Citation Nr: 21012925 Decision Date: 03/08/21 Archive Date: 03/08/21 DOCKET NO. 15-29 947 DATE: March 8, 2021 ORDER Entitlement to service connection for a bilateral hip disability is denied. FINDING OF FACT The probative and competent medical evidence shows the Veteran’s bilateral hip disability was not shown as chronic in service and did not manifest to a compensable degree within the applicable presumptive period; continuity of symptomatology is not established; and the disability is not otherwise etiologically related to an in-service injury or disease. CONCLUSION OF LAW The criteria for service connection for a bilateral hip disability are not met. 38 U.S.C. §§ 1101, 1110, 1112, 1113, 1131, 1137, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309.   REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from October 1958 to April 1962. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from an April 2013 rating decision issued by a Department of Veterans Affairs (VA) Regional Office (RO). In April 2018, the Board remanded the issue on appeal for further development; there was substantial compliance with the remand directives. This case has been advanced on the docket pursuant to 38 C.F.R. § 20.800(c). 1. Entitlement to service connection for a bilateral hip disability. The Veteran seeks entitlement to service connection for a bilateral hip disability. In a May 2011 correspondence, the Veteran contends that his hip disability is related to an injury he incurred from an in-service fall while performing a practice maneuver from a parachute jump tower. A November 2017 buddy statement from R.B., who served with the Veteran, provides corroboration to the in-service fall. During an October 2020 VA examination, the Veteran asserted that he developed hip (and back) pain from the fall that has continued since that time and become progressively worse. Service connection may be granted for disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. § 3.303. The three-element test for service connection requires evidence of: (1) a current disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the current disability and the in-service disease or injury. Shedden v. Principi, 381 F.3d 1163, 1166 -67 (Fed. Cir. 2004). Certain chronic diseases will be presumed related to service, absent an intercurrent cause, if they were shown as chronic in service; or, if they manifested to a compensable degree within a presumptive period following separation from service; or, if they were noted in service (or within an applicable presumptive period) with continuity of symptomatology since service that is attributable to the chronic disease. 38 U.S.C. §§ 1101, 1112, 1113, 1137; 38 C.F.R. §§ 3.303, 3.307, 3.309. Walker v. Shinseki, 708 F.3d 1331, 1338 (Fed. Cir. 2013). The Veteran has a current diagnosis of bilateral degenerative arthritis of the hip as evidenced by a February 2013 VA treatment record. Arthritis is an enumerated condition under 38 C.F.R. § 3.309(a); Walker, 708 F.3d 1331. However, the disability was not shown as chronic in service, did not manifest to a compensable degree within the one-year presumptive period, and was not noted in service with attributable continuity of symptomatology. VA treatment records show the Veteran was not diagnosed with bilateral degenerative arthritis of the hip until February 2013, decades after his separation from service in April 1962 and decades outside of the applicable presumptive period. His service treatment records (STRs) are unremarkable for a fall or injury related to parachute practice maneuvers. Moreover, the STRs are unremarkable for complaints referable to his hips or back. Neither the self-reported medical history upon separation, nor the medical examination provided for separation purposes note any hip or musculoskeletal issues, including his back. In a letter to the Department of the Army dated in May 1964, the Veteran wrote that he experienced two injuries in service, an injury to the lower back, knees, feet and ankles while training to jump from a tower and an eye injury from brake fluid splashing his eye. No mention was made of a hip injury. A letter dated in May 1964 from his then-personal physician shows the Veteran complained of pain in the knees, back, and bilateral heels and feet. No mention was made of hip complaints. Further, the first recorded complaint of hip pain in any private or VA medical record is in relation to a February 1997 low back surgery by Dr. M.K. The operative report notes that the Veteran was in a car accident in August 1996 which resulted in pain in his left leg. A second car accident in November 1996 resulted in pain in the left hip and leg, as well as back pain resulting in the February 1997 surgery. Subsequent to the surgery the Veteran began having pain in his right hip as well, as noted by a September 1997 treatment record from Dr. M.K. The same treatment record also pointed out that at the time the