Citation Nr: 21065154 Decision Date: 10/25/21 Archive Date: 10/25/21 DOCKET NO. 16-01 286 DATE: October 25, 2021 ORDER Service connection for a left hip disorder is denied. Service connection for a right hip disorder is denied. FINDINGS OF FACT 1. The Veteran served on active duty from October 1984 to October 1987; he has been 100 percent disabled based on unemployability since March 2014. 2. A left hip disorder was not shown in service, was not shown to a compensable degree within one year of service, and symptoms were not continuous since service; a current left hip disorder, diagnosed as osteoarthritis, is not causally or etiologically related to service and was not caused by or permanently worsened in severity by a service-connected disability. 3. A right hip disorder, currently diagnosed as bursitis, was not shown in service, is not causally or etiologically related to service, and was not caused by or permanently worsened in severity by a service-connected disability. CONCLUSIONS OF LAW 1. A left hip disorder was not incurred in service, is not presumed to have been incurred in service, and is not proximately due to, aggravated by, or the result of a service-connected disability. 38 U.S.C. §§ 1131, 5103(a), 5103A, 5107 (2012); 38 C.F.R. §§ 3.159, 3.303, 3.307, 3.309, 3.310 (2020). 2. A right hip disorder was not incurred in service and is not proximately due to, aggravated by, or the result of a service-connected disability. 38 U.S.C. §§ 1131, 5103(a), 5103A, 5107 (2012); 38 C.F.R. §§ 3.159, 3.303, 3.310 (2020). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS Turning to the relevant laws and regulations, service connection may be granted on a direct basis as a result of disease or injury incurred in service based on nexus using a three-element test: (1) the existence of a present disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the present disability and the disease or injury incurred in or aggravated by service. See 38 C.F.R. §§ 3.303(a), (d); Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009). Service connection may be granted on a secondary basis for a disability which is aggravated by, proximately due to, or the result of a service-connected disease or injury under 38 C.F.R. § 3.310. Allen v. Brown, 7 Vet. App. 439 (1995). In order to establish service connection on a secondary basis, there must be (1) evidence of a current disability; (2) evidence of a service-connected disability; and (3) medical evidence establishing a link between the service-connected disability and the current disability. See Wallin v. West, 11 Vet. App. 509, 512 (1998). Service connection may be granted on a presumptive basis for diseases listed in 38 C.F.R. § 3.309 under the following circumstances: (1) where a chronic disease or injury is shown in service and subsequent manifestations of the same disease or injury are shown at a later date unless clearly attributable to an intercurrent cause; or (2) where there is continuity of symptomatology since service; or (3) by showing that the disorder manifested itself to a degree of 10 percent or more within one year from the date of separation from service. See 38 C.F.R. § 3.307. Turning to the medical evidence, a March 2013 VA examiner noted a diagnosis of mild left hip osteoarthritis and right hip bursitis. As such, a current disorder has been shown for both hips and the first element of service connection has been met. As to in-service incurrence, the service treatment records (STRs) do not reflect complaints of, treatment for, or a diagnosis of a hip disorder. Further, the Veteran does not contend that a bilateral hip disorder began during service. Accordingly, the evidence does not support service connection on a direct basis. Rather, the main contention is that a hip disorder is due to a right knee disorder. Specifically, the Veteran contends that the limp and altered gait resulting from the right knee disorder caused the bilateral hip disorder. As a current hip disorder has been shown and the Veteran is currently service connected for a right knee disorder, the first two elements of secondary service connection have been met. Nonetheless, the medical evidence does not support a link between a hip disorder and a right knee disorder. In March 2013, a VA examiner opined that a hip disorder was less likely than not proximately due to or the result of the Veteran's service-connected disorder. The examiner noted that there was no evidence of a hip disorder during service. As the Veteran worked as a warehouse worker and truck driver after separation, the physician concluded it would be mere speculation to opine that a hip condition was due to a right knee disability rather than wear and tear from post-service jobs. Further weighing against the claim, an April 2015 VA examiner opined that left hip osteoarthritis and right hip bursitis were less likely than not aggravated beyond their natural progression by a right knee disability. He explained that a review of orthopedic literature showed no clear evidence which would suggest that an injury to one lower extremity would have significant impact on the opposite uninjured limb unless there was major muscle or nerve damage. A reasonable reading of this opinion is that the Veteran did not have such muscle or nerve damage. As such, the medical evidence does not support the claim. There are no contradictory medical opinions of record. Therefore, the medical evidence does not support service connection on a secondary basis. The Veteran has challenged the adequacy of the VA examiner's opinions. Specifically, he contended that because the requested medical opinion addressed aggravation of the hip disorders due to the right knee disorder, it was assumed that the hip disabilities pre-existed service. Therefore, the Veteran requested an independent medical examination. However, the Board has reviewed the VA medical opinions of record and finds that they are adequate. Specifically, the examiners addressed the requested opinions and provided a rationale for the conclusions. Further, the examiners did not assume that a bilateral hip disorder pre-existed service and no factual errors were made. For those reasons, the medical opinions are adequate. Next, as osteoarthritis of the left hip has been shown, presumptive service connection will be addressed. As noted above, no chronic hip disorder was shown during service and the Veteran does not contend otherwise. Therefore, the medical evidence does not support presumptive service connection on a "chronic disease or injury shown in service" basis. Further, the medical evidence does not support presumptive service connection based on continuity of symptomatology. Specifically, the record does not show complaints of hip pain until September 2012, some 25 years after discharge. In addition, at the March 2013 VA examination, the Veteran reported that the onset of bilateral hip pain was approximately 1998, more than 10 years after separation from service. As such, the medical evidence does not support service connection on a "continuity of symptomatology" basis. As to the one-year presumptive period, the Veteran's bilateral hip disorder did not manifest itself to a degree of 10 percent or more within one year of separation. The Veteran separated from service in 1987 but the medical evidence does not show treatment for hip pain until September 2012. Even assuming the onset of symptoms came in 1998 as reported by the Veteran during a March 2013 VA examination, this is well outside the one-year presumptive period. As such, the medical evidence does not support presumptive service connection on a "manifest within one-year from separation" basis. Therefore, presumptive service connection on any basis is not supported by the medical evidence. The Board has considered the Veteran's lay statements that his disorders were caused by a service-connected disability. He is competent to report symptoms because this requires only personal knowledge as it comes to him through his senses. However, he is not competent to offer an opinion as to the etiology of his current disorders due to the medical complexity of the matters involved. Such competent evidence has been provided by the service records, clinical evidence, and examinations obtained and associated with the claims file. Here, the Board attaches greater probative weight to the clinical findings than to his statements. In light of the above, the preponderance of the evidence is against the claims for service connection and there is no doubt to be otherwise resolved. As such, the appeals are denied. Finally, the Veteran has not raised any other issues, nor have any other issues been reasonably raised by the record, for the Board's consideration. See Doucette v. Shulkin, 28 Vet. App. 366, 369-370 (2017) (confirming that the Board is not required to address issues unless they are specifically raised by the claimant or reasonably raised by the evidence of record). L. HOWELL Veterans Law Judge Board of Veterans' Appeals Attorney for the Board T. Kokolas, 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.