Citation Nr: 21009133 Decision Date: 02/19/21 Archive Date: 02/19/21 DOCKET NO. 18-23 094 DATE: February 19, 2021 ORDER Service connection for a right hip disorder is denied. Service connection for a left hip disorder is denied. Service connection for a cervical spine disorder is denied.   FINDINGS OF FACT 1. The Veteran’s right and left hip disorders were not incurred in or caused by service, and were not caused or aggravated by a service-connected disability. The Veteran’s cervical spine disorder was not incurred in or caused by service. CONCLUSIONS OF LAW 1. The criteria for service connection for a right hip disorder are not met. 38 U.S.C. §§ 1101, 1110, 1112, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309, 3.310 2. The criteria for service connection for a left hip disorder are not met. 38 U.S.C. §§ 1101, 1110, 1112, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309, 3.310. 3. The criteria for service connection for a cervical spine disorder are not met. 38 U.S.C. §§ 1101, 1110, 1112, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from December 1960 to December 1964. The case is on appeal from an August 2014 rating decision. In June 2019, the Veteran testified at a Board hearing. In July 2019, the Board remanded the appeal for additional development. The Board has limited the discussion below to the relevant evidence required to support its findings of fact and conclusions of law, as well as to the specific contentions regarding the case as raised directly by the Veteran and those reasonably raised by the record. See Scott v. McDonald, 789 F.3d 1375, 1381 (Fed. Cir. 2015); Robinson v. Peake, 21 Vet. App. 545, 552 (2008). Legal Criteria Service connection may be granted for a disability resulting from a disease or injury incurred in or aggravated by active service. See 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303. A veteran seeking compensation under these provisions must establish three elements: “(1) the existence of a present disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the present disability and the disease or injury incurred or aggravated during service.” Saunders v. Wilkie, 886 F.3d 1356, 1361 (Fed. Cir. 2018) (quoting Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004)). In addition, certain chronic diseases, including arthritis, are presumed to be incurred in or aggravated by service if manifest to a compensable degree within one year of separation from service. 38 U.S.C. §§ 1101, 1112; 38 C.F.R. §§ 3.307, 3.309(a); Fountain v. McDonald, 27 Vet. App. 258 (2015). Service connection may also be granted for a disability that is proximately due to, or aggravated by, service-connected disease or injury. See 38 C.F.R. § 3.310. Where there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, VA shall give the benefit of the doubt to the claimant. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102; see also Gilbert v. Derwinski, 1 Vet. App. 49, 53 (1990). 1. Service connection for a right hip disorder. 2. Service connection for a left hip disorder. The Veteran contends that he has right and left hip disorders due to service, or secondary to service-connected bilateral knee and foot disabilities. The Veteran reported injuring his hips during a fall from a helicopter, a distance of 35 to 50 feet, during service. See June 2019 Board hearing testimony. He reported experiencing the onset of bilateral hip symptoms that persisted for the rest of his active duty service. Pursuant to the Board’s July 2019 remand, the Veteran was afforded a VA examination in February 2020. The examiner diagnosed osteoarthritis of the right hip and tenosynovitis of the left hip. Although the Veteran’s service treatment records (STRs) document a fall from a helicopter, the examiner noted no reference to hip symptoms during service or at separation. In addition, medical literature was reported to reflect that posttraumatic arthritis usually begins within 15 years after an injury, whereas the Veteran’s hip pain was noted to have had its onset many years after service, in 2005. As such, the evidence does not indicate hip arthritis had its onset within one year of discharge. The Board notes that although an April 2015 letter from a private physician reflects the Veteran’s reported history of bilateral hip pain since falling from a helicopter during service in the 1970s, the history is not credible as the Veteran was not in service in the 1970s and other records show a much later onset. In addition, and although the physician requested that the hip disorders be included as part of the Veteran’s service-connected disability rating, the physician did not directly offer an opinion as to whether the hip conditions were caused by the Veteran’s in-service fall from a helicopter. The Board notes that the June 2014 VA examiner opined that such was less than likely. Additionally, the February 2020 VA examiner reported that the Veteran’s right and left hip disorders most likely occurred spontaneously rather than as a result of service-connected bilateral knee or foot conditions. It was noted that generalized osteoarthritis was commonly found in 10 to 20 percent of septuagenarians, that the Veteran’s contemporaneous complaints of hip and knee symptoms was the usual situation with onset of generalized osteoarthritis, and that based on examination of other joints in the Veteran’s hands and wrists, the Veteran appeared to have generalized osteoarthritis. Therefore, the examiner concluded that the worsening of the Veteran’s hip symptoms was much more likely due to the natural progression of the conditions rather than aggravated by the service-connected bilateral knee or foot disabilities. See also March 2018 VA addendum opinion. The Board notes that although the Veteran is competent to report his symptoms, to include hip pain, a determination