Citation Nr: 21006997 Decision Date: 02/08/21 Archive Date: 02/08/21 DOCKET NO. 16-36 009 DATE: February 8, 2021 REMANDED Entitlement to service connection for a right hip disability is remanded. Entitlement to service connection for a left hip disability is remanded. Entitlement to service connection for a right knee disability is remanded. Entitlement to service connection for a left knee disability is remanded. REASONS FOR REMAND The Veteran served on active duty from February 2010 to July 2010. This matter comes before the Board of Veterans’ Appeals (Board) from an October 2015 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO) in Des Moines, Iowa. The Veteran testified before the undersigned Veterans Law Judge in February 2019. A transcript of the hearing has been associated with the record. The Board remanded these claim in September 2019. 1. Entitlement to service connection for a right hip disability is remanded. 2. Entitlement to service connection for a left hip disability is remanded. 3. Entitlement to service connection for a left knee disability is remanded. 4. Entitlement to service connection for a right knee disability is remanded. The Veteran contends that he is entitled to service connection for a bilateral hip disability because the alleged disability is the result of active service. More specifically, he asserts that the claimed disability was caused by training during active service. The service medical records showed no indication of chronic knee or hip pain or condition. The Veteran responded “no” to a question regarding any dislocation or limited motion of the hips. In a February 2011 Periodic Health Assessment, the Veteran indicated that he did not have joint pain or chronic pain. In a February 2020 VA examination, the examiner noticed that the Veteran has a diagnosis of non-debilitating right hip pain. No other hip condition was identified on examination or in the records. The examiner indicated that there was no knee disability on examination. The Veteran reported that during active service he rolled his ankle on a hill and landed on the sidewalk causing hip pain. He asserted that he reported the hip pain during service and was treated for it. He stated that the left hip did not really bother him. The examiner opined that it was less likely than not that any left or right hip disability was related to active service. The rationale was that an April 2010 service medical record showed treatment for hip pain, and that the injury was acute. Beyond that, the examiner referenced a bone scan. When VA obtains an examination or opinion, the examination or opinion must be adequate.  Barr v. Nicholson, 21 Vet. App. 303 (2007). In support of the opinion, the February 2020 examiner referenced a 2010 in-service incident in the service medical records regarding treatment for hip and knee pain following a fall. The examiner noted that the service medical records included a bone scan that alluded to overuse of the joints and a “Dead Man’s Profile.” The Board notes that the service medical records contained in the Veteran’s file do not contain that information. As a result, the medical opinion is insufficient because it is predicated on an inaccurate factual basis. Further examination is necessary. The matters are REMANDED for the following action: 1. Associate with the record any VA medical records not already of record of treatment of the Veteran. Verify that all service medical records and service personnel records are included in the file. 2. Schedule the Veteran for a VA examination by an appropriate clinician to determine the nature and etiology of any right and left hip disability. The examiner must review the claims file and should note that review in the report. The examiner should review the claims file and note that review in the report. All indicated tests should be conducted. The examiner should discuss the Veteran’s lay statements regarding the history and continuity of symptomatology. The examiner should diagnose all right and left hip disabilities found. The examiner should opine whether it is at least as likely as not (50 percent probability or greater) that any right or left hip disability is related to the Veteran’s service. The examiner is requested to provide a complete rationale for any opinion expressed based on the examiner’s clinical experience, medical expertise, and established medical principles. If the examiner determines that any right and left hip disabilities are not the result of active service, but can be attributed to some other cause, the examiner should so state, taking into account the Veteran’s full post-service work and medical history. The examiner cannot rely solely on silence of the service medical records for a diagnosis or treatment to support a negative opinion. 3. Schedule the Veteran for a VA examination to determine the nature and etiology of any right and left knee disability. The examiner should review the claims file and note that review in the report. All indicated tests should be conducted. The examiner should discuss the Veteran’s lay statements regarding the history and continuity of symptomatology. The examiner should provide an explanation for all conclusions. The examiner should opine whether it is at least as likely as not (50 percent probability or greater) that any right or left knee disability is related to service. The examiner should discuss the matter thoroughly and provide a rationale for the opinion. If the examiner determines that any right and left knee disabilities are not the result of active service, but can be attributed to some other cause, the examiner should so state, taking into account the Veteran’s full post-service work and medical history. The examiner cannot rely solely on silence of the service medical records for a diagnosis or treatment to support a negative opinion. Harvey P. Roberts Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board K. Cross, 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.