Citation Nr: 21075168 Decision Date: 12/17/21 Archive Date: 12/17/21 DOCKET NO. 16-35 902 DATE: December 17, 2021 REMANDED Entitlement to service connection for a right hip disorder is remanded. Entitlement to service connection for a left hip disorder is remanded. Entitlement to service connection for a low back disorder is remanded. Entitlement to service connection for a left leg disorder is remanded. Entitlement to service connection for a right leg disorder is remanded. REASONS FOR REMAND The Veteran served on active duty from January 1974 to March 1976. The issues on appeal were remanded for additional development in November 2018 and June 2021. 1. Entitlement to service connection for a right hip disorder is remanded. 2. Entitlement to service connection for a left hip disorder is remanded. 3. 4. Entitlement to service connection for a low back disorder is remanded. 5. Entitlement to service connection for a left leg disorder is remanded. 6. Entitlement to service connection for a right leg disorder is remanded. The June 2021 remand found the evidence obtained did not comply with the November 2018 remand directives as to the issues on appeal. Significantly, that VA examiners had not considered and discussed the Veteran's November 2014 Decision Review Officer (DRO) hearing testimony and did not provide rationale for the provided secondary service connection opinions. It was additionally noted that the low back and leg disorder issues were inextricably intertwined with the hip disorder claims, and that a September 2020 VA examiner found it was more likely that lumbar spine and lower extremity radiculopathy were secondary to severe hip disorders. The June 2021 remand directives included requests that "the clinician must specifically consider and discuss" the Veteran's statements at the November 2014 DRO hearing that he started having hip and low back problems after a wall locker incident in service. The examiners were also instructed to provide opinions as to whether it was at least as likely as not that any hip or low back disorder was (i) caused by or (ii) aggravated by the Veteran's service-connected left and/or right knee disorder. The directives further stated that, in providing these opinions, the clinician must provide separate findings and rationale for causation and aggravation. Although additional VA examinations were conducted in August 2021 and medical opinions were provided in August 2021 with an addendum opinion signed in September 2021, the provided reports do not indicate that the examiner considered and discussed the Veteran's statements at the November 2014 DRO hearing that he started having hip and low back problems after a wall locker incident in service nor were separate findings and rationale provided for the specific causation and aggravation opinions addressing the hip, low back, or leg disorder issues. A remand confers on a veteran or other claimant, as a matter of law, the right to compliance with the remand orders; therefore, additional examinations are required prior to appellate review. See Stegall v. West, 11 Vet. App. 268 (1998). It is acknowledged that the August 2021 VA examiner found the Veteran did not have a diagnosis of a current right or left leg condition; however, in light of the other deficiencies in the intertwined issue examination reports an additional examination required as to this issue. Further, the Board notes a diagnosis is not required to establish service connection for a disability in the presence of symptoms that result in functional impairment in earning capacity. See Saunders v. Wilkie, 886 F.3d 1356 (Fed. Cir. 2018). The Veteran is also shown to have provided a July 2021 statement indicating that he had training at Pope Air Force Base in 1975 and that he "jumped in HQHQ Battery 18th Co-[Artillery]." While it is unclear how these statements pertain to the present appeal, it is noted that the DRO considered the Veteran's testimony in November 2014 that he had completed approximately 20 parachute jumps and in a July 2016 statement of the case found military personnel records did not show service or training as a paratrooper. The November 2014 testimony included report of injuries associated with parachute jumps believed to have resulted in his having been put on profile and/or light duty. The Veteran should be requested to provide clarifying information in support of his claims. The matters are REMANDED for the following action: 1. Request that the Veteran provide clarifying information in support of his July 2021 statement that he had training at Pope Air Force Base and that he "jumped in HQHQ Battery 18th Co-[Artillery]." He should be notified that information sufficient to identify and locate any existing records is required for VA assistance as to such matters. 2. Obtain any VA treatment records not of record, to include those pertaining to treatment after September 14, 2021. 3. Schedule the Veteran for a new VA examination with an examiner who has not previously provided an opinion regarding his claims to assist in determining the nature and etiology of any left and/or right hip disorders and any relationship to active service. The examiner must review the record, with specific consideration and discussion of the Veteran's statements at the November 2014 DRO hearing that he started having hip problems after the wall locker incident. That review must be noted in the report. A rationale for all opinions should be provided. The examiner should: (a) Diagnose all left and/or right hip disabilities found. (b) Provide an opinion as to whether it is at least as likely as not (a 50 percent probability or greater) that any diagnosed left and/or right hip disorder had its onset in, or is otherwise related to, the Veteran's active duty service. (c) Provide an opinion regarding whether it is at least as likely as not (a 50 percent probability or greater) that any diagnosed left and/or right hip disorder was (i) caused by; or (ii) aggravated by his service-connected left and/or right knee disorder. Aggravation in this context is defined as any increase in disability. In providing these opinions, the clinician must provide separate findings and rationales for causation and aggravation. The examiner is advised that the Veteran is competent to report his symptoms/history and that such reports must be acknowledged and considered in formulating any opinion. If his reports are discounted, the examiner should provide a reason for doing so. 4. Schedule the Veteran for a new VA examination with an examiner who has not previously provided an opinion regarding his claims to assist in determining the nature and etiology of any low back disorder and any relationship to active service. The examiner must review the record, with specific consideration and discussion of the Veteran's statements at the November 2014 DRO hearing that he started having low back problems after the wall locker incident. That review must be noted in the report. A rationale for all opinions should be provided. The examiner should: (a) Diagnose all low back disabilities found. (b) Provide an opinion as to whether it is at least as likely as not (a 50 percent probability or greater) that any diagnosed low back disorder had its onset in, or is otherwise related to, the Veteran's active duty service. (c) Provide an opinion regarding whether it is at least as likely as not (a 50 percent probability or greater) that any diagnosed low back disorder was (i) caused by; or (ii) aggravated by his service-connected left and/or right knee disorder. Aggravation in this context is defined as any increase in disability. In providing these opinions, the clinician must provide separate findings and rationales for causation and aggravation. The examiner is advised that the Veteran is competent to report his symptoms/history and that such reports must be acknowledged and considered in formulating any opinion. If his reports are discounted, the examiner should provide a reason for doing so. 5. Schedule the Veteran for a new VA examination with an examiner who has not previously provided an opinion regarding his claims to assist in determining the nature and etiology of any right and/or left leg disabilities and any relationship to active service. The examiner must review the record and should note that review in the report. A rationale for all opinions should be provided. The examiner should: (a) Diagnose all left and/or right leg disabilities found. If no disability or residuals are identified as distinguishable from knee or sciatic nerve disabilities, the examiner must specifically state that fact. (b) Provide an opinion as to whether it is at least as likely as not (a 50 percent probability or greater) that any diagnosed left and/or right leg disorder had its onset in, or is otherwise related to, the Veteran's active duty service. (Continued on the next page) (c) Provide an opinion regarding whether it is at least as likely as not (a 50 percent probability or greater) that any diagnosed left and/or right hip disorder was (i) caused by; or (ii) aggravated by his service-connected left and/or right knee disorder. Aggravation in this context is defined as any increase in disability. In providing these opinions, the examiner must provide separate findings and rationales for causation and aggravation. The examiner is advised that the Veteran is competent to report his symptoms/history and that such reports must be acknowledged and considered in formulating any opinion. If his reports are discounted, the examiner should provide a reason for doing so. Lewis Kyle Acting Veterans Law Judge Board of Veterans' Appeals Attorney for the Board T. Douglas 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.