Citation Nr: 21020887 Decision Date: 04/08/21 Archive Date: 04/08/21 DOCKET NO. 14-24 208 DATE: April 8, 2021 REMANDED Entitlement to service connection for bilateral hip degenerative joint disease, to include as secondary to service-connected low back, pes planus, and bilateral ankle disabilities is remanded. REASONS FOR REMAND The Veteran served on active duty from August 1977 to April 1986. The Board most recently remanded the claim in August 2020 for further development. There has not been substantial compliance with the remand directives and the claim must be remanded again. Stegall v. West, 11 Vet. App. 268 (1998). The Veteran contends that his bilateral hip disability is either directly related to an in-service fall or secondary to his service-connected low back, pes planus, and bilateral ankle disabilities. The claim must be remanded again because the January 2021 VA opinion obtained on remand is inadequate. The January 2021 examiner did not provide an opinion as to secondary causation and used the wrong standard for aggravation. 38 C.F.R. § 3.310(b); Allen v. Brown, 7 Vet. App. 439 (1995). The matters are REMANDED for the following action: 1. Obtain an addendum opinion from a different VA examiner than the January 2021 VA examiner, if possible, regarding the likely etiology of any bilateral hip disability. Copies of all pertinent records must be made available to the examiner for review. If the examiner determines that an opinion cannot be provided without an examination, (or telehealth interview, if an in-person examination is not feasible) then one should be scheduled Based a complete review of the record, the examiner should provide opinions as to the following: (a.) Is it at least as likely as not that the Veteran’s current bilateral hip disability is caused by his service-connected low back, pes planus, and/or bilateral ankle disabilities? Why or why not? (b.) Is it at least as likely as not that the Veteran’s current bilateral hip disability is aggravated by his service-connected low back, pes planus, and/or bilateral ankle disabilities? Aggravation here is defined as any increase in disability. If aggravation is present, the clinician should indicate, to the extent possible, the approximate level of disability (baseline) before the onset of the aggravation. 2. The examiner must explain the rationale for all opinions in detail, citing to supporting clinical data and/or medical literature, as appropriate. If an opinion cannot be provided, the examiner should indicate why. 3. Confirm that the VA medical opinion provided comports with this remand, specifically that the standard for the secondary aggravation opinion is any increase in disability, not the standard of beyond the natural progression as noted on the examination form itself. If not, get an addendum. M.E. Larkin Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board S.E. Bresler, 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.