Citation Nr: 21075217 Decision Date: 12/17/21 Archive Date: 12/17/21 DOCKET NO. 17-35 226 DATE: December 17, 2021 REMANDED Entitlement to service connection for right hip strain is remanded. Entitlement to service connection for left hip strain is remanded. Entitlement to service connection for a right knee disability is remanded. Entitlement to service connection for a left knee disability is remanded. Entitlement to service connection for a right ankle disability is remanded. Entitlement to service connection for a left ankle disability is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Marine Corps from May 1996 to May 2000. These matters come before the Board of Veterans' Appeals (Board) on appeal from an April 2016 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO) in Jackson, Mississippi. The Veteran requested a Board videoconference hearing in his March 2020 appeal to the Board. Subsequently, in an April 2020 correspondence, the Veteran's representative withdrew his request for a Board hearing. Under these circumstances, the regulations consider the hearing request to have been withdrawn. 38 C.F.R. § 20.704(e). This matter was previously before the Board in June 2020 when it was remanded for additional development. 1. Entitlement to service connection for right hip strain is remanded. 2. Entitlement to service connection for left hip strain is remanded. The Veteran was afforded a VA hip and thigh conditions examination in April 2021. Bilateral hip strain was diagnosed. The Veteran could not recall any specific injury, but reported having pain in his hips, knees, and ankles and described it as a "heavy numbing aching pain." He further stated that any prolonged standing and any activity caused increased pain. He then asserted that the wear and tear of the military had caused his pain. The examiner provided a negative nexus opinion, noting the service treatment records were silent for any complaints, treatments, or diagnoses for these conditions. Here, the examiner relied entirely on the lack of a documented in-service injury and failed to discuss the Veteran's contention that the rigors of service caused his bilateral hip disabilities. As such, the Board finds the examination is inadequate and remands the matter for a new VA examination. 3. Entitlement to service connection for a right knee disability is remanded. 4. Entitlement to service connection for a left knee disability is remanded. The Veteran was afforded a VA knee and lower leg conditions examination in April 2021. Bilateral knee instability was diagnosed. The Veteran reported bilateral pain, instability, and stiffness. The examiner provided a negative nexus opinion, noting the service treatment records were silent for any complaints, treatments, or diagnoses for these conditions. Here, the examiner relied entirely on the lack of a documented in-service injury and failed to discuss the Veteran's contention that the rigors of service caused his bilateral knee conditions. As such, the Board finds the examination is inadequate and remands the matter for a new VA examination. 5. Entitlement to service connection for a right ankle disability is remanded. 6. Entitlement to service connection for a left ankle disability is remanded. The Veteran was afforded a VA ankle conditions examination in April 2021. It was noted that the Veteran did not have a current diagnosis. It was noted that the Veteran reported difficulty with walking, standing, stooping, and stair climbing. It was also noted that the Veteran's range of motion was abnormal, bilaterally. Pain was noted bilaterally upon examination. In Saunders v. Wilkie, 886 F.3d 1356 (Fed. Cir. 2018), the United States Court of Appeals for the Federal Circuit (Federal Circuit) held that pain, a symptom, may constitute a disability if it produces functional limitation or impairment without identification of the underlying cause of pain. As such, the Board finds that a remand for a new examination consistent with the opinion in Saunders is required. The matters are REMANDED for the following action: 1. Schedule the Veteran for a VA examination (or telehealth interview, review of the record, etc., if an in-person examination is not feasible) to determine the onset and etiology of his bilateral hip disabilities. All indicated tests and studies should be conducted, and all findings reported in detail. The examiner must review the claims file. The examiner must identify any right and left hip impairment and/or functional loss. The examiner should then opine whether it is at least as likely as not that the Veteran's right and left hip disability/functional impairment had its onset or is otherwise related to the Veteran's active service, to include as due to wear and tear of military life. A complete rationale should be given for all opinions and conclusions expressed. It is not sufficient to base an opinion on a mere lack of documentation of complaints in the service or post-service treatment records. 2. Schedule the Veteran for a VA examination (or telehealth interview, review of the record, etc., if an in-person examination is not feasible) to determine the onset and etiology of his bilateral knee disabilities. All indicated tests and studies should be conducted, and all findings reported in detail. The examiner must review the claims file. The examiner must identify any right and left knee impairment and/or functional loss. The examiner should then opine whether it is at least as likely as not that the Veteran's right and left knee disability/functional impairment had its onset or is otherwise related to the Veteran's active service, to include as due to wear and tear of military life. A complete rationale should be given for all opinions and conclusions expressed. It is not sufficient to base an opinion on a mere lack of documentation of complaints in the service or post-service treatment records. 3. Schedule the Veteran for a VA examination (or telehealth interview, review of the record, etc., if an in-person examination is not feasible) to determine the onset and etiology of his bilateral ankle disabilities. The examiner must review the claims file. The examiner must identify any right and left ankle impairment and/or functional loss. The examiner should then opine whether it is at least as likely as not that the Veteran's right and left ankle disability/functional impairment had its onset or is otherwise related to the Veteran's active service, to include as due to wear and tear of military life. A complete rationale should be given for all opinions and conclusions expressed. It is not sufficient to base an opinion on a mere lack of documentation of complaints in the service or post-service treatment records. Jarrette A. Marley Acting Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Keeley, Brian 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.