Citation Nr: 21074452 Decision Date: 12/15/21 Archive Date: 12/15/21 DOCKET NO. 16-26 674 ODATE: December 15, 2021 ORDER Entitlement to service connection for a left hip disability is granted. FINDING OF FACT Resolving all reasonable doubt in the Veteran's favor, the evidence of record supports finding that the Veteran's left hip disability is secondary to service-connected low back disability. CONCLUSION OF LAW The criteria for entitlement to service connection for a left hip disability are met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.303(b). REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from September 1965 to November 1968. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a July 2014 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO) in Augusta, Maine. A Board hearing was conducted via videoconference with the RO in Newark, New Jersey. A transcript of this hearing is contained within the electronic claims file. This claim has been remanded three times (February 2020, November 2020, and June 2021). The first two remands were required because this claim inextricably was tied to his prior back claim. At the same time the agency of original jurisdiction (AOJ) awarded service connection for the Veteran's knee and back it provided the Veteran with medical opinions for his left hip on both a direct and secondary basis. For the first time, in his March 2021 examination, the Veteran made allegations that his left hip directly was related to two in-service motor vehicle accidents. In its most recent June 2021 remand, the Board found the March 2021 opinions legally inadequate and instructed the AOJ to obtain new ones. In September 2021, the AOJ secured new opinions. For brevity's sake, suffice it to say that these opinions are inadequate for largely the same reasons as the March 2021 opinions. The Board has limited the discussion below to the relevant evidence required to support its finding of fact and conclusion of law, as well as to the specific contentions regarding the case as raised directly by the Veteran and those reasonably raised by the record. See Scott v. McDonald, 789 F.3d 1375, 1380 (Fed. Cir. 2015); Robinson v. Peake, 21 Vet. App. 545, 552 (2008), aff'd sub nom. Robinson v. Shinseki, 557 F.3d 1355 (Fed. Cir. 2009). For disability resulting from personal injury suffered or disease contracted in line of duty, or for aggravation of a preexisting injury suffered or disease contracted in line of duty, in the active military, naval, or air service, during a period of war, the United States will pay to any veteran thus disabled and who was discharged or released under conditions other than dishonorable from the period of service in which said injury or disease was incurred, or preexisting injury or disease was aggravated, compensation as provided in this subchapter, but no compensation shall be paid if the disability is a result of the veteran's own willful misconduct or abuse of alcohol or drugs. 38 U.S.C. § 1110. To establish service connection, there must exist medical or, in certain circumstances, lay evidence of (1) a current disability; (2) an in-service incurrence or aggravation of a disease or injury; and (3) a nexus between the claimed in-service disease or injury and the present disability. Romanowsky v. Shinseki, 26 Vet. App. 289, 293 (2013); 38 C.F.R. § 3.303(a). For certain chronic diseases, including arthritis, a presumption of service connection arises if the disease is manifested to a degree of ten percent within one year following discharge from service. When a chronic disease is not shown to have manifested to a compensable degree within one year after service, there is required, under 38 C.F.R. § 3.303(b), a combination of manifestations sufficient to identify the disease entity and sufficient observation to establish chronicity at the time. When the fact of chronicity in service is not adequately supported, a showing of continuity after discharge is required to support a claim for such diseases; however, such continuity of symptomatology may only support a claim for those chronic diseases listed under 38 C.F.R. § 3.309(a). Walker v. Shinseki, 708 F.3d 1331, 1336 (Fed. Cir. 2013); 38 C.F.R. § 3.303(b), 3.307(a)(3), 3.309(a). In rendering a decision on appeal, the Board must analyze the competency, credibility, and probative value of the evidence, account for the evidence that it finds to be persuasive or unpersuasive, and provide the reasons for its rejection of any material evidence favorable to the claimant. Buchanan v. Nicholson, 451 F.3d 1331, 133537 (Fed. Cir. 2006). When there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, the Secretary shall resolve all reasonable doubt in favor of the claimant. 38 U.S.C. § 5107(b); Gilbert v. Derwinski, 1 Vet. App. 49, 53 (1990); 38 C.F.R. § 3.102. Service treatment records (STRs) do indeed verify that the Veteran suffered two, in-service motor vehicle accidents (September and December 1967). Post-service VA medical center (VAMC) records as early as August 2010 show that the Veteran complained of pain in his hips. By 2016, he had a confirmed diagnosis of degenerative arthritis in the left hip. At his hearing, the Veteran also testified that, while serving in Vietnam, he did convoy duty, which required him to be in trucks, which tossed him around and hurt his hip. Given the persistent inadequacy of the obtained opinions in the past, the Board finds that any additional attempts to obtain an adequate opinion would be futile. Thus, the Board will resolve reasonable doubt in the Veteran's favor and find that the application for presumptive service connection for a chronic condition based on continuity of symptomatology is appropriate. The Board finds credible the Veteran's testimony regarding the pain he experienced during convoy duty, and his STRs clearly document in-service motor vehicle accidents. The post-service records show a documented history of the Veteran reporting left hip pain, and his condition is degenerative in nature. Thus, the Board finds that the evidence shows a continuity of symptomatology has been established. See Walker, 708 F.3d at 1336; 38 C.F.R. §§ 3.303(b), 3.307(a)(3), 3.309(a). Therefore, the Veteran's appeal is granted. JONATHAN B. KRAMER Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Trevor T. Bernard, 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.