Citation Nr: 21062473 Decision Date: 10/07/21 Archive Date: 10/07/21 DOCKET NO. 18-30 851 DATE: October 7, 2021 ORDER Service connection for a right hip condition is granted. Service connection for a left hip condition is granted. REMANDED Service connection for right leg radiculopathy is remanded. Service connection for left leg radiculopathy is remanded. FINDING OF FACT Resolving reasonable doubt in favor of the Veteran, the evidence supports finding that his bilateral hip disability was due to his active duty service, based on a continuity of symptomatology. CONCLUSIONS OF LAW 1. The criteria for service connection for a right hip condition have been met. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303. 2. The criteria for service connection for a left hip condition have been met. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from August 1982 to June 1996, from November 2004 to November 2005, and from November 2005 to October 2011. The Veteran provided testimony before the undersigned Veterans Law Judge (VLJ) at a September 2020 Board hearing. A complete transcript is of record. Service Connection Service connection for a bilateral hip condition is granted. The Veteran testified that he experienced bilateral hip symptoms during his active duty service, was unable to run after his separation from the military in 2011, and eventually had right hip replacement in 2016 and left hip replacement in 2019. The Veteran was afforded a VA examination in April 2019. The examiner indicated that the Veteran was diagnosed with left hip arthritis, but also noted that the Veteran underwent a right hip replacement. After an in-person examination and a review of the Veteran's claims file, the examiner provided a negative nexus opinion. The examiner explained that the claims file did not reveal any mention of an in-service left hip injury. The Veteran was provided an addendum medical opinion in June 2019. The June 2019 VA examiner also provided a negative nexus opinion. The examiner explained that there was no evidence to indicate that the Veteran's left hip pain in August 2009 during service, did not resolve without residual. The examiner noted that the Veteran's first post-service presentation for left hip pain was in 2017. The examiner attributed the Veteran's left hip diagnosis to natural aging. The Veteran provided credible testimony at the September 2020 Board hearing. He testified that during his active duty service, he participated in very long hikes, which caused his body to break down. He also testified that he was involved in many IED attacks, where he was thrown around his military vehicle. He reported that when he separated from the military, he realized he could not run well because he could not play sports the way he used to. He reported that after his separation from the military, he became a police officer and during training at the police academy, he was able to meet the time requirements of the physical test, but had to alternate between running and walking. The Veteran testified that during his active duty service, he was put on profile for his hips because he could not run. However, the representative stated that their review of the claims file did not reveal the physical profile, but reported that they may be able to find them. The Board notes that the Veteran's in-service physical profile from August 2009 was associated with the claims file in November 2020. The Veteran's medical condition was noted to be bilateral hip pain, low back pain, and parathesis. He was placed on permanent profile. The profile indicated that he was not able to perform a 2-mile run. He was advised to walk, bike, and swim at his own pace and distance. He was encouraged to participate in pool therapy for cardiovascular benefit to substitute running. The Board has weighed the probative evidence of record and finds that it is in approximate balance with respect to establishing service connection by way of continuity of symptomatology. See 38 C.F.R. § 3.303 (b); Walker, 708 F.3d at 1337. Here, the Veteran has shown evidence of in-service bilateral hip symptoms, which caused him to be placed on a physical profile. Further, he credibly testified that he continued to experience bilateral hip pain, which caused an inability to run and play sports. The Veteran was shown to have arthritis in both of his hips, which caused him to have bilateral hip replacement. In light of the in-service physical profile due to bilateral hip pain and the Veteran's competent and credible accounts regarding the continued symptomatology of his bilateral hip pain, and the bilateral hip replacement; the Board affords the Veteran the benefit of the doubt and finds that service connection is warranted. Accordingly, service connection for a bilateral hip disability is granted. REASONS FOR REMAND Service connection for bilateral leg radiculopathy is remanded. The Veteran asserts that he has radiculopathy symptoms associated with his service-connected low back disability. The Veteran testified that he experiences stiffness in his legs, as well as pain that runs down the side of his legs. However, the Veteran was unsure whether he was ever diagnosed with a neurologic condition such as radiculopathy or sciatica. The Veteran's representative stated that a VA examination should be ordered so there can be an official diagnosis and to assess the severity of his radiculopathy. The Veteran's STRs show that his after a spinal cord surgery to remove a tumor, he experienced increased pain in his lower extremities. See STR dated April 2, 2008. The Veteran's post-service treatment records show that he complained of low back pain that radiated down to his hip and down the right leg. See VA Treatment Record dated December 10, 2015. However, after a careful review of the Veteran's treatment records, there is no diagnosis for a bilateral lower extremity radiculopathy. For example, he was afforded a VA examination for his low back in January 2016. The examiner indicated that he did not have any radicular pain or any other signs or symptoms due to radiculopathy. Here, the Board finds that the evidence suggests that the Veteran may have a neurologic condition associated with his service-connected low back disability. As such, the Board finds that VA's duty to assist has been triggered and a VA examination is required to clarify whether there is a current diagnosis for bilateral lower extremity radiculopathy. See McLendon v. Nicholson, 20 Vet. App. 79, 81 (2006). Accordingly, service connection for a bilateral lower extremity radiculopathy is remanded. The matters are REMANDED for the following action: 1. Schedule the Veteran for a VA examination to determine whether there is a current diagnosis for lower extremity radiculopathy and/or neuropathy, and if diagnosed, to determine the nature and etiology of the bilateral lower extremity condition. If a diagnosis can be made, the examiner should provide the following opinions: a) Is it at least as likely as not (50 percent or greater) that the Veteran's neurologic impairment in his lower extremities was caused by his service-connected lumbar spine disability? Why or why not? b) Is it at least as likely as not (50 percent or greater) that the Veteran's neurologic impairment in his lower extremities was aggravated (made worse) by his service-connected lumbar spine disability? Why or why not? In so doing, the examiner should address the Veteran's STRs, which show low back pain with increased pain in his lower extremities and his post-service treatment records which show of low back pain that radiated down to his hip and down the right leg. See STR dated April 2, 2008 and VA Treatment Record dated December 10, 2015. If aggravation is found, the examiner should identify the baseline level of severity of the neurologic impairment by medical evidence created before the onset of aggravation or by the earliest medical evidence created at any time between the onset of aggravation and the receipt of medical evidence establishing the current level of severity of the neurologic impairment. MATTHEW W. BLACKWELDER Veterans Law Judge Board of Veterans' Appeals Attorney for the Board E. Fu, 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.