. Cir. 2002) (noting that the definition of evidence encompasses "negative evidence" which tends to disprove the existence of an alleged fact). Moreover, negative nexus opinion from the 2015 VA examiner is further evidence against the claim. While the Veteran believes his left hip disability is related to an in-service injury, he is not competent to provide a nexus opinion regarding this issue. The issue is medically complex, as it requires knowledge of orthopedics and the interpretation of complicated diagnostic medical testing. Therefore, it is outside the competence of the Veteran in this case, because the record does not show that he has the medical training or credentials to make such a determination. Jandreau v. Nicholson, 492 F.3d 1372, 1377 n.4 (Fed. Cir. 2007); see also Kahana v. Shinseki, 24. Vet. App. 428 (2011). Consequently, the Board gives more probative weight to the Veteran’s medical records in and after service, aside from the opinion of the opinion of the February 2015 VA examiner. In sum, the preponderance of the competent, credible evidence of record is against a finding that the Veteran had a left hip disability in service or that his current left hip replacement is the result of a disease, injury or other incident in service. Accordingly, he does not meet the criteria for service connection. There is no doubt to resolve. 38 U.S.C. § 5107; 38 C.F.R. § 3.102. 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. B.T. KNOPE Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Harold A. Beach, Counsel