Citation Nr: 21013731 Decision Date: 03/10/21 Archive Date: 03/10/21 DOCKET NO. 11-05 777 DATE: March 10, 2021 REMANDED Entitlement to service connection for a right knee disability, to include as secondary to a bilateral hip disability, is remanded. Entitlement to service connection for a bilateral hip disability, to include as secondary to a right knee and/or right ankle disability, is remanded. Entitlement to service connection for a right ankle disability, to include as secondary to a bilateral hip disability, is remanded. REASONS FOR REMAND The Veteran had active service from February 1969 to December 1971. This matter comes before the Board of Veterans’ Appeals (BVA or Board) from a February 2010 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO) in St. Petersburg, Florida. The Veteran requested a hearing before the Board. The requested hearing was conducted in September 2011 by the undersigned Veterans Law Judge. A transcript is associated with the claims file. In February 2014, the Board remanded these claims for additional development. In an August 2016 decision, the Board declined to reopen the claims of entitlement to service connection for a right ankle disorder and a right knee disorder and denied the claim of entitlement to service connection for a bilateral hip disorder. Thereafter, the Veteran appealed the August 2016 decision in its entirety to the United States Court of Appeals for Veterans Claims (Court). In a May 2017 Joint Motion for Remand (JMR), the Secretary of VA and the Veteran’s representative (the parties) moved the Court to vacate the August 2016 decision. The Court granted the JMR in a May 2017 Order. The case was then returned to the Board for further review. In July 2017, the Board reopened the Veteran’s claims for service connection for a right knee disorder and a right ankle disorder and remanded all claims on appeal for additional development. The Board denied these claims in a July 2018 decision. The Veteran appealed the July 2018 decision to the Court, and in a May 2019 JMR, the parties moved the Court to vacate the July 2018 decision. The Court granted the JMR in a May 2019 Order. The issues were again denied by the Board in an October 2019 decision. The Veteran appealed the October 2019 decision to the Court, and in an October 2020 JMR, the parties moved the Court to vacate the October 2019 decision. The Court granted the JMR in an October 2020 Order. 1. Entitlement to service connection for a right knee disability, to include as secondary to a bilateral hip disability. As discussed in the October 2020 JMR, the April 2014 and July 2017 VA examiners did not opine as to whether the Veteran’s right knee disorder is directly related to “stresses that military activities placed on his knee.” As directed in the JMR, a medical opinion should be obtained that opines as to whether the Veteran’s right knee disorder is related to service and addresses multiple in-service treatment records documenting right knee pain. On remand, an addendum opinion should be obtained. 2. Entitlement to service connection for a bilateral hip disability, to include as secondary to a right knee and/or right ankle disability. As discussed in the October 2020 JMR, in the September 2011 Board hearing, the Veteran testified that during service he experienced a clicking sensation in his right hip more than the left, like a catch. The JMR indicates that a medical opinion should be obtained that addresses this statement, as it was not addressed by the April 2014 VA examiner. On remand, an addendum opinion should be obtained. 3. Entitlement to service connection for a right ankle disability, to include as secondary to a bilateral hip disability. The claimed right ankle disability is inextricably intertwined with the claim for service connection for a bilateral hip disability, as it is claimed as secondary to the hip disability. As such, a decision is deferred pending development ordered on remand pertaining to the claimed hip disability. The matters are REMANDED for the following action: 1. Obtain and associate with the claims file all updated treatment records. 2. Obtain an addendum VA medical opinion for the Veteran’s claimed right knee disability. If deemed necessary, afford the Veteran a VA examination. All indicated tests and studies should be accomplished, and all clinical findings should be reported in detail. The claims folder must be provided to the examiner for review. The examiner must state in the examination report that the claims folder has been reviewed. *The examiner should opine as to whether it is at least as likely as not (i.e., 50 percent or greater probability) that the Veteran's claimed right knee disability is causally or etiologically due to service, to include “stresses that military activities placed on his knee.” *In rendering this opinion, the examiner is asked to consider whether there is a medically sound basis to attribute in any way the Veteran's right knee disorder to his time in service. *The examiner should consider and discuss multiple in-service treatment records pertaining to the right knee, to include a November 1969 service treatment record, July 1971 service treatment record, and December 1971 separation report of medical history noting “swollen or painful joints.” All opinions should be supported by a clear rationale, and a discussion of the facts and medical principles involved would be of considerable assistance. 3. Obtain an addendum VA medical opinion for the Veteran’s claimed bilateral hip disability. If deemed necessary, afford the Veteran a VA examination. All indicated tests and studies should be accomplished, and all clinical findings should be reported in detail. The claims folder must be provided to the examiner for review. The examiner must state in the examination report that the claims folder has been reviewed. *The examiner should opine as to whether it is at least as likely as not (i.e., 50 percent or greater probability): a) that the Veteran’s claimed bilateral hip disability is causally or etiologically due to service; b) that the Veteran’s claimed bilateral hip disability is proximately due to or aggravated (beyond a natural progression) by his right knee disorder; or c) that the Veteran’s claimed bilateral hip disability is proximately due to or aggravated (beyond a natural progression) by his right ankle disorder. *The examiner must consider and discuss the Veteran’s testimony in September 2011 that during service he experienced “a clicking sensation in the right hip more than the left. It was just like a catch.” *In rendering this opinion, the examiner is asked to consider whether there is a medically sound basis to attribute in any way the Veteran’s bilateral hip disorder to his time in service, or to his right knee or right ankle. All opinions should be supported by a clear rationale, and a discussion of the facts and medical principles involved would be of considerable assistance. TANYA SMITH Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board L. Andersen, 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.