Citation Nr: 21022441 Decision Date: 04/15/21 Archive Date: 04/15/21 DOCKET NO. 13-03 910 DATE: April 15, 2021 REMANDED Entitlement to service connection for degenerative joint disease of the right hip is remanded. Entitlement to service connection for degenerative joint disease of the left hip is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Marine Corps from November 1965 to February 1972 and from January 1973 to May 1973, including service in the Republic of Vietnam. These matters come before the Board of Veterans’ Appeals (Board) on appeal from a September 2017 rating decision issued by the Department of Veterans Affairs (VA) Regional Office (RO). The claims were previously before the Board in November 2017, at which time the Board remanded the claims to the agency of original jurisdiction (AOJ) in order to issue the Veteran a Statement of the Case (SOC) addressing the merits of the claims before the Board can assume jurisdiction. The AOJ subsequently issued the Veteran an SOC in which the Veteran’s claims for service connection for degenerative joint disease of the right hip and left hip were denied. See Statement of the Case dated March 29, 2018. The Veteran perfected an appeal to the Board by submitting a VA Form 9, Appeal to Board of Veterans’ Appeals, in April 2018. Notably, the Veteran originally requested a Board hearing in his VA Form 9; however, the Veteran’s representative withdrew the request in March 2020 correspondence with VA. Thus, the Veteran’s hearing request is deemed withdrawn. 38 C.F.R. § 20.704(e). 1. Entitlement to service connection for degenerative joint disease of the right hip is remanded. 2. Entitlement to service connection for degenerative joint disease of the left hip is remanded. Although it regrets the additional delay, the Board finds that a remand is necessary in order to procure a VA medical opinion addressing whether the Veteran’s diagnosed right and left hip disabilities are at least as likely as not etiologically related to his military service. VA must provide a medical examination or obtain a medical opinion when there is (1) competent evidence of a current disability or persistent or recurring symptoms of a disability; (2) evidence establishing than an event, injury, or disease occurred in service, or establishing that certain diseases manifested during an applicable presumptive period for which the claimant qualifies; and (3) an indication that the disability or persistent or recurrent symptoms of a disability may be associated with the veteran’s service or with another service-connected disability; but (4) there is insufficient competent medical evidence on file for the Secretary to make a decision on the claim. McLendon v. Nicholson, 20 Vet. App. 79 (2006); see also 38 U.S.C. § 5103A(d)(2); 38 C.F.R. § 3.159(c)(4)(i). The third prong, which requires that the evidence of record “indicate” that the claimed disability or symptoms “may be” associated with the established event, disease, or injury, is a low threshold. McLendon, supra, at 83. Given the record before it, the Board finds that a nexus opinion must be obtained before the Veteran’s claims can be properly adjudicated. First, post-service medical records document diagnostic findings of severe degenerative joint disease (DJD) of the right hip and moderate DJD of the left hip. See, e.g., medical treatment records dated September 14, 2017. Second, the Veteran has consistently asserted in lay testimony that he sustained an injury after falling off a climbing rope during bootcamp. See, e.g., Notice of Disagreement dated September 20, 2017. This is supported by, in relevant part, service treatment records reflecting that the Veteran injured his right leg and subsequently sought medical treatment for lingering pain. See, e.g., service treatment records dated May 18, 1973. Third, there is evidence of record suggesting an association between the Veteran’s in-service injury and his current disabilities. Specifically, medical treatment records indicate that the Veteran has relayed to VA clinicians that he has experienced a continuity of symptomatology since service. See, e.g., medical treatment records dated January 24, 2017. Finally, the Board observes that the evidentiary record currently contains insufficient information to allow the Board to render a fully-informed decision on the merits of the Veteran’s appeal. To date, no nexus opinion has been obtained addressing whether the Veteran’s hip disabilities are etiologically related to his military service. In light of the foregoing, VA’s duty to assist by obtaining a medical opinion is triggered in this case; and a remand is warranted. See, e.g., McLendon, supra. Accordingly, the matters are REMANDED for the following action: 1. Send the Veteran’s claims file to an appropriate VA clinician for review and for the opinions sought regarding the Veteran’s claims for service connection for degenerative joint disease of the right hip and left hip. ONLY IF an examination is deemed necessary to answer the questions below, should one be scheduled. The clinician is asked to address the following: (a.) Is it at least as likely as not (50 percent probability or greater) that the Veteran’s diagnosed degenerative joint disease of the right hip is etiologically related to his active duty military service, to include the accident in which the Veteran reportedly fell off a climbing rope and injured his right leg? (b.) Is it at least as likely as not (50 percent probability or greater) that the Veteran’s diagnosed degenerative joint disease of the left hip is etiologically related to his active duty military service, to include the accident in which the Veteran reportedly fell off a climbing rope and injured his right leg? Notably, the phrase “at least as likely as not” does not mean “within the realm of medical possibility,” but rather that the medical evidence both for and against the claim is so evenly divided that it is as medically sound to find in favor of a conclusion as it is to find against it. It should be noted that the Veteran is competent to attest to observable symptomatology. The clinician’s attention is directed to the Veteran’s statements concerning the injury (or injuries) he sustained in bootcamp and the continuity of symptomatology he has experienced since service. The clinician is reminded that an absence of prior medical documentation of symptoms or treatment is not, per se, a sufficient basis upon which to find the lack of an association between a current disability and an in-service event or injury. A clear rationale for all opinions expressed would be helpful; and a discussion of the facts and medical principles involved would be of considerable assistance to the Board. ANTHONY C. SCIRÉ, JR Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board G. Tolbert, 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.