Citation Nr: 21030161 Decision Date: 05/18/21 Archive Date: 05/18/21 DOCKET NO. 15-37 649 DATE: May 18, 2021 REMANDED Entitlement to service connection for a right hip disability, to include avascular necrosis, is remanded. REASONS FOR REMAND The Veteran served on active duty from February 1983 to February 1987. The matter comes before the Board of Veterans' Appeals (Board) on appeal from a September 2014 rating decision issued by a Department of Veterans Affairs (VA) Regional Office (RO). The Veteran testified at a Board hearing in September 2019 before a Veterans Law Judge (VLJ). A copy of the transcript of the hearing is of record. When that VLJ retired from employment with the Board, a March 2021 letter was sent requesting clarification whether the Veteran wanted a new hearing. The letter informed the Veteran that he was entitled to another hearing with a different VLJ or, if he did not respond within thirty days, the Board would assume that he does not want another hearing and proceed accordingly. The Veteran indicated in an April 2021 correspondence that he did not wish to appear at another hearing and requested that the Board consider his claim based on the evidence of record. In a July 2020 decision, the Board reopened the claim for service connection for a right hip disability and remanded the issue for further development. While the Board regrets the additional delay, further development is required before the Board may address the issue on the merits. Entitlement to service connection for a right hip disability, to include avascular necrosis, is remanded. The Veteran has asserted that his right hip disability, to include arthritis, is due to his active duty service, specifically a 1984 injury while playing football in service. Additionally, the Veteran asserted that he was exposed to jet fuel on a regular basis during service and that he was told by a nurse that there was a correlation between jet fuel exposure and avascular necrosis. See September 2019 Hearing Transcript. In the July 2020 remand, the Board found that September 2014 VA examination provided for the Veteran's right hip was inadequate for rating purposes. Therefore, the Veteran was afforded a new VA examination to determine the nature and etiology of his right hip disability in November 2020. The November 2020 VA examiner indicated diagnoses of right hip degenerative arthritis and avascular necrosis and opined that the Veteran's right hip disability was less likely than not incurred in or caused by service. As rationale, the examiner stated that the Veteran's right hip injury noted during service was acute only. He noted that the Veteran's separation examination was silent for complaints of hip pain and there are no other complaints pertaining to the right hip until approximately 20 years after the initial injury in service. Therefore, the examiner concluded that there was no basis to establish a nexus between service and the Veteran's current hip disability. The Board finds the November 2020 VA opinion to be partially inadequate for rating purposes as the examiner failed to address the Veteran's contention that his right hip avascular necrosis is due to jet fuel exposure during service. The Board notes that the Veteran's DD-214 indicates that the Veteran's military occupational specialty (MOS) was a Maintenance Technician, and he testified that he was exposed to jet fuels on a regular basis. Further, the Veteran asserted that he has experienced right hip pain continuously since his 1984 injury playing football in service. The Board notes that the examiner's rationale does not address the Veteran's lay reports regarding the continuity of symptomatology with regard to his right hip pain. Due to these deficiencies, the Board finds the November 2020 VA examination to be inadequate for rating purposes. Therefore, an addendum opinion addressing these deficiencies is warranted. The matter is REMANDED for the following action: 1. Obtain an addendum opinion from a clinician of appropriate expertise to determine the nature and etiology of the Veteran's right hip disability, to include degenerative arthritis and avascular necrosis. The examiner is to be provided access to the Veteran's electronic claims file and must specify in the report that these records have been reviewed. After the review of the electronic claims file (and examination of the Veteran if deemed necessary), the examiner should identify and state all right hip disabilities found. The examiner should then opine whether any identified disabilities are at least as likely as not (50 percent or greater probability) began in or are otherwise the result of military service, to include in-service exposure to jet fuels. The examiner should specifically address the Veteran's lay statements regarding the onset and continuity of symptomatology since service. The examiner should also address and reconcile any previous reports and pertinent evidence of record as necessary. The examiner is advised that the Veteran is competent to attest to matters of which he has first-hand knowledge, including observable symptomatology. If there is a medical basis to support or doubt the history provided by the Veteran, the examiner should explain why. The examiner must provide a complete rationale for any opinions expressed, based on the examiner's clinical experience, medical expertise, and established medical principles. If an opinion cannot be made without resort to speculation, the examiner should provide an explanation as to why this is so and note what, if any, additional evidence would permit such an opinion to be made. If it is determined that another VA examination is required in order to provide the requested opinions, such examination should be arranged. The examiner is advised that the fact that a disability may occur as a result of normal aging, alone, is not sufficient rationale for a negative etiological opinion. 2. After the development requested has been completed, the Agency of Original Jurisdiction (AOJ) should review any report to ensure that it is in complete compliance with the directives of this remand. If the report is deficient in any manner, the AOJ must implement corrective procedures at once. MICHAEL D. LYON Veterans Law Judge Board of Veterans' Appeals Attorