Citation Nr: 21028772 Decision Date: 05/12/21 Archive Date: 05/12/21 DOCKET NO. 17-30 641 DATE: May 12, 2021 REMANDED Entitlement to service connection for a right hip disorder is remanded. Entitlement to service connection for a left hip disorder is remanded. Entitlement to a total disability rating based on individual unemployability (TDIU) due to service-connected disabilities is remanded. REASONS FOR REMAND The Veteran served on active duty from March 1970 to March 1974 and later served in the Air National Guard from November 1986 to August 2010. In February 2021, he testified at a virtual hearing held before a Veterans Law Judge (VLJ). A transcript of the hearing is of record. bilateral hips The Veteran contends his bilateral hip disorders are related to his service-connected lumbar spine disability. See VA 21-526 received in September 2010. More recently at his February 2021 Board hearing, he testified that he sustained hip injuries in a fall during his period of active duty from 1970 to 1974-the same incident in which he injured his service-connected lumbar spine. Service treatment records show the Veteran did not indicate any specific complaints of generalized joint pain related to his hips including at separation from service in 1974. However, these records do confirm that he was seen in May 1971 for lower back strain and muscle spasm after a fall. At that time, his complaints and findings were solely confined to the back with no mention of the hips. The Veteran was seen for additional back complaints in October 1973, again with no mention of the hips. There are no records of additional follow-up evaluations or clinical findings to suggest that the 1971 injury resulted in chronic hip problems. At separation in March 1974, the clinical evaluation of all systems including the spine and lower extremities was normal and no chronic hip abnormalities were noted. In September 2011, a VA examiner diagnosed recurring trochanteric bursitis and degenerative arthritis of the hips and concluded they had no relationship to the back. It was explained that although hip pain is often part of the symptomatology of lumbosacral arthritis, there is nothing to support that the Veteran's back disability causes antalgic gait or unusual hip movements which might be responsible for hip arthritis. See Hip and Thigh Conditions Disability Benefits Questionnaire (DBQ), dated September 19, 2011. In February 2014 a second VA examiner found there was no evidence in treatment records to suggest the service-connected lumbar spine disability either caused or aggravated the bilateral hip disabilities. See Hip and Thigh Conditions DBQ, dated February 21, 2014. However, neither examiner addressed the likelihood that the hip bursitis and arthritis were causally related to the Veteran's 1971 in-service injury. When VA undertakes to provide an examination or opinion, it must ensure that the examination or opinion is adequate. Barr v. Nicholson, 21 Vet. App. 303, 312 (2007). The Board finds the VA medical opinion is inadequate and that an addendum opinion is necessary to properly address the theory of entitlement to service connection for bilateral hip disorders on a direct basis. TDIU Because the Veteran's hip disability picture is unresolved, the TDIU claim is inextricably intertwined with it. Harris v. Derwinski, 1 Vet. App. 180, 183 (issues are "inextricably intertwined" when a decision on one issue would have a "significant impact" on a veteran's claim for the second issue). By this remand, the Board makes no determination, express or implied, concerning the credibility of any statements on file. The matters are REMANDED for the following action: 1. Schedule the Veteran for a VA examination (conducted via telehealth or similar service during the social distancing restrictions of the COVID-19 pandemic if in-person is not feasible). The electronic claims file should be made available for review in connection with this examination. Any appropriate evaluations, studies, and testing deemed necessary by the examiner should be conducted, and the results included in the examination report. The examiner should identify all current bilateral disorders. The examiner should state whether it is at least as likely as not (50 percent or better probability) that any diagnosed hip disorders including trochanteric bursitis and degenerative arthritis of the hips are related to the documented fall injury in May 1971. If any diagnosed hip disorders cannot be regarded as related to service, the examiner should explicitly indicate so and provide an appropriate explanation. In providing this opinion the examiner must discuss: a) the objective medical findings in service treatment records associated with the May 1971 fall injury and b) the Veteran's February 2021 testimony that he injured his hips in this incident. The opinion should be accompanied by a clear rationale consistent with the evidence of record. If an opinion cannot be given without resorting to mere speculation, the examiner should explain why. 2. Also, readjudicate the inextricably intertwined TIDU claim. In doing so, proceed with any additional development deemed necessary, including the procurement of VA examinations and/or opinions. Thomas H. O'Shay Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Bryant, Jeana R 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.