Citation Nr: 21074297 Decision Date: 12/14/21 Archive Date: 12/14/21 DOCKET NO. 17-45 389 DATE: December 14, 2021 ORDER Entitlement to service connection for left hip hypertrophic spurring (claimed as degenerative arthritis, left hip) is denied. FINDING OF FACT The preponderance of the evidence is against finding that left hip hypertrophic spurring (claimed as degenerative arthritis, left hip), began during active service, or is otherwise related to an in-service event, injury, or disease. CONCLUSION OF LAW The criteria for service connection for left hip hypertrophic spurring (claimed as degenerative arthritis, left hip) have not been met. 38 U.S.C. § 1110; 38 C.F.R. §§ 3.102, 3.303, 3.304, 3.309 REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from April 1978 to February 1994. Service Connection Service connection may be granted for disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. § 3.303. The three-element test for service connection requires evidence of: (1) a current disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the current disability and the in-service disease or injury. Shedden v. Principi, 381 F.3d 1163, 1166 -67 (Fed. Cir. 2004). Entitlement to service connection for left hip hypertrophic spurring (claimed as degenerative arthritis, left hip) The Veteran contends that his left hip condition is the result of his active service. Serviced treatment records indicate a fall from a tank in 1979 with soft tissue trauma and accompanying negative x-ray. The remaining service treatment records are silent for any further complaints or treatment of a left hip condition. In a letter dated August 2015, Dr G.G. indicated that the Veteran has been under his care for the left hip since August 2014 and that after reviewing the Veteran's complete medical history, his condition appears to be service connected. In March 2016, the Veteran attended a VA Hip Conditions examination. The examiner diagnosed left degenerative arthritis as of January 20, 2011. Further he opined that his condition was less likely than not due to his hip complaints during service. The rationale provided was: In order to establish direct service connection for a disorder claimed by this Veteran, the following three questions must be addressed and answered in the affirmative; 1. Is there competent evidence of the current existence of the disability for which service connection is being claimed? Veteran has evidence of OA of the left hip since 2011. he is s/p Left hip replacement due to left hip OA in 2015. 2. Is there competent evidence of a disease contracted, an injury suffered, or an event witnessed or experienced in active service... (That an injury or disease occurred in service is not enough; is there a showing of a resulting chronic disability DURING service OR is there a showing of continuity of symptoms AFTER service?) NO. After careful review of STR there is evidence of a Fall from a tank in1979 resulting soft tissue trauma to his left hip, Neg X-ray. This was treated, The following STRs from 1979 to 1993, veteran's time in active service, there are no further complaints of a Left hip condition showing evidence that it resolved. IN 1992 veteran did complain of RIGHT hip pain with radiculopathy. A bone scan was done in 9/1992 due to his Right hip pain and showed evidence of osteophyte formation on the right hip. The Bone scan showed stress reaction in the right hip, both shins, and both ankles and feet.... No evidence of pathology in the Left hip. This is 13 years after his left hip trauma. There are no further records following service until 2011 at a C&P claim where he claimed his left hip and an x-ray showed minimal hypertrophic changes at the base of the femoral head. This is diagnosed 32 years after his injury in 1979. Therefore it is less likely than not his current hip condition is a result of a soft tissue injury in 1979 which resolved. It would be expected that there would be objective evidence of pathology on the bone scan in 1992 (13 years after the injury) If that one time incident had caused his arthritis. Comment on Dr. [G.G.] note dated 8-21-15 it is questionable he had access to all STR, it is not clear what medical records he had to base his opinion on. Per his letter he has only been seeing the veteran since 8/2014, where he is given the subjective history from the patient that he has had hip pain since 1979. His letter also states that the veteran is asymptomatic in his right hip and therefore it is unlikely his current hip condition to be attributed to general OA, however in the STR there is radiologic evidence per bone scan of OA in the Right hip. And therefore his rational for his left hip not being due to general age related OA is a weak argument. The fact that minimal OA started to show on x-ray in 2011 at age of 58, and his occupational history as a bush hog farmer it more likely his OA in the left hip is due to general arthritis and not due to a one time soft tissue injury in 1979, 32 years ago. ...3. Is there competent evidence of a nexus or connection between the disease, injury or event in service and the current disability? without continuity of symptoms in service or following service there can be no nexus. The remaining evidence of record details continued complaints of a left hip condition but no discussion on its etiology. Based on the foregoing evidence of record, the Board finds that service connection is not warranted. The Board finds the April 2016 VA opinion of record the most probative evidence of record as to the etiology of the Veteran's left hip condition because it is based on an accurate medical history and provides an explanation that contains clear conclusions and supporting data. While the Board notes the positive March 2016 positive private opinion, it has been afforded less probative value. Indeed, as noted in the April 2021 opinion, it is not clear if this opinion is based on review of the Veteran's entire claims file. The Board considered the Veteran's lay assertions as to the etiology of his left hip condition. Although the Veteran is competent to attest to his experiences, he is not competent in these circumstances to opine as to the etiology of his left hip condition. The Veteran has not been shown to have specialized medical knowledge that would be necessary to provide a competent opinion regarding service connection. The Board finds the April 2016 VA opinion of record to be more probative in this regard. The examiner considered the Veteran's history, and ultimately concluded that from a medical perspective, it is less likely that his left hip condition is related to hip complaints in service. In conclusion, the weight of the evidence is against the claim for service connection for a left hip condition. L. M. BARNARD Veterans Law Judge Board of Veterans' Appeals Attorney for the Board R. A. Elliott II, 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.