Citation Nr: 21011131 Decision Date: 03/01/21 Archive Date: 03/01/21 DOCKET NO. 14-39 283 DATE: March 1, 2021 REMANDED Entitlement to service connection for a left hip condition is remanded. Entitlement to service connection for a right hip condition is remanded. Entitlement to service connection for a left knee condition, to include as secondary to a hip condition, is remanded. Entitlement to service connection for a right knee condition, to include as secondary to a hip condition, is remanded. Entitlement to service connection for a left ankle condition, to include as secondary to a hip condition, is remanded. Entitlement to service connection for a right ankle condition, to include as secondary to a hip condition, is remanded. REASONS FOR REMAND The Veteran served on active duty from July 1967 to February 1969. In the October 2014 Form 9, the Veteran requested a videoconference hearing before the Board of Veterans’ Appeals (Board). The hearing was scheduled for December 2018, and the Veteran failed to appear for the hearing. The Veteran has not requested a rescheduled hearing. 1. Entitlement to service connection for a bilateral hip condition is remanded. The Veteran was provided a VA examination in February 2020. The examiner did not find any diagnosable hip conditions. In the Medical History, the examiner noted that an extensive work up would be necessary, and the risks and benefits would need to be weighted by the Veteran’s primary care physician (PCP). Evaluation by the Veteran’s PCP was necessary in order for a diagnosis to be made due to the Veteran’s morbid obesity and poor endurance. The Veteran stated he would discuss with his PCP to see what can be evaluated without causing risk to the Veteran. See February 2020 Medical Opinion. Although the examiner was unable to provide a positive nexus opinion, the examiner noted that evaluation by the Veteran’s PCP was necessary in order to provide any proper diagnosis due to the Veteran’s other medical conditions interfering with the ability to provide a comprehensive examination. The Veteran stated he would discuss the situation with his PCP, and therefore, additional development is necessary to ensure that the Veteran is afforded the opportunity to identify all relevant private treatment providers, and that any outstanding private and VA treatment records are secured and associated with the claims file. The Board notes the examiner failed to address any functional impairment of earning capacity in the absence of a diagnosable hip condition. In this case, the Board also finds that the Veteran should be afforded an addendum opinion now that the Veteran has had the time to consult with his PCP regarding his bilateral hip disability claim; specifically addressing his contentions that these disabilities are related to his in-service jeep accident. 2. Entitlement to service connection for a bilateral knee condition, to include as secondary to a hip condition is remanded. The Veteran was provided a VA examination in February 2020. The examiner provided a negative nexus opinion, finding the Veteran’s bilateral knee pain was related to his degenerative joint disease (DJD) in the knees. The examiner did not explain why the Veteran’s diagnosis of bilateral knee DJD was not related to the Veteran’s active duty service. Therefore, the Board finds this rationale and opinion inadequate. An addendum opinion is necessary in order to determine the nature and etiology of the Veteran’s diagnosed bilateral knee conditions. Additionally, because the Board has remanded the bilateral hip service connection claims, the bilateral knee condition claims are inextricably intertwined and must also be remanded. See Harris v. Derwinski, 1 Vet. App. 180, 183 (1991). 3. Entitlement to service connection for a bilateral ankle condition, to include as secondary to a hip condition is remanded. Because the Board has remanded the bilateral hip service connection claims, the bilateral ankle condition claims are inextricably intertwined and must also be remanded. Id. The Veteran was provided a VA examination in February 2020. The Board notes that although the examiner failed to find evidence of an ankle condition, pain may be considered a disability for VA purposes if it results in functional impairment of earning capacity. See Saunders v. Wilkie, 886 F.3d 1356 (Fed. Cir., 2018). Accordingly, an addendum opinion is necessary to determine if any functional impairment of earning capacity is related to active duty service and/or the Veteran’s hip condition. The matters are REMANDED for the following action: 1. Contact the Veteran and request authorization to obtain any outstanding records pertinent to the claim, including any private treatment records following proper VA procedures (38 C.F.R. § 3.159(c)). 2. After all outstanding records have been associated with the claims file, forward the Veteran’s claims file to a qualified medical professional for a new VA medical examination to determine the nature and etiology of the Veteran’s hip, knee, and ankle disabilities. Based on the examination results and a review of the entire record, the examiner must respond to the following: (a.) Provide current diagnoses for any left or right hip conditions which manifested at any time during the period on appeal; (b.) If no hip conditions are diagnosed, identify any functional impairment of earning capacity caused by left or right hip pain. If no functional impairment is found, the examiner should state negative findings; (c.) Provide an opinion as to whether any diagnosed left or right hip condition (to include any identified functional impairment of earning capacity) at least as likely as not (a 50 percent or greater probability) is etiologically related to service, to include the May 1968 motor vehicle accident (MVA); (d.) Provide current diagnoses for any left or right knee conditions which manifested at any time during the period on appeal; (e.) Provide an opinion as to whether any diagnosed left or right knee condition at least as likely as not is etiologically related to service, to include the May 1968 MVA; (f.) Provide an opinion as to whether any diagnosed left or right knee condition at least as likely as not was caused or aggravated (increased in severity beyond the natural progression of the disorder) by the Veteran’s bilateral hip condition; (g.) Provide current diagnoses for any left or right ankle conditions which manifested at any time during the period on appeal; (h.) If ankle conditions are not diagnosed, identify any functional impairment of earning capacity caused by left or right hip pain. If no functional impairment is found, the examiner should state negative findings; (i.) Provide an opinion as to whether any diagnosed left or right ankle condition (to include any identified functional impairment of earning capacity) at least as likely as not is etiologically related to service, to include the May 1968 MVA; (j.) Provide an opinion as to whether any diagnosed left or right ankle condition (to include any identified functional impairment of earning capacity) at least as likely as not was caused or aggravated by the Veteran’s bilateral hip condition. In answering all questions, please articulate the reasoning underpinning the conclusions. That is, (1) identify what facts and information--whether found in the record or outside the record--support the opinion, and (2) explain how that evidence justifies the opinion. A. C. MACKENZIE Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board B. N. Quarles, 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.