Citation Nr: 21004375 Decision Date: 01/27/21 Archive Date: 01/27/21 DOCKET NO. 15-03 224 DATE: January 27, 2021 ORDER Entitlement to service connection for degenerative arthritis in the right hip is granted. FINDING OF FACT The evidence is in a state of relative equipoise regarding whether degenerative arthritis in the right hip is due to service-connected right tibia, fibula, and knee disability. CONCLUSION OF LAW The criteria for service connection for degenerative arthritis in the right hip are met. 38 U.S.C. §§ 1110, 5107(b); 38 C.F.R. §§ 3.102, 3.310. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from March to October 1967. This matter comes before the Board of Veterans’ Appeals (Board) on appeal of a rating decision by a U.S. Department of Veterans Affairs (VA) Regional Office (RO). In January 2018, the Veteran testified before the Board in a videoconference hearing. A transcript of the hearing has been included in the electronic claims file and has been reviewed. In August 2018, the Board remanded the claim on appeal for additional development. The issue is again before the Board for appellate review. Service Connection Since June 2009 the Veteran has been service connected for right tibia, fibula, and knee disability incurred in service as the result of a motor vehicle accident (MVA). He claims that he has developed a right hip disorder secondary to the service-connected disability. Laws and regulations Service connection may be granted for disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. § 1110; 38 C.F.R. § 3.303. Service connection may be established on a secondary basis for a disability which is proximately due to or the result of service-connected disease or injury. 38 C.F.R. § 3.310. Establishing service connection on a secondary basis requires evidence showing (1) that a current disability exists and (2) that the current disability was either (a) proximately caused by or (b) proximately aggravated by service-connected disability. Allen v. Brown, 7 Vet. App. 439, 448 (1995) (en banc). When there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, the benefit of the doubt will be granted to the claimant. 38 U.S.C. § 5107; 38 C.F.R. § 3.102; Gilbert v. Derwinski, 1 Vet. App. 49, 53 (1990). To deny a claim on the merits, the preponderance of the evidence must be against the claim. Alemany v. Brown, 9 Vet. App. 518, 519 (1996). Evidence and analysis The evidence in this matter consists of private and VA treatment records, lay statements from the Veteran and a friend, private medical opinions dated in February 2015 and September 2020, and VA compensation examination reports dated in May 2014, November 2019, and October 2020. For the reasons set forth below, a service connection finding is warranted. First, the evidence documents that the Veteran has a current right hip disorder. This is demonstrated most recently in the October 2020 VA report, which includes a diagnosis of right hip degenerative joint disease. Second, the Veteran is service connected for right tibia, fibula, and knee disability. Third, the evidence is divided with regard to whether the right hip degenerative arthritis is due to the right leg disability. See 38 C.F.R. § 3.310. Certain evidence counters the proposition that service-connected disability caused a right hip disorder. The May 2014 and November 2019 VA reports indicate that the two are unrelated. The November 2019 VA report is probative. In it the examiner described why, in his opinion, right hip problems were not related to the leg problems. The examiner indicated that the hip problems were due to normal wear and tear of a joint rather than leg problems. The May 2014 report will not be relied upon, however. In the August 2018 remand, the Board found the opinion inadequate. See Barr v. Nicholson, 21 Vet. App. 303, 312 (2007) (noting that once VA undertakes an examination, an adequate one must be produced). Certain other evidence supports the claim. In the February 2015 private opinion, a treating physician found right hip disability due to right leg problems. As noted in the August 2018 remand, the probative value of the opinion is undermined by certain deficiencies. Nevertheless, the opinion states clearly that the hip problem is due to a “significant antalgic gait” resulting from the leg and knee disability. It is therefore medical evidence in favor of the claim. The September 2020 private medical opinion also supports the claim, by connecting “musculoskeletal misalignment” from service-connected disability to “the chronicity of hip problems.” Moreover, the October 2020 VA report supports the claim. Therein, the VA examiner stated that the fracture of the tibia and fibula during service most likely impacted the right labrum. The examiner also indicated that the MVA itself may have directly caused the labrum injury. See 38 C.F.R. § 3.303. As with the November 2019 VA opinion, this opinion is probative because it is explained and is based on the evidence of record. See Bloom v. West, 12 Vet. App. 185, 187 (1999) (the value of a physician’s statement is dependent, in part, upon the extent to which it reflects clinical data or other rationale to support the opinion). Based on the foregoing, the Board cannot find that a preponderance of the evidence is against the claim of entitlement to service connection. Indeed, the evidence addressing the issue of medical nexus is divided, with persuasive opinions countering and supporting the claim. Accordingly, this is an appropriate case in which to invoke VA’s doctrine of reasonable doubt, grant the Veteran the benefit of the doubt, and grant the claim. 38 U.S.C. § 5107; 38 C.F.R. § 3.102. G. A. WASIK Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Christopher McEntee, 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.