Veteran was working as a contractor who owned his own construction company which required him to “do much work” and “be mobile.” The Veteran has complained of hip pain in treatment records ever since. While the Veteran is competent to state that he fell in service and hurt his hips, the Board finds that his contention as to the onset, chronicity and/or continuity of hip pain since service is not credible given the record as a whole. The Board notes that a prolonged period without medical complaint can be considered, along with other factors concerning a claimant’s health and medical treatment during and after military service, as evidence of whether an injury or a disease was incurred in service which resulted in any chronic or persistent disability. Maxson v. Gober, 230 F.3d 1330, 1333 (Fed. Cir. 2000). Here, not only do the service treatment records not reflect any hip (or back) complaints during service after a fall, they also show the Veteran did not report any hip pain or similar symptoms at discharge. He affirmatively denied problems with his bones or joints on his Report of Medical History and no hip abnormalities were noted on the physical examination. The Board also observes that post-service private medical records demonstrate the initial onset of hip complaint many years after service and following two motor vehicle accidents and subsequent low back surgery that occurred in 1996. This evidence, along with the October 2020 VA unfavorable nexus opinion is probative evidence against finding that a hip disability is related to service. Service connection for a bilateral hip disability may still be granted on a direct basis; however, the preponderance of the evidence is against finding that a medical nexus exists between the Veteran’s bilateral hip disability and an in-service injury, event or disease. 38 U.S.C. §§ 1110, 1131; Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009); 38 C.F.R. § 3.303. The October 2020 VA examiner opined that the Veteran’s bilateral degenerative arthritis of the hip is not at least as likely as not related to an in-service injury, event, or disease, including the Veteran’s reported in-service fall. The rationale again, was that the extended, 30 plus year period after service until hip pain was reported in 1997 cannot be concluded as due to service. The Board finds this opinion adequate and persuasive. It was based on claims file review, interview of the Veteran, and physical examination. The examiner’s factual finding with respect to the lengthy period after service with no hip complaints or treatment is an accurate history based on the Board’s review of the evidentiary record. Contrary to that opinion, the October 2019 VA examiner opined that the Veteran’s bilateral degenerative arthritis of the hip is at least as likely as not related to an in-service injury, event, or disease, including the Veteran’s reported in-service fall. However, the rationale provided shows the examiner relied upon the injury history as provided by the Veteran’s statements at the examination as to his alleged chronic hip injury in service. As the Board has found that the Veteran’s statements regarding the chronicity of his hip symptoms since service discharge are not credible, the examiner’s opinion and rationale are not probative. A medical opinion based upon factual inaccuracy renders it devoid of any probative value. Reonal v. Brown, 5 Vet. App. 458, 461 (1993). The Board has additionally considered the lay statements submitted by two of the Veteran’s daughters. While they show the struggles that the Veteran has dealt with in regard to musculoskeletal pain, they do not provide specific details regarding hip pain, nor do they provide sufficient information indicating when the onset of hip pain began. Without these details, the statements, unfortunately, do not provide relevant information that can be utilized to substantiate the assertion of chronic hip pain since an injury during service. While the Veteran believes his bilateral degenerative arthritis of the hip is related to his in-service parachute practice maneuver fall, he is not competent to provide a nexus opinion in this case. This issue is also medically complex, as it requires specialized medical education. Jandreau v. Nicholson, 492 F.3d 1372, 1377, 1377 n.4 (Fed. Cir. 2007). As the Veteran has not shown he is competent through medical training, experience or credentials, the Board gives more weight to the probative October 2020 VA opinion. For these reasons, the Board finds that service connection for a bilateral hip disability is not warranted. As the preponderance of the evidence is against the claim the benefit of the doubt doctrine is not applicable in the instant appeal. Service connection is denied. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102. D. JOHNSON Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board R. Caban, 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.