Citation Nr: A21018466 Decision Date: 11/18/21 Archive Date: 11/18/21 DOCKET NO. 190731-24978 DATE: November 18, 2021 REMANDED Entitlement to service connection for a left hip disability is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Marine Corps from May 1997 to May 2001. The Veteran also served on active duty for training (ACDUTRA) from January 4, 2016 to January 26, 2016. See Nov. 2017 Medical Treatment Record Government Facility, p. 2. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a May 2019 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO). In the July 2019 VA Form 10182, Decision Review Request: Board Appeal, the Veteran elected the Evidence Submission docket. Therefore, the Board may only consider the evidence of record at the time of the agency of original jurisdiction (AOJ) decision on appeal, as well as any evidence submitted by the Veteran or his representative with, or within 90 days from receipt of, the VA Form 10182. 38 C.F.R. § 20.303. Entitlement to service connection for a left hip disability is remanded. The Veteran contends that his left hip disability is related to his active duty and/or ACDUTRA service. The Veteran's April 1997 enlistment examination did not note any disabilities or symptoms regarding the left hip. See May 2001 STR Medical, pp. 91-92. In January 2001, the Veteran's service treatment records reflect that he endorsed left hip pain. Id. at 81. In March 2001, the Veteran reported that there was no significant improvement of the status of his left hip. Id. at 106. In addition to his active-duty service, military records indicate that the Veteran also served on ACDUTRA from January 4, 2016 to January 26, 2016. See Oct. 2018 STR Reserve, p. 65. Records also indicate that the Veteran was injured in a motor vehicle accident on January 7, 2016 in the course of his duties during ACDUTRA. Id. The documents further note that the Veteran experienced chronic left hip pain, which was exacerbated by the January 2016 accident. Id. at 66. In November 2018, the Veteran underwent a VA hip and thigh conditions examination in which he was diagnosed with left hip strain. However, the examiner opined that it was less likely than not that the condition was incurred in or caused by the Veteran's service. Regarding rationale, the examiner relied on the length of time between the 2001 reports of in-service hip pain and his reports of left hip pain in 2015. The examiner also opined that the condition clearly and unmistakably was not aggravated beyond its natural progression by an in-service injury, event, or illness. The examiner provided the same rationale as outlined above, and further stated that the rationale supported that the Veteran's left hip condition was not exacerbated by the motor vehicle accident. The examiner did not address the Veteran's Reserve records outlined above regarding exacerbation of his left hip condition by the accident. In July 2019, the Veteran submitted a private treatment records by his physician, Dr. L.S. Dr. L.S. stated that the Veteran continued to have problems with his lower back, left hip, and left leg with radiculopathy. He further noted that he has seen the Veteran for six years and the pain has continued to progress. Dr. L.S. also noted, "pain has worsened since his accident in 2016 . . . since he was rear ended while he was serving military orders." He concluded that the 2016 injury "significantly passed its normal and natural progression." While the Board acknowledges the favorable nature of the July 2019 statement by Dr. L.S., it unfortunately is inadequate to render the evidence of nexus in equipoise. Dr. L.S. began the statement by referring to multiple problems, specifically regarding the lower back, left hip, and left leg. Unfortunately, Dr. L.S. did not specify which conditions were aggravated beyond their normal and natural progression by the 2016 injury. Further, the Board finds the November 2018 VA examination to be inadequate for adjudication purposes. The examiner's opinion as to aggravation was conclusory and failed to consider all relevant evidence of record, specifically military documents outlined above that discuss exacerbation of the Veteran's left hip disability by the motor vehicle accident that occurred during ACDUTRA. As the November 2018 examination predates the rating decision on appeal, this constitutes a pre-decisional error. Accordingly, the claim must be remanded in order to obtain an adequate examination and opinion. See Barr v. Nicholson, 21 Vet. App. 303, 312 (2007) (when VA undertakes to provide a VA examination or obtain a VA opinion, it must ensure that the examination or opinion is adequate). The matters are REMANDED for the following action: 1. Schedule the Veteran for a VA examination to determine the nature and etiology of his left hip disability. Any indicated evaluations, studies, or tests deemed necessary by the examiner should be accomplished. The entire claims file, to include a complete copy of this REMAND, should be made available to the examiner designated to provide an opinion and the examination report should include a discussion of the Veteran's documented medical history and assertions. The examiner must address the following: (a.) Determine whether it is at least likely as not (a 50 percent probability or greater) that the Veteran's left hip disability was caused or aggravated by his active duty or ACDUTRA service. (b.) Assume in-service aggravation of the Veteran's left hip disability is conceded and determine the base level of the disability prior to the January 2016 motor vehicle accident. In responding to the above, the examiner must address all relevant lay and medical evidence of record, to include the Reserve documentation submitted in October 2018 discussing a motor vehicle accident in which the Veteran's left hip condition may have been exacerbated. The examiner is advised that the Veteran is competent to report symptoms, treatment, and injuries and that his reports must be considered in formulating the requested opinions. D. SMART Acting Veterans Law Judge Board of Veterans' Appeals Attorney for the Board R. Watkins, 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.