Citation Nr: 21062316 Decision Date: 10/07/21 Archive Date: 10/07/21 DOCKET NO. 16-55 114 DATE: October 7, 2021 REMANDED Entitlement to service connection for a left hip disability is remanded. Entitlement to service connection for residuals of a head injury (claimed as skull fracture) is remanded. REASONS FOR REMAND The Veteran served on active duty with the United States from June 1979 to April 1985. For his meritorious service, the Veteran awarded (among other decorations) the Army Commendation and Achievement Medals. These matters come before the Board of Veterans' Appeals (Board) on appeal of a June 2012 rating decision by Department of Veterans Affairs (VA) Regional Office (RO). In August 2019, the Veteran provided testimony at a hearing before the undersigned Veterans Law Judge. A transcript of the hearing is of record. In September 2020, the Board remanded the claims for further development. 1. Entitlement to service connection for a left hip disability is remanded. The Veteran contends that his left hip disability is a result of multiple parachute jumps performed during service. Specifically, he reports ongoing left hip pain since service. In the alternative, he claims that his left hip condition is secondary to his service-connected left foot disability. This claim was previously remanded as an April 2012 VA examination report did not adequately address the Veteran's contentions. The Veteran underwent further examination in November 2020; however, the examiner's opinion discounts, without explanation, the probative weight of the Veteran's lay statements concerning continuity of symptomatology since discharge from service. Moreover, while the examiner notes the Veteran's treatment for left hip pain during service, the examiner did not provide an adequate rationale for why the treatment is not relevant to his current left hip disability. Essentially, the November 2020 examiner provided a similar rationale as the previous April 2012 examiner, which was deemed inadequate in the September 2020 remand. With respect to the claim on a secondary basis, the examiner found that the left hip disability was not aggravated by the service-connected left foot disability stating that the medical evidence did not confirm such aggravation but did not provide further explanation. Thus, the Board remands this matter for an additional VA opinion. 2. Entitlement to service connection for residuals of a head injury is remanded. The Veteran has current diagnoses of traumatic brain injury and post traumatic headaches. In November 2020 opinions, following VA headache and traumatic brain injury examinations, the examiner provided positive nexus statements based on the Veteran's reported history of having a "skull fracture" during service. The RO requested an addendum from the examiner, noting that there was no medical evidence of an actual skull fracture in service. In a January 2021 report, the examiner agreed that there was no objective evidence that the Veteran had an actual skull fracture during service but did not provide a further nexus statement based on this evidence. To clarify, the Veteran reports that he suffered concussions as a result of boxing during service and that he injured his head (claimed as a "skull fracture") in February 1981 following a vehicle accident. Thus, further opinion is warranted. The matters are REMANDED for the following action: 1. Obtain an addendum opinion from an appropriate clinician (but not from any examiner who has previously examined the Veteran or commented on his case) regarding the Veteran's claim for service connection for a left hip disability. The examiner must opine as to the following: (a) Whether the Veteran's left hip disability at least as likely as not (1) began during active service, (2) was noted during service with continuity of the same symptomatology since service, or (3) is otherwise related to service. The examiner must address the Veteran's competent statement that he had left hip pain since service, (simply noting that the left hip pain is subjective will be deemed an inadequate rationale as well as a rationale solely relying on the absence of post-service chronicity of care). (b) The examiner must also provide an opinion as to whether it as at least as likely as not that any diagnosed left hip disability was aggravated by the Veteran's service-connected left foot disability. The examiner must provide a complete rationale for all opinions expressed and conclusions reached. 2. Schedule the Veteran for a VA examination regarding the Veteran's claim for residuals of a head injury (claimed as a skull fracture), but not from any examiner who has previously examined the Veteran or commented on his case. Any and all studies, tests, and evaluations deemed necessary by the examiner should be performed. The examiner is requested to review all pertinent records associated with claims file, including the Veteran's service treatment records, post-service medical records, and assertions. The examiner must opine as to whether it is at least as likely as not that the disability began in service, was caused by service, or is otherwise related to the Veteran's military service. The examiner must provide a complete rationale for all opinions expressed and conclusions reached. Evan M. Deichert Veterans Law Judge Board of Veterans' Appeals Attorney for the Board J. Henriquez, 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.