Citation Nr: 21005928 Decision Date: 02/02/21 Archive Date: 02/02/21 DOCKET NO. 08-30 588 DATE: February 2, 2021 REMANDED Entitlement to service connection for a bilateral hip or thigh disability, including as secondary to a service connected back, knee, shin, foot, or toe disability is remanded. REASONS FOR REMAND The Veteran served on active duty with the United States Marine Corps from November 1985 to August 1993. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a February 2008 rating decision issued by a Department of Veterans Affairs (VA) Regional Office (RO). The Veteran testified before an Acting Veteran’s Law Judge in January 2011 who is no longer employed by the Board. The Veteran testified at a subsequent hearing before the undersigned in December 2015. The Board remanded this matter in February 2012, July 2014, August 2015, February 2016, December 2017, and February 2020 for additional development. The matter is now returned to the Board for further appellate review. Unfortunately, another remand is necessary. The Board remanded this matter in February 2020 to obtain outstanding VA treatment records, including January 2018 bilateral hip x-rays; request the Veteran complete VA Form 21-4142 for any medical treatment provider, including Dr. F. A. A.; schedule the Veteran for an examination to determine the nature and etiology of any bilateral hip/thigh disabilities; and have an examiner provide a nexus opinion concerning direct and secondary service connection theories of entitlement. The RO obtained outstanding VA treatment records, requested the veteran complete VA Form 21-4142, and scheduled the Veteran for an examination. However, the Veteran did not respond to the RO’s request that he complete VA Form 21-4142 and according to an August 2020 Exam Request, the Veteran cancelled his examination. In an August 2020 Deferred Rating, VA noted the veteran declined his April 2020 examination and due to Covid-19 considerations, VA would attempt to contact the examination provider to reschedule the examination. However, there is no evidence in the file VA attempted to reschedule the examination. In order to afford the Veteran every opportunity to substantiate his claim, the Board finds that a remand is warranted to attempt to reschedule the examination. Nonetheless, the Veteran is advised he must cooperate with the AOJ's efforts to obtain relevant evidence and schedule the requested examination or otherwise the issue on appeal will be decided based on the evidence of record. See Wood v. Derwinski, 1 Vet. App. 190, 193 (1991) (indicating the duty to assist is not always a one-way street). The matters are REMANDED for the following action: 1. Ask the Veteran to complete a VA Form 21-4142 for any medical treatment provider, including Dr. F. A. A., who may have records relevant to his claim. Make two requests for the authorized records from Dr. F. A. A. and any other medical treatment provider identified, unless it is clear after the first request that a second request would be futile. 2. Schedule the Veteran for an examination by an appropriate clinician to determine the nature and etiology of any right or left hip and/or thigh disabilities present at any time over the appeal period (from July 2007 to the present). The examiner must opine whether any condition diagnosed is at least as likely as not related to an in-service injury, event, or disease, including running, marching, or participating in military parades. The examiner must review the medical history reported within the medical records associated with the claims file and within the Veteran’s January 2011 and December 2015 testimony. Please note, if the examiner deems it reasonable, an alternate format such as telehealth interview is acceptable. If there is no current diagnosis for right or left hip and/or thigh disability, the examiner must address whether the Veteran experiences hip and/or thigh pain which results in functional loss. If so, the examiner must opine whether the Veteran’s right or left hip and/or thigh functional loss due to pain is at least as likely as not related to his military service. The examiner must provide a comprehensive rationale for each opinion provided. The examiner is advised that the Veteran is competent to report his symptoms and history, and such reports are to be considered in formulating any opinion. If the examiner dismisses any of the Veteran’s reported symptomatology, a reason for doing so must be provided. The examiner must also opine whether any right or left hip and/or thigh disability (or functional loss due to hip and/or thigh pain) diagnosed at any time over the appeal period is at least as likely as not (1) proximately due to any service connected back or lower extremity (knees, shins, feet, toe) disability, or (2) aggravated beyond its natural progression by any service-connected back or lower extremity (knees, shins, feet, toe) disability. Aggravation and causation are distinct theories and must be addressed separately and independently of each other. If aggravation is found the examiner must attempt to establish a baseline level of severity of any right or left hip and/or thigh disability prior to aggravation by the service connected back or lower extremity (knees, shins, feet, toe) disability. M. HYLAND Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Zachery S.C. Luce, 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.