Citation Nr: 21004464 Decision Date: 01/27/21 Archive Date: 01/27/21 DOCKET NO. 14-29 639 DATE: January 27, 2021 REMANDED Entitlement to service connection for a left hip disability is remanded. REASONS FOR REMAND The Appellant served on active duty for training (ACDUTRA) in the United States Army Reserve from April 1986 to August 1986. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from an August 2013 rating decision issued by the Department of Veterans Affairs (VA) Regional Office (RO) in Montgomery, Alabama. The issue was previously remanded by the Board in May 2018 and again in September 2019. For the reasons discussed below, the Board finds that there has not been substantial compliance with the directives of the its September 2019 remand. See Stegall v. West, 11 Vet. App. 268, 271 (1998). Entitlement to service connection for a left hip disability is remanded. Although the additional delay is regrettable, the Board finds that another remand is required before the Appellant’s claim for service connection for a left hip disability can be properly adjudicated on its merits. The Appellant contends that her current left hip disability results from an injury sustained while on ACDUTRA; specifically, a pulled muscle sustained in basic training. See, e.g., Appellate Brief dated January 13, 2021. Per the directives of the Board’s September 2019 remand, the Appellant was afforded a VA examination to determine the nature and etiology of her left hip disability. In January 2020, a clinician evaluated the Appellant and diagnosed her with bursitis of the left hip. See VA examination dated January 23, 2020. The clinician further noted that diagnostic testing conducted on the Appellant’s left hip in 2013 revealed a large calcification/enthesophyte of the lesser trochanter and possible left sacroiliitis. Concerning a nexus between the Appellant’s ACDUTRA injury and a current diagnosis, the physician opined that the Appellant has “no diagnosis” of a left hip disability “that is at least as likely as not […] incurred in or caused by” service, reasoning that the Appellant’s disorder is a back disability rather than a hip disability. Specifically, he notes that, based upon the Appellant’s gesturing and description of the pain, the cause of her left hip pain originates from the left sacroiliac joint and radiates into her left hip. However, the clinician’s reasoning is inadequate for adjudicative purposes. See Barr v. Nicholson, 21 Vet. App. 303, 311 (2007). As an initial matter, the conclusion appears to be inconsistent with the diagnosis of left hip bursitis insofar as it refers to “no diagnosis.” Furthermore, the clinician failed to address the Appellant’s lay testimony regarding a continuity of symptomatology, as well as favorable medical evidence of record cited by the Board in its prior remand. Finally, the physician did not provide an opinion as to whether any diagnosed back condition, such as sacroiliac disorder, was incurred in or is otherwise etiologically related to the injury the Appellant sustained while on ACDUTRA. The Board must ensure compliance with the terms of its prior remand directives. See Stegall v. West, 11 Vet. App. 268, 271 (1998) (a remand confers on the appellant, as a matter of law, the right to compliance with the remand orders). In the present case, the Board finds that there has not been substantial compliance with its September 2019 remand directives. Therefore, another remand is required in order to procure a medical opinion adequately addressing the Appellant’s statements that she has experienced chronic hip pain since her ACDUTRA injury, the cited favorable medical evidence of record, and whether any diagnosed hip or back disability is related to the Appellant’s ACDUTRA injury. Accordingly, the matter is REMANDED for the following action: 1. Send the Appellant’s claims file to an appropriate examiner for review and for the opinions sought regarding the Appellant’s claim for service connection for a left hip disability. ONLY IF another examination is deemed necessary to answer the questions below, should one be scheduled. The examiner is asked to address the following: (a.) Please identify all current left hip disorders or lower back disorders manifesting in hip pain that the Appellant experiences. If any previously diagnosed disorder is no longer present, the examiner must provide an explanation. For each diagnosed left hip or lower back disorder, the examiner is asked to provide the following opinion: Is it at least as likely as not (50 percent probability or greater) that the diagnosed left hip or lower back disorder was incurred in, or is otherwise etiologically related to, the Appellant’s injury sustained in 1986 while on ACDUTRA? The examiner is specifically asked to address the July 2003 notation of left hip “DJD,” the September 2004 notation of left hip arthritis, and the December 2005 notation of left hip bursitis. The examiner should also address the July 2013 notation of left hip strain. In providing the requested opinions, please consider and address (i) the Appellant’s 1986 service treatment records indicating that she sustained a pulled left thigh muscle; (ii) the February 2006 medical record attributing the Appellant’s left hip bursitis to a pulled muscle; and (iii) the Appellant’s lay statements regarding the onset of hip pain beginning in basic training and the continuity of symptomatology experienced since that time. The examiner must explain the rationale for all opinions in detail, citing to supporting clinical data and/or medical literature, as appropriate. The examiner should take into consideration that the Appellant is competent to report symptomology she has experienced firsthand. ANTHONY C. SCIRÉ, JR Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board G. Tolbert, 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.