Citation Nr: 21009046 Decision Date: 02/18/21 Archive Date: 02/18/21 DOCKET NO. 13-14 526 DATE: February 18, 2021 REMANDED Entitlement to service connection for a left hip disability is remanded. Entitlement to service connection for a right hip disability is remanded. Entitlement to a total disability rating based on individual unemployability is remanded. REASONS FOR REMAND The Veteran had active service from February 1976 to February 1983. These matters were previously before the Board and were remanded for further development in September 2020. The development was completed, and the matters are again before the Board. The Board regrets the delay, but finds another remand is necessary. While development directed in the previous remand was completed, the Board finds it is not adequate. These matters were remanded in September 2020 in order to obtain an opinion as to the etiology of the Veteran’s hip conditions that considered her lay statements of pain since service as well as the instances of treatment for both her left and right hip while in service. The Veteran’s service treatment records (STRs) show that she was seen in service for her left hip in August 1981 and her right hip in December 1980, November and December 1981. The Veteran had an examination for her hips in November 2020 in which the examiner saw the Veteran in person and reviewed her file. The examiner noted the Veteran had been diagnosed with a bilateral hip strain for that examination. The examiner noted the Veteran’s contentions that she started having pain in her right hip during basic training and that she continued to have hip pain. The examiner opined it was less likely than not the Veteran’s hip disability was incurred in and due to her time in service. The examiner reported the Veteran’s statements that she had an onset of right pain in service. The examiner noted the Veteran had an abnormal hip finding on the present examination but that previous examinations, while showing back problems, did not show the Veteran’s back was related to her hip condition. The examiner noted the Veteran was seen in service for her right hip, but that it was acute only in service and that STRs were negative for diagnosis of a left hip condition, including her November 1982 separation examination. The examiner also noted the Veteran’s file lacked evidence of chronicity of care and that her diagnosis of a hip condition was noted in 2004, over 20 years from her separation of service. This examination only addressed a theory of direct service connection and whether the Veteran’s hip conditions were due to her in-service back injury. The Board finds this examination to be inadequate. While the examiner noted the Veteran’s statements of pain since service, she did not explain why those statements were insufficient to link the Veteran’s current hip problems to her hip problems in service. Additionally, while the examiner stated the Veteran was not diagnosed with a left hip condition in service, she did not address the August 1981 treatment for a left hip condition while in service. Additionally, the previous Board decision found a March 2019 hip examination to be inadequate because it did not consider the Veteran’s lay statements. This examination considered whether the Veteran’s hip conditions were due to any of her service-connected disabilities, but again, this examination has been found to be inadequate. Therefore, another remand is necessary. Barr v. Nicholson, 21 Vet. App. 303 (2007), See Stegall v. West, 11 Vet. App. 268, 271 (1998). The Board finds a remand is also required in the Veteran’s claim to a TDIU because it is inextricably intertwined with her claim to service connection for her left and right hip disabilities. See Harris v. Derwinski¸1 Vet. App. 180, 193 (1991). The matters are REMANDED for the following action: 1. Obtain any outstanding VA treatment records and associate the same with the Veteran’s claims folder. If possible, the Veteran’s representative or the Veteran herself, to avoid further delay, should obtain these records (both VA and private treatment) and submit them to the VA. If all available records have been submitted, the Veteran’s representative should so indicate (in writing). 2. Schedule the Veteran for an appropriate VA examination to determine the nature and etiology of her left and right hip disabilities. The claims file must be made available to, and reviewed by, the examiner. Any indicated studies should be performed. If, due to COVID-19, the Veteran does not feel comfortable or safe appearing in person for an examination, an opinion by a qualified examiner should still be obtained. The examiners should provide an opinion as to the following for both her right and left hip disabilities: (a) Whether it is at least as likely as not (50 percent or greater probability) the Veteran’s disability was incurred in and due to her time in service. (b) Whether it is at least as likely as not the Veteran’s disability is proximately due to any of her service-connected disabilities. (c) Whether it is at least as likely as not the Veteran’s disability was aggravated beyond its natural progression by her time in service. Any opinion should be accompanied by an explanation. The examiner should explicitly note the Veteran’s statements about what she believes the etiology of her hip disabilities are and explicitly address them in the opinion offered. 3. Readjudicate the issue on appeal based on the additional evidence of record. If the determinations remain adverse to the Veteran, he must be provided with a supplemental statement of the case. An appropriate period of time must then be allowed for a response before the record is returned to the Board for further review. John J. Crowley Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board A. Snoparsky 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.