Citation Nr: 21023775 Decision Date: 04/21/21 Archive Date: 04/21/21 DOCKET NO. 19-29 056 DATE: April 21, 2021 ORDER Entitlement to service connection for right hip osteoarthritis is granted. Entitlement to service connection for left hip osteoarthritis is granted. Entitlement to service connection for erectile dysfunction is granted. FINDINGS OF FACT 1. Resolving reasonable doubt in the Veteran’s favor, his right hip osteoarthritis began during active service. 2. Resolving reasonable doubt in the Veteran’s favor, his left hip osteoarthritis began during active service. 3. Resolving reasonable doubt in the Veteran’s favor, his erectile dysfunction began during active service. CONCLUSIONS OF LAW 1. The criteria for service connection for right hip osteoarthritis are met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303. 2. The criteria for service connection for let hip osteoarthritis are met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303. 3. The criteria for service connection for erectile dysfunction 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 served on active duty in the United States Army from June 1978 to July 1998, to include service in the Persian Gulf. These matters come before the Board of Veterans’ Appeals (Board) on appeal from a June 2018 rating decision of the Department of Veterans Affairs (VA) Regional office (RO) in Honolulu, Hawaii. The Veteran and his wife presented sworn testimony at a hearing before the undersigned Veterans Law Judge in April 2021. Service Connection 1. Entitlement to service connection for right hip osteoarthritis. 2. Entitlement to service connection for left hip osteoarthritis. A March 16, 1995 service treatment record notes the Veteran reported pain and discomfort in his hips following a March 13, 1995 motor vehicle accident. The Veteran was afforded a VA hip and thigh conditions examination in February 2018; the diagnosis was bilateral hip osteoarthritis. The VA examiner opined that the Veteran's bilateral hip osteoarthritis was less likely than not proximately due to or the result of his service-connected lumbar spine condition, noting that hip osteoarthritis is a condition associated with wear that occurs with aging and that lumbar spine degenerative joint disease has no significant impact on the wear and aging process that occurs naturally in separate joints. The examiner added that his bilateral hips were less likely than not aggravated beyond their natural progression by his service-connected lumbar spine and provided the same rationale. An April 2018 private treatment record from Dr. J. Garcia notes the Veteran's hip pain is “likely secondary to the initial diagnosis of low back pain” based on “patient reports and special testing.” An April 5, 2018 private treatment record from Hawaii Institute of Pain notes the Veteran's “[h]ip pain is secondary to low back pain.” In a May 2018 opinion, the VA examiner opined that the Veteran's bilateral hip osteoarthritis was less likely than not incurred in or caused by the Veteran's service, noting that his service treatment records are “unremarkable for a chronic bilateral hip condition”. It was further noted that the Veteran's December 20, 1997 separation examination revealed normal hips. The examiner then noted that bilateral hip osteoarthritis is consistent with aging. An October 2018 private treatment record form the Hawaii Institute of Pain notes the Veteran's hip pain is secondary and related to his lumbar spine problem. The Veteran testified at the April 2021 Board hearing that while in service he took Motrin and his that wife rubbed in Bengay to his lower extremities. He endorsed having numbness, swelling and stiffness in his hips in service, and further testified that these problems continued after service. He also testified that his Military Occupational Specialty (MOS) of petroleum supply required heavy lifting and physical labor. The evidence shows that the Veteran reported hip pain in service and later testified under oath that his hip pain continued after service; his wife, to whom he was married during service, corroborated his account. A VA examiner has opined that his bilateral hips are unrelated to his service or to his service-connected lumbar spine. However, the opinion relies heavily on a lack of documented treatment for hip pain in-service and did not take into account the Veteran’s contention regarding the ongoing nature of the hip pains, instead indicating that his hips condition is due entirely to aging, much of which in fact occurred while the Veteran was on active duty. As such, the Board finds this opinion to be of little probative value. The private medical opinions from Hawaii Institute of Pain link the Veteran’s hip pain to his lumbar spine, but these opinions are lacking a rationale and are merely conclusory. As such, these too are of limited probative value. Here, the Board finds the Veteran’s testimony of hip pain that began in service and which continued after to be the most probative evidence. The Veteran is certainly competent to offer testimony regarding the symptoms he observed, and the Board finds his testimony is credible. Layno v. Brown, 6 Vet. App. 465 (1994). Further, considering the lay evidence of record concerning the onset and continuity of his bilateral hip symptoms, the strenuous nature of his MOS while in service for 20 years, and the VA examiner’s conclusion that his bilateral hip osteoarthritis is due to the aging process, the Board finds the evidence to at least be in equipoise as to whether the Veteran’s osteoarthritis of the bilateral hips arose in service. Although there is no probative medical opinion of record that supports a nexus between the Veteran's in-service incidences of hip pain and his current symptoms, such evidence is not necessary considering the lay evidence of record concerning the onset and continuity of his symptoms. King v. Shinseki, 700 F.3d 1339 (Fed. Cir. 2012); Flynn v. Brown, 6 Vet. App. 500 (1994). Accordingly, after resolving all doubt in favor of the Veteran, the Board finds that service connection for osteoarthritis of the bilateral hips is warranted. 38 U.S.C. § 5107; 38 C.F.R. § 3.102. 3. Entitlement to service connection for erectile dysfunction. The Veteran contends that his erectile dysfunction was incurred during his active duty service. The Board concludes that the Veteran has a current disability that began during active service. 38 U.S.C. §§ 1110, 1131, 5107(b); Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009); 38 C.F.R. § 3.303(a). Initially, the Board notes that VA treatment records are replete with references to diagnosed male erectile dysfunction. The Veteran was afforded a VA male reproductive system examination in February 2018. It was noted that the Veteran had been having difficulty obtaining and maintaining an erection since 2003. The VA examiner opined that the Veteran's erectile dysfunction is less likely than not proximately due to, a result of, or aggravated by his service-connected lumbar spine, noting that the condition does not contribute to the vascular changes involved with obtaining and maintaining an erection. At the April 2021 hearing, the Veteran and his wife testified that while he was still on active duty, he began having problems with impotency after returning from the Persian Gulf. The Veteran and his wife are both competent to offer testimony regarding the symptoms they observed, and the Board finds these reports to be credible. Layno v. Brown, 6 Vet. App. 465 (1994). Although there is no medical opinion of record that supports a nexus between the Veteran's in-service incidences of impotence and his current symptoms, such evidence is not necessary considering the lay evidence of record concerning the onset and continuity of his symptoms. King v. Shinseki, 700 F.3d 1339 (Fed. Cir. 2012); Flynn v. Brown, 6 Vet. App. 500 (1994). Upon review of the record, the Board finds the evidence to at least be in equipoise as to whether the Veteran’s current erectile dysfunction arose in service. Accordingly, after resolving all doubt in favor of the Veteran, the Board finds that service connection for erectile dysfunction is warranted. 38 U.S.C. § 5107; 38 C.F.R. § 3.102. STEVEN D. REISS Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Brian P. Keeley 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.