Citation Nr: 21006645 Decision Date: 02/04/21 Archive Date: 02/04/21 DOCKET NO. 12-35 442 DATE: February 4, 2021 REMANDED Entitlement to service connection for a right hip disorder, other than scar, is remanded. REASONS FOR REMAND The Veteran served on active duty from May 1995 to May 1998, and from September 1998 to September 2000. This matter comes to the Board of Veterans’ Appeals (Board) on appeal from an August 2011 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO) in St. Petersburg, Florida. In May 2016 the Veteran presented testimony at a Travel Board hearing before the undersigned Veterans Law Judge (VLJ). 1. Entitlement to service connection for a right hip disorder, other than scar, is remanded. Although the Board regrets additional delay, remand is required for an adequate VA opinion. Where VA provides the Veteran with an examination in a service connection claim, the examination must be adequate. Barr v. Nicholson, 21 Vet. App. 303, 311 (2007). A medical examination report must contain not only clear conclusions with supporting data, but also a reasoned medical explanation connecting the two. Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 301 (2008). The Board is also obligated by law to ensure that the RO complies with its directives. Stegall v. West, 11 Vet. App. 268, 271 (1998). RO compliance with remand directives is not optional or discretionary and the Board errs as a matter of law when it fails to ensure remand compliance. Stegall, 11 Vet. App. at 271. The Veteran was provided with a VA examination in September 2020. Although the examiner found that the Veteran’s hip condition was at least as likely as not related to service, his opinion supported a negative nexus. The Board notes that the examiner likely selected the wrong nexus opinion statement. The examiner acknowledged the Veteran’s lay statement that he had experienced right hip pain for 10 years, but found that the medical records contradicted this statements as there were no complaints of or treatment for hip pain. The Veteran noted that there was radiographic evidence that indicated minimal degenerative changes but determined that it was likely age related and not trauma induced or related to the stresses of military service such as running, carrying heavy equipment, or hand to hand combat. First, the Board finds this rationale to be inadequate as it is largely conclusory. The examiner simply stated that the degenerative changes in the Veteran’s hip was age related rather than trauma related, but provided no medical support or explanation for this opinion. Second, the Board also notes that the examiner was specifically instructed to reconcile a July 2006 radiograph that showed minimal degenerative changes and spurring off the lateral acetabulum with maintenance of the joint with 2017 radiographs that did not show any pathology. Although the examiner generally mentioned the results from the July 2006 radiograph and “later” x-ray findings, it isn’t clear that these were the March 2017 x-rays. Finally, the Board notes that the examiner dismissed the Veteran’s complaints of continuous hip pain for the past decade by citing the lack of documentation in medical records. The examiner noted three medical records where the Veteran reported left hip pain but not right hip pain. The Veteran stated, however, in the May 2016 hearing that he often did not report or pay attention to his right hip pain as his left pain would overshadow it at times. 1. Return the claims folder to an examiner qualified to provide an opinion on the etiology of the claimed right hip disorder. An examination shall be conducted if the examiner deems it necessary. The entire claims file must be made available to and be reviewed by the examiner. An explanation for all opinions expressed must be provided. First, the examiner must clarify all currently present right hip diagnoses, and attempt to reconcile the July 2006 VA radiographs showing minimal degenerative changes, and spurring off the lateral acetabulum with maintenance of the joint space with the March 2017 VA examiner’s findings. Second, for each identified right hip disorder, provide an opinion regarding whether it is at least as likely as not (50 percent or greater probability) that the disorder had onset in, manifested within one year of service discharge, or is otherwise caused by the Veteran’s military service. The examiner must address the following: 1) the July 2006 radiograph and March 2017 radiograph findings; 2) the Veteran’s assertion that his right hip disorder is due to his in-service bone graft; 3) the Veteran’s May 2016 testimony of intermittent right hip pain for 10 years; and 4) the Veteran’s assertion that he experienced consistent stress on his hip joint due to running, carrying heavy artillery and equipment, and practicing hand to hand combat in service. For purposes of this opinion only, the examiner should presume the Veteran’s reports of right hip pain are true. 2. Notify the Veteran that it is his responsibility to report for any scheduled examination and to cooperate in the development of the claim, and that the consequences for failure to report for a VA examination without good cause may include denial of the claim. 38 C.F.R. §§ 3.158, 3.655 (2017). In the event that the Veteran does not report for any scheduled examination, documentation must be obtained which shows that notice scheduling the examination was sent to the last known address. It must also be indicated whether any notice that was sent was returned as undeliverable. K. MILLIKAN Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Ashley Ki 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.