Citation Nr: 21067716 Decision Date: 11/05/21 Archive Date: 11/05/21 DOCKET NO. 18-21 044 DATE: November 5, 2021 ORDER Entitlement to service connection for a right hip flexor groin condition is granted. FINDING OF FACT Resolving doubt in the Veterans favor, the Veteran's right hip flexor groin condition had its onset during his active service. CONCLUSION OF LAW The criteria for service connection for right hip flexor groin condition have been met. 38 U.S.C. § 1110, 5107; 38 C.F.R. § 3.102, 3.303. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from July 2011 to July 2014. This appeal comes to the Board of Veterans' Appeals (Board) from a January 2018 rating decision of the Department of Veterans' Affairs (VA) regional office (RO). The Veteran testified at a hearing with the undersigned in August 2021. Entitlement to service connection for a right hip flexor groin condition Generally, direct service connection may be granted for a disability resulting from disease or injury incurred in or aggravated by service. 38 U.S.C. § 1110; 38 C.F.R. § 3.303 (a). Service connection requires: (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 or aggravated during service. See Shedden v. Principi, 381 F.3d 1163, 1166-1167 (Fed. Cir. 2004). First the Board must assess if the Veteran has a current disability. In June 2018, the Veteran underwent an MRI which showed a small undersurface tear of the labrum near the attachment to the anterolateral bony acetabulum. As such, the first element has been met. Next the Board turns to the second criteria for entitlement to service connection: the in-service incurrence of disease or injury. In the August 2021 hearing with the undersigned, the Veteran testified to his in-service injury. The Veteran asserted that one morning while on a ruck march he slipped and felt a sharp pain in his leg that has pained him since. The Veteran did not seek immediate medical attention because he was embarrassed. However, he did eventually seek medical treatment and was provided with basic care. Service treatment records (STRs) show ongoing treatment for groin pain and "chronic right hip pain." See, e.g., May 2013 STR. These treatment records establish an injury to the right hip/groin in service, and the second element of service connection is met. Finally, the Board must assess whether a nexus exists between the Veteran's in-service injury and his current disability. STR show that in October 2013 the Veteran underwent an MRI without contrast. This MRI did not show any irregularities or provide a diagnosis. However, the Veteran was placed on a P2 profile and had been "vetted by Physical Therapy." The Veteran was described as having a "long established history of right hip/inguinal pain." X-ray of the pelvis and frogleg lateral view of the hip showed no evidence of acute fracture or dislocation. During the hearing with the undersigned the Veteran explained his reasoning for not seeking treatment for his right hip condition after service, even though his pain never dissipated. The Veteran explained that when he left service in 2014 he was directed to get assistance from the VA. However, at the time the Veteran did not have the finances to pay for health care and so he did not seek care. In December 2017 the Veteran was afforded a C&P examination. There the examiner opined it was less likely than not the right hip condition was incurred in or caused by active duty. The examiner there stated the Veteran did not have a right hip injury/diagnosis that was incurred in or caused by active service. The examiner stated there was no medical evidence of the Veteran being seen and/or treated for a condition since 2013. In June 2018 the Veteran underwent the MRI that produced his diagnosis of right labral tear. This MRI was administered with contrast, and as such could analyze more of the image than the 2013 MRI. Private treatment records show physical therapy for the right hip in 2017 and 2018. In his medical history form the Veteran reported that an "Army injury" in 2013 in Texas caused a hip tear and that the Veteran has constant pain that is getting worse. The record contains an August 2, 2021 opinion from the Veteran's private physical therapist who is a licensed medical doctor. The examiner concludes the Veteran's right hip labral tear was a direct result of his fall during his active service. The private examiner explains how they have personally worked together and interviewed the patient and reviewed all medical records. He cited to the Veteran's pain for five years following the injury in service until it was finally diagnosed by MRI with contrast in 2018. The private physician fully considered the Veteran's history, current medical diagnosis, and is knowledgeable of his condition. The Board finds this opinion probative, as it provided a clear conclusion with supporting data, and reasoned medical explanations connecting the two. Stefl v. Nicholson, 21 Vet. App. 120, 124-25 (2007); Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 304 (2008). Lay evidence is competent if it is provided by a person who has knowledge of facts or circumstances and conveys matters that can be observed and described by a layperson. 38 C.F.R. § 3.159(a)(2). The Veteran is competent to report both his experience with his injury, his continued chronic pain, and his reason for not seeking medical treatment in the first few years after separation. The Board finds the Veteran's very specific account of why he did not seek treatment for a few years after service to be credible. Jandreau v. Nicholson, 492 F.3d 1372, 1376-77 (Fed. Cir. 2007). The Board affords more weight to the private opinion due to the examiner's consideration of the Veteran's lay statements as well as the benefit of an accurate MRI with contrast, which did not exist at the time of the VA examination. The most probative evidence establishes a nexus between the injury in service and the current right hip labral tear. The Board grants the Veteran's claim of entitlement to service connection for a right hip labral tear. LAURA E. COLLINS Veterans Law Judge Board of Veterans' Appeals Attorney for the Board M. Brewer, 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.