Citation Nr: 21027935 Decision Date: 05/07/21 Archive Date: 05/07/21 DOCKET NO. 05-12 730 DATE: May 7, 2021 REMANDED Entitlement to service connection for a bilateral hip disorder is remanded. Entitlement to a rating in excess of 10 percent prior to January 20, 2020 and in excess of 50 percent therefrom for a left knee disorder is remanded. REASONS FOR REMAND The Veteran served on active duty from November 1963 to November 1966. In a decision issued in April 2018, the Board denied entitlement to service connection for bilateral hip disorders and entitlement to an increased rating for the left knee. The Veteran appealed that decision to the United States Court of Appeals for Veterans Claims (Court). In February 2019, the Court issued an Order that vacated the Board's August 2018 decision and remanded the matters on appeal for adjudication consistent with the instructions outlined in a February 2019 Joint Motion for Partial Remand (JMPR) by the parties. In July 2019, the Board remanded the matters for actions consistent with the directives outlined in the February 2019 JMPR. Thereafter, in March 2021, the Board again remanded these claims for the Agency of Original Jurisdiction (AOJ) to consider in the first instance additional VA treatment records and the January 2021 VA examination report. In a separate August 2020 decision, the Board remanded the issue of entitlement to a total disability based on individual unemployability (TDIU). That issue is still undergoing development with the AOJ and has not yet been returned to the Board. As such, that issue will be the subject of a separate Board decision at a later date. 1. Entitlement to service connection for a bilateral hip disorder is remanded. In January 2020, the Veteran underwent a VA examination and medical opinion to assess the etiology of his bilateral hip disorder. The examiner diagnosed the Veteran with bilateral hip osteoarthritis and opined that it was less likely than not that his bilateral hip disorders were not aggravated beyond their natural progression by the service-connected bilateral knee disorders. In rendering this opinion, however, the VA examiner did not consider/discuss relevant private treatment records from May 2019 that indicate the Veteran fell on his right hip secondary to his "severe" bilateral knee disorders. Consequently, the Board finds the January 2020 VA medical opinion is insufficient for rating purposes. Remand is warranted for a new VA medical opinion consistent with the directives herein. 2. Entitlement to a rating in excess of 10 percent prior to January 20, 2020 and in excess of 50 percent therefrom for a left knee disorder is remanded. A review of the Veteran's claims file reveals that there are missing, relevant, private treatment records that have not been obtained or requested. In that regard, in an August 2020 correspondence, the Veteran indicated that he fell in July 2020 and was taken to Saint Peters Hospital. The Veteran also indicated he was receiving private orthopedic treatment for his bilateral knees. However, the most recent private orthopedic treatment records are dated in October 2019. As this evidence bears directly on the current status of the Veteran's left knee disorder, the Board finds that remand is necessary to obtain the missing treatment records. See 38 C.F.R. § 3.159(c)(2). The matters are REMANDED for the following actions: 1. With the Veteran's assistance, obtain outstanding private treatment records, to include July 2020 treatment records from Saint Peters Hospital and updated treatment records from Orthopaedic Center of New Jersey. All reasonable attempts to obtain such records should be made and documented. If VA attempts to obtain any outstanding records which are unavailable, the Veteran should be notified in accordance with 38 C.F.R. § 3.159(e). 2. Following the development above, obtain a VA medical opinion from an appropriate examiner to determine the nature and etiology of the Veteran's bilateral hip disorder. The claims folder (including a copy of this remand) must be provided to and reviewed by the examiner as part of the medical opinion. The examiner must provide an opinion as to whether it is at least as likely as not (i.e., 50 percent probability or greater) that the Veteran's bilateral hip disorders were caused or aggravated by his service-connected knee disorders. Aggravation in this context is defined as any increase in disability. In rendering the above opinion, the examiner must specifically consider and discuss the Veteran's May 2019 private treatment records that indicate the Veteran fell on his right hip secondary to "severe" bilateral knee arthritis and the VA treatment records that document bilateral knee pain with knee buckling and risk of falling. See May 2018 VA Treatment records. A rationale for all requested opinions shall be provided. The rationale must include a discussion of the underlying medical principles specific to the facts of this case and not simply reference generic medical literature. If the examiner cannot provide an opinion without resorting to mere speculation, he or she shall provide a complete explanation stating why this is so. In so doing, the examiner shall explain whether the inability to provide a more definitive opinion is the result of a need for additional information or that he or she has exhausted the limits of current medical knowledge in providing an answer to that particular question. A. ISHIZAWAR Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Metzner, Paul 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.