as to whether the Veteran’s current right and left hip disorders are related to service is a complex matter requiring related medical expertise. See Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007) (holding that a lay person is not considered competent to testify regarding medically complex issues); see also Kahana v. Shinseki, 24. Vet. App. 428 (2011). As the Veteran has no known or reported medical expertise, he is not legally competent to establish a nexus between these disabilities and service; thus, his opinions as to causation lack probative value, and opinions by a qualified medical professional are required to decide the claims. In that regard, the opinions rendered by the February 2020 VA examiner, a VA physician, constitute such competent medical evidence. Further, as these opinions are unequivocally stated, consistent with the record, and supported by cited evidence of record, the Board finds that these medical opinions are probative evidence against the Veteran’s claims. The examiner’s opinions are probative, because they are based on an accurate medical history and provide explanations that contain clear conclusions and supporting data. Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 304 (2008). In consideration of the evidence, the Board finds that the Veteran’s right and left hip disorders were not incurred in or caused by service, and were not caused or aggravated by a service-connected disability. This includes insufficient evidence to show that any hip arthritis manifested within one year of service or a continuity of symptomatology since service. Thus, the preponderance of the evidence is against the claims, particularly the nexus element. Therefore, the benefit-of-the-doubt doctrine is not applicable, and service connection for right and left hip disorders is not warranted. See 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102. 3. Service connection for a cervical spine disorder. Similarly, the Veteran contends that he has a cervical spine disorder due to a fall from a helicopter, a distance of 35-50 feet, during service. He reported experiencing the onset of neck symptoms that persisted for the rest of his active duty service. Pursuant to the Board’s July 2019 remand, the Veteran was afforded a VA cervical spine examination in February 2020. The report of examination reflects degenerative arthritis of the cervical spine and spinal stenosis. No reference to neck symptoms was noted in the Veteran’s STRs, including at the time of the fall, and the Veteran clarified that damage to his helmet involved the webbing and chin strap rather that the shell of the helmet liner. In addition, no neck condition was noted at separation. The examiner cited medical literature reflecting that whiplash has its onset immediately within a few days of an injury, noting the Veteran was returned to full duty two weeks after the fall, and that posttraumatic arthritis usually began within 15 years after injury. The Veteran’s neck pain was noted to have had its onset in 1971, seven years after separation, and arthritis of the cervical spine was diagnosed in 2014. As such, the evidence does not indicate the onset arthritis of the cervical spine within one year of discharge. The Board notes that although a December 1996 record notes a history of a shoulder injury as a result of the fall from the helicopter during service, again, there is no reference to cervical spine symptoms. See December 2019 private treatment records. In addition, as noted above, although an April 2015 letter from a private physician reflects the Veteran’s reported history of neck pain since falling from a helicopter during service in the 1970s, the history is not credible as the Veteran was not in service in the 1970s and, even with an onset during that time period, it is several years after service. Further, the physician did not directly offer an opinion as to whether the neck condition was caused by the Veteran’s in-service fall from a helicopter. The Board notes that although the Veteran is competent to report his symptoms, to include neck pain, a determination as to whether the Veteran’s current neck disorder is related to service is a complex matter requiring related medical expertise. See Jandreau, 492 F.3d at 1372; Kahana, 24. Vet. App. at 428. As the Veteran has no known or reported medical expertise, he is not legally competent to establish a nexus between a cervical spine disorder and service; thus, his opinion as to causation lacks probative value, and an opinion by a qualified medical professional is required to decide the claim. In that regard, the opinion rendered by the February 2020 VA examiner, a VA physician, constitutes such competent medical evidence. Further, as this opinion is unequivocally stated, consistent with the record, and supported by cited evidence of record, the Board finds that this medical opinion is probative evidence against the Veteran’s claim. The examiner’s opinion is probative, because it is based on an accurate medical history and provides an explanation that contains clear conclusions and supporting data. Nieves-Rodriguez, 22 Vet. App. at 304. In consideration of the evidence, the Board finds that the Veteran’s cervical spine disorder was not incurred in or caused by service. This includes insufficient evidence to show that any cervical spine arthritis manifested within one year of service or a continuity of symptomatology since service. Thus, the preponderance of the evidence is against the claim. Therefore, the benefit-of-the-doubt doctrine is not applicable, and service connection for a cervical spine disorder is not warranted. See 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102. RYAN T. KESSEL Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board M. Taylor 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.