Citation Nr: 21063383 Decision Date: 10/14/21 Archive Date: 10/14/21 DOCKET NO. 16-15 045A DATE: October 14, 2021 ORDER Entitlement to service connection for a right hamstring disorder is denied. Entitlement to service connection for left hamstring disorder is denied. FINDINGS OF FACT 1. The preponderance of the evidence is against finding that residuals of right hamstring disorder began during active service, or is otherwise related to an in-service event, injury, or disease. 2. The preponderance of the evidence is against finding that residuals of left hamstring disorder began during active service, or is otherwise related to an in-service event, injury, or disease. CONCLUSIONS OF LAW 1. The criteria for service connection for residuals of right hamstring condition are not met. 38 U.S.C. § 1110; 38 C.F.R. §§ 3.102, 3.303, 3.304, 3.309. 2. The criteria for service connection for residuals of left hamstring condition are not met. 38 U.S.C. § 1110; 38 C.F.R. §§ 3.102, 3.303, 3.304, 3.309. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran had active service from May 1986 to December 1989, from November 1990 to April 1991, and from March 2003 to June 2004. In April 2021, the Board most recently remanded the issues on appeal for further development, and the case has since been returned to the Board. The Board finds that the AOJ has substantially complied with the remand directives. See Stegall v. West, 11 Vet. App. 268, 271 (1998). Service Connection 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). Entitlement to service connection for a right hamstring disorder Entitlement to service connection for left hamstring disorder The Veteran asserts that his hamstrings have been problematic since service and that he suffers from recurrent cramps as a result of his injury. His separation medical board examination documents that he suffered a hamstring injury in March 2003. As required by an October 2018 Board remand, in December 2018, the Veteran attended a VA Muscle Injuries examination. The examiner diagnosed bilateral hamstring strain with a diagnosis date of December 4, 2018. He stated: Review of separation exam shows that veteran mentioned hamstring strain. He also mentioned that it is improved. Post active military service medical record does not show any follow up of this condition. Review of separation exam shows that veteran reported hamstring strain but he reported that it is improved. No post military service follow up is seen in his record to see the continuity of the symptomatology. Nevertheless, in a May 2020 Board remand, the Board found this opinion to be insufficient because it was unclear by the examiner discounted the Veteran's reports of hamstring problems since service. Accordingly, an additional examination was ordered. In July 2020, an addendum opinion was provided. The examiner opined: The Veterans Bilateral Hamstring Sprain is less likely than not incurred or caused by hamstring injury in service. The veteran recalls playing football in March 2003 and in which while running injured both his hamstrings. He also said he went to sick call because of this issue. However, I find no record that he was placed in sick call for bilateral hamstring injury nor did I find any record of limitations because of this injury. There are multiple records for this Veteran in 2003 and 2004, however there is only one mention of bilateral hamstring injury that "has improved" in 2004. There is no other mention of any issue with the bilateral hamstrings. Of note there is mention of a left effusion that was recorded by the physician in Iraq in 2003. On subsequent physical exams for back injuries and multiple physical exams in regard to his hypertension and kidney disease there is no mention of lower extremity weakness or pain as it relates to posterior thigh or hamstring problems. Also in 2004 because of back problems he had limitations on walking, going up stairs, lifting and repetitive motions but no restrictions when he came to in the hamstring lower leg injury. In fact he was approved for thigh stretches hamstring stretches etc. So the medical records do not support a chronic injury of bilateral hamstrings while in service. However, in an April 2021 Board remand, the Board found this opinion to be insufficient because the examiner failed to answer whether the Veteran's in-service injury caused his current disability, but instead answered whether he had a "chronic injury of bilateral hamstrings" in service. Accordingly, an addendum opinion was ordered. In July 2021, an addendum opinion was provided. The examiner opined that the Veteran's bilateral hamstring condition was less likely than not incurred in or caused by the claimed in-service injury, event, or illness. The rationale provided was: It is less likely than not that the veterans right hamstring disorder occurred or caused by specific illness during service. The veteran stated that he injured his right hamstring while playing football in March 2003. He also stated that he went to sick call for this issue but I find no medical record of him being evaluated or treatment for a right hamstring injury. Although he did mention a hamstring injury on his separation exam but there was no subsequent follow-up or treatment the year after his discharge. It is less likely than not that a left hamstring injury was caused by or occurred in active duty service. The veteran states that he injured his left hamstring while playing football in March 2003. The veteran states that he went to sick call for this issue but there is no record of any left hamstring injury. Although the veteran mention a hamstring injury on his separation exam in 2004, there has been no subsequent complaints or treatment on this issue in the year post discharge. The remaining evidence indicates continued complaints and treatment of a bilateral hamstring condition but no discussion on its etiology. Based on the foregoing evidence of record, the Board finds that service connection is not warranted. The Board finds the July 2021 VA addendum opinion of record the most probative evidence of record as to the etiology of the Veteran's bilateral hamstring condition because it is based on an accurate medical history and provides an explanation that contain clear conclusions and supporting data. Further, it is noted that the record is silent for a medical opinion stating otherwise. The Board considered the Veteran's lay assertions as to the etiology of his claimed disability. Although the Veteran is competent to attest to his experiences, he is not competent in these circumstances to opine as to the etiology of bilateral hamstring condition. The Veteran has not been shown to have specialized medical knowledge that would be necessary to provide a competent opinion regarding service connection. The Board finds the July 2021 VA opinion of record to be more probative in this regard. The examiner considered the Veteran's history, and ultimately concluded that from a medical perspective, it is less likely that his claimed disability is related to service. In conclusion, the weight of the evidence is against the claim for service connection for a bilateral hamstring condition. L. M. BARNARD Veterans Law Judge Board of Veterans' Appeals Attorney for the Board R. A. Elliott II, 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.