Citation Nr: 21011508 Decision Date: 03/02/21 Archive Date: 03/02/21 DOCKET NO. 16-27 719 DATE: March 2, 2021 ORDER Entitlement to service connection for left hip osteoarthritis and hip replacement is granted. Entitlement to service connection for right hip osteoarthritis and hip replacement is granted. FINDINGS OF FACT 1. The Veteran’s left hip osteoarthritis and hip replacement is related to service. 2. The Veteran’s right hip osteoarthritis and hip replacement is related to service. CONCLUSIONS OF LAW 1. The criteria for service connection for left hip osteoarthritis and hip replacement are met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303. 2. The criteria for service connection for right hip osteoarthritis and hip replacement are met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran had active service from August 1983 to May 1993 and December 2003 to March 2005. In an October 2019 decision, the Board denied the Veteran’s claims for service connection for disabilities of the left and right hips. The Veteran appealed the decision to the United States Court of Appeals for Veterans Claims (Court). In October 2020, the Court granted a Joint Motion for Remand and remanded the claims to the Board for readjudication. Service Connection 1. Entitlement to service connection for left hip osteoarthritis and hip replacement 2. Entitlement to service connection for right hip osteoarthritis and hip replacement The Veteran contends that his bilateral hip disabilities are related to service. He asserts that his hip disabilities are related to the activities and physical demands of his military service. In a June 2016 statement, the Veteran described his service activities, including: 12-mile marches with a 70-pound rucksack and combat gear; constant climbing and jumping on and off track vehicles; and foot patrols while wearing combat gear, a flak vest, weapons, and ammo. He stated that these activities all contributed to his hip disabilities. Service connection will be granted if the evidence demonstrates that a current disability resulted from an injury or disease incurred in or aggravated by active military service. 38 U.S.C. § 1110; 38 C.F.R. § 3.303 (a). Establishing service connection generally requires competent evidence of three things: (1) a current disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship, i.e., a nexus, between the claimed in-service disease or injury and the current disability. Holton v. Shinseki, 557 F.3d 1362, 1366 (Fed. Cir. 2009); 38 C.F.R. § 3.303 (a). In some cases, service connection may be established by showing evidence of a chronic disease in service, which requires a combination of manifestations sufficient to identify the disease entity, and sufficient observation to establish chronicity at the time. 38 C.F.R. § 3.303 (b). If chronicity in service is not established, a showing of continuity of symptoms after discharge is required to support the claim. Id. The provisions of 38 C.F.R. § 3.303 (b) pertaining to continuity of symptomatology can be applied only in cases involving those conditions explicitly recognized under 38 C.F.R. § 3.309 (a). Walker v. Shinseki, 708 F.3d 1331 (Fed. Cir. 2013). Arthritis is listed among the chronic diseases in 38 C.F.R. § 3.309 (a). The Veteran has current diagnoses of left and right total hip arthroplasty. See October 2019 VA treatment records and January 2021 physician statement. Service treatment records do not reflect complaints of a hip condition. However, the Veteran's statements regarding his activities in service are competent, credible, and consistent with the circumstances of his service. See 38 U.S.C. § 1154 (a). Post-service treatment records reflect treatment for hip disabilities from 2013. However, in the June 2016 substantive appeal, the Veteran indicated that his hip symptoms started about six months after he returned from Iraq. The Veteran is considered competent to report symptoms such as hip pain. The Veteran had a VA examination in March 2016. The examiner gave a negative nexus opinion for a bilateral hip disability. The examiner noted that the service treatment records do not show treatment for a hip disability. It was noted that the Veteran had a history of five parachute jumps that were performed without incident. The examiner opined that there was no credible evidence to support a nexus between five jumps and osteoarthritis of the bilateral hips. The March 2016 examination did not address the Veteran’s statements about his other service activities, besides his parachute jumps, or the credible history of hip symptoms starting six months after service. In January 2021, the Veteran submitted a medical opinion from a private physician, Dr. K.E., who opined that his bilateral total hip replacements are related to service. Dr. K.E. noted that the Veteran had osteoarthritis of the hips that led to hip replacements. He noted that the Veteran is the youngest person in his practice to undergo hip replacements who did not have a congenital hip disorder. Dr. K.E. opined that, “After a review of his military career and activities, it is at least as likely than not that his arthritis and joint degeneration were service connected. To assume otherwise does not make sense to me and I feel a majority of his repetitive trauma that caused his arthritis was truly from his military duties as his complaints started in a timeframe consistent with that." The record contains conflicting medical opinions regarding an etiological relationship to service. The Board accords greater probative value to the January 2021 medical opinion, as the opinion contained a more detailed rationale which considered the history of bilateral hip symptoms since service. Moreover, the March 2016 VA opinion did not consider the Veteran’s lay statements about his service activities other than his parachute jumps and is found to be less probative. Therefore, a medical nexus linking the Veteran’s bilateral hip disabilities to service is established. Service connection is warranted for left and right hip osteoarthritis and hip replacements. 38 U.S.C. § 5107; 38 C.F.R. § 3.102. JENNIFER HWA Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Catherine Cykowski 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.