Citation Nr: 21067144 Decision Date: 11/03/21 Archive Date: 11/03/21 DOCKET NO. 16-03 681 DATE: November 3, 2021 REMANDED Entitlement to service connection for a left hip condition with arthritis, to include as secondary to the service-connected bilateral knee strain is remanded. Entitlement to service connection for a right hip condition with arthritis, to include as secondary to the service-connected bilateral knee strain is remanded. Entitlement to service connection for left foot arthritis with four joints missing is remanded. Entitlement to service connection for arthritis of the right foot with four joints missing is remanded. Entitlement to service connection for a right shoulder condition with arthritis is remanded. Entitlement to service connection for a left shoulder condition with arthritis is remanded. REASONS FOR REMAND The Veteran had active service in the United States Army from September 1972 to August 1974. These matters are on appeal from a January 2014 rating decision. In January 2019, the Board testified at a Board videoconference hearing before the undersigned. A copy of the transcript is associated with the record. In May 2019 and July 2020, the Board remanded the appeal for additional evidentiary development. 1. Entitlement to service connection for a left hip condition with arthritis, to include as secondary to the service-connected bilateral knee strain is remanded. 2. Entitlement to service connection for a right hip condition with arthritis, to include as secondary to the service-connected bilateral knee strain is remanded. 3. Entitlement to service connection for left foot arthritis with four joints missing is remanded. 4. Entitlement to service connection for arthritis of the right foot with four joints missing is remanded. 5. Entitlement to service connection for a right shoulder condition with arthritis is remanded. 6. Entitlement to service connection for a left shoulder condition with arthritis is remanded. The Veteran has advanced several theories of entitlement to service connection for his bilateral shoulder, bilateral hip, and bilateral foot disabilities. He testified that he sustained several falls during his active service, which caused injuries to his feet, hips, and shoulders and eventually led to him developing osteoarthritis. In the alternative, the Veteran contends that his swollen joints during active service and treatment for rubella were in-service manifestations of rheumatoid arthritis. The Veteran indicated that he has experienced bilateral shoulder, bilateral hip, and bilateral foot pain since his active service. Finally, the Veteran asserted that his bilateral hip disability may have been caused or aggravated beyond its natural progression by his service-connected knee disabilities. In July 2020, the Board remanded the appeal to obtain adequate VA medical opinions that addressed the Veteran's contentions. After reviewing the record, the Board finds that the August 2020 addendum opinions are inadequate. Specifically, the only rationale for the VA examiner's negative direct service connection opinions is a lack of medical documentation. The VA examiner did not address the Veteran's lay statements regarding shoulder, hip, and foot pain since active service. With regard to the Veteran's contention that his arthritis was precipitated by rubella, the VA examiner stated that rubella does not cause arthritis. There was no rationale provided for this conclusion. He did not address any of the literature discussed in the May 2020 brief from the Veteran's attorney such as Rubella Virus and Arthritis. Finally, with regard to secondary service connection, the sole rationale only appears to consider the Veteran's knee symptomatology during his active service. Based upon the forgoing, a remand is required to obtain adequate medical opinions. The matters are REMANDED for the following action: 1. Obtain an addendum opinion from an appropriate clinician regarding whether the Veteran's bilateral hip disabilities are at least as likely as not related to his in-service falls or his in-service treatment for rubella. The VA examiner must consider the Veteran sound upon entry to active service. The examiner must also provide an opinion regarding whether the Veteran's bilateral hip disabilities are at least as likely as not proximately due to or aggravated by the service-connected bilateral knee strain. The examiner must provide a rationale for all opinions. In rendering the opinion, the VA examiner must address the Veteran's lay statements regarding pain since service and the medical literature cited in the May 2020 brief. 2. Obtain an addendum opinion from an appropriate clinician regarding whether the Veteran's bilateral foot and bilateral shoulder disabilities are at least as likely as not related to his in-service falls or his in-service treatment for rubella. The VA examiner must consider the Veteran sound upon entry to active service. The examiner must provide a rationale for all opinions. In rendering the opinion, the VA examiner must address the Veteran's lay statements regarding pain since service and the medical literature cited in the May 2020 brief. 3. After the above development, and any additionally indicated development, has been completed, readjudicate the issues on appeal. If the benefits sought are not granted to the Veteran's satisfaction, send the Veteran and his representative a Supplemental Statement of the Case and provide an opportunity to respond. If necessary, return the case to the Board for further appellate review. DAVID L. WIGHT Veterans Law Judge Board of Veterans' Appeals Attorney for the Board R.R. Watkins, 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.