Citation Nr: 21069035 Decision Date: 11/17/21 Archive Date: 11/17/21 DOCKET NO. 13-31 424A DATE: November 17, 2021 ORDER Entitlement to service connection for right hip trochanteric bursitis is denied. FINDING OF FACT The evidence of record is insufficient to establish that the Veteran's right hip trochanteric bursitis is proximately due to or aggravated by his service-connected left knee disability. CONCLUSION OF LAW The criteria for service connection for right hip trochanteric bursitis have not been met. 38 U.S.C. § 1131; 38 C.F.R. § 3.310(a). REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from June 1975 to August 1978. This matter comes before the Board of Veterans' Appeals (Board) on appeal from an August 2014 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO). In June 2021, the Board remanded the matter for a new VA examination and etiology opinion. The Veteran seeks service connection for a condition of his right hip, which he contends is secondary to his service-connected left knee disability. Generally, service connection may be established for disability resulting from personal injury suffered or disease contracted in the line of duty in the active military, naval, or air service. 38 U.S.C. § 1131; 38 C.F.R. § 3.303. Service connection may also be granted for a current disability that is proximately due to or aggravated in severity beyond its natural progression by a service-connected injury or disease. 38 U.S.C. § 1131; 38 C.F.R. § 3.310(a); Allen v. Brown, 7 Vet. App. 439 (1995). After review of the evidence of record at this time, the Board finds that it is not sufficient to grant service connection. The Veteran has contended that he has a right hip condition related to constant favoring of his left leg due to his service-connected left knee condition, as well as due to an incident in which, as related by the Veteran in an April 2013 work injury report, his left knee gave way when he was stepping out of a trailer at his work, causing him "to land awkwardly on [his] right leg." VA examinations provided in April 2018 and February 2021 noted the Veteran's diagnosis of right hip trochanteric bursitis based on December 2013 x-rays finding the hip joint normal with "scattered areas of chronic periostitis and minimal changes suggestive of chronic trochanteric bursitis." Based on physical examination and review of the Veteran's history and his treatment records, the February 2021 examiner concluded that the Veteran's trochanteric bursitis was less likely than not secondary to his service-connected left knee condition. Regarding aggravation, the clinician noted that the evidence shows the hip pain has been "unchanged" throughout the appeal period, and therefore there the examiner did not find any evidence of aggravation. Regarding proximate causation by the April 2013 fall at work, the clinician explained that trochanteric bursitis is "caused by direct trauma to the tip of the trochanter or overuse of the hip," whereas the Veteran "reports hitting his iliac during the fall, not his trochanter." Moreover, regarding a relation to general compensation for his left knee, the clinician explained that "[i]f he had hip pain due to favoring his knee, it would be in the hip joint"; at the examination, however, the location of the Veteran's pain or any other symptoms was not located in the hip joint, but was rather located at his posterior iliac. It was at the February 2021 VA examination that the record first contained the Veteran's report of "pain over the posterior iliac where he landed during the fall [at work in April 2013]." Given that location of the Veteran's complaint of pain and symptoms, the clinician stated that "[t]his is not related to the hip joint and is more likely from a back condition," which she found was outside the scope of the examination for the hip. Accordingly, in light of this new evidence, the Board remanded the claim in June 2021 in order to provide the Veteran with an examination and etiology opinion regarding any condition of his posterior iliac region as secondary to the April 2013 work fall when his service-connected left knee gave out. The record reflects, however, that when the Veteran was contacted about scheduling a new examination, he refused to attend a new examination, preferring his claim to be returned for adjudication. Accordingly, the Board must adjudicate the claim only on the other evidence of record. 38 C.F.R. § 3.655(b). Based on the evidence of record at this time in this case, the Board therefore finds that entitlement to service connection has not been established. As relates to the Veteran's claimed condition of a right hip condition, the evidence supports only that the Veteran has a current diagnosis of trochanteric bursitis, which the preponderance of the competent evidence establishes is not secondary to the left knee, either as due to or aggravated by the April 2013 work fall or as due to or aggravated by compensating for the left knee disability. The Board acknowledges that the Veteran's claim for his right hip may have been intended to seek compensation for the pain he experiences in the posterior iliac region that he relates began when he fell on that area in April 2013; however, as the Veteran refused to attend a VA examination to determine the nature and etiology of any condition at that region, there is not sufficient evidence to support service connection for any condition that may be present in the posterior iliac. See Wood v. Derwinski, 1 Vet. App. 190, 193 (1990) ("The duty to assist is not always a one-way street."); 38 C.F.R. § 3.655(b). Accordingly, service connection for right hip trochanteric bursitis, claimed as secondary to the service-connected left knee condition, must be denied. 38 U.S.C. § 1131; 38 C.F.R. § 3.310(a). K. Parakkal Veterans Law Judge Board of Veterans' Appeals Attorney for the Board M. Davis, 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.