Citation Nr: 21010614 Decision Date: 02/25/21 Archive Date: 02/25/21 DOCKET NO. 11-23 689A DATE: February 25, 2021 REMANDED Entitlement to service connection for left hip disability, diagnosed as osteoarthritis, is remanded. Entitlement to service connection for right hip disability, diagnosed as osteoarthritis, is remanded. Entitlement to service connection for arthritis of joints other than the right and left hip, is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Army from August 1966 to June 1968, including service in the Republic of Vietnam from June 1967 to June 1968. These matters come before the Board of Veterans’ Appeals (Board) on appeal from a February 2010 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO) in Detroit, Michigan. These matters were previously before the Board in August 2014, following an April 2013 Travel Board hearing, at which time they were remanded because they were intertwined with other issues being remanded. The same was true in May 2017 when other related matters were remanded for outstanding medical records. Most recently, these matters were remanded in August 2018 for adequate VA examinations and etiological opinions, and they have now been returned to the Board for further adjudication. Clarification of the Issues on Appeal Given that the Veteran’s appeal includes a separate claim for service connection for arthritis and he has already been diagnosed with right and left hip osteoarthritis, the Board has included this diagnosis within the Veteran’s hip disorder claims and re-characterized the Veteran’s arthritis claim as entitlement to service connection for arthritis of joints other than the right and left hip. Clemons v. Shinseki, 23 Vet. App. 1, 6 (2009) (holding that when a claimant makes a claim, the claimant is seeking service connection for symptoms regardless of how those symptoms are diagnosed or labeled). 1. Entitlement to service connection for left hip disability, diagnosed as osteoarthritis, is remanded. 2. Entitlement to service connection for right hip disability, diagnosed as osteoarthritis, is remanded. The July 2019 post remand VA examiner’s assessment is that while there is no documentation of the Veteran’s report of his in-service bilateral hip injury (which the Veteran asserts is the basis for his current bilateral hip disability), she finds the Veteran’s report to be credible. However, the examiner opined that it is as less likely as not (less than 50 percent probability) that the Veteran’s bilateral hip disability is etiologically related to his active duty service, and for her rationale she lists chronological events post service, including three specific risk factors – age, obesity and his occupation, which she cites as the primary bases for the Veteran’s current bilateral hip disability. While these specific references to the chronology of events in the record provide context, the Board is unable to accept such references as a rationale. This is because the examiner failed to adequately explain why she was giving greater weight to the three risk factors (age, obesity and occupation) as bases for the Veteran’s current bilateral hip disability, over the Veteran’s reported in-service injury, which she acknowledged was credible. Consequently, the Board must regrettably find that this July 2019 VA opinion lacks substantial compliance of the Board’s August 2018 remand directive, which states that “[a] complete rationale should be given for all opinions and conclusions expressed.” Thus, these issues must again be remanded for a compliant opinion before they can be adjudicated on their merits. Stegall v. West, 11 Vet. App. 268, 271 (1998). 3. Entitlement to service connection for arthritis of joints other than the right and left hip. The Board notes that the Veteran’s claim for service connection for arthritis stems from the same facts as that of his claim for bilateral hip disability, which includes his assertion of an in-service injury that resulted when he fell off a road grader, as reported by the Veteran during his April 2013 Board hearing. Since the Veteran has not been afforded an examination for this specific claim, the Board finds that the Veteran should also be provided an examination and opinion in order to determine the current nature and etiology of any joint arthritis other than that which is associated with the Veteran’s right and left hip. The matters are REMANDED for the following action: 1. Obtain an addendum opinion for an adequate medical explanation to support the nature and etiology of the Veteran’s claimed bilateral hip disability claim. The claims folder, including VA treatment records, private treatment records and a copy of this remand, should be reviewed by the examiner and this should be noted in the examination report. The examiner is advised that the Veteran’s lay statements regarding credible and competent reports of ongoing hip pain, including an in-service injury which resulted when he fell off a road grader, as reported by the Veteran during his April 2013 Board hearing, has been deemed credible. Following a review of the record, the examiner should then: Provide a thorough medical explanation to support whether the Veteran’s current bilateral hip disability is less likely than not (50 percent probability or greater) resulted from his active military service, to include the Veteran’s credible report of his in-service hip injury. If the examiner finds that the etiology of the Veteran’s bilateral hip disability is due to age, obesity and occupation (or any other factor), then he/she must provide a thorough medical explanation to support why such factor(s) is given more probative weight as the etiological basis for the Veteran’s current bilateral hip disability, over that of the Veteran’s reported in-service hip injury and ongoing hip pain. 2. With regards to the Veteran’s claim for service connection for arthritis of joints other than the right and left hip, schedule the Veteran for a VA examination with an appropriately qualified examiner to determine the nature and etiology of any such disability. The examiner should report the following: a) State whether the Veteran has arthritis of joints other than the right and left hip. b) If so, whether it is as least as likely as not (50 percent probability or more) that the Veteran’s arthritis of joints other than the right and left hip had its onset in service or is otherwise etiologically related to his active duty service. The examiner is advised that the Veteran is considered competent to be able to report injuries and symptoms, and that his reports must be considered in formulating the requested opinions. If the Veteran’s reports are discounted, the examiner should provide a reason for doing so. The examiner should provide a clear and thorough rationale in support of his opinions, and if the examiner must resort to speculation for the requested opinions, an explanation as to why this is so, is required. After completing the above actions, the Agency of Jurisdiction (AOJ) should review the report to ensure its compliance with the directives of this remand. If the report is deficient in any manner, the AOJ must implement corrective procedures at once, and readjudicate these issues, if necessary, based on the entirety of the evidence. Michael J. Skaltsounis Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board J.B. King, 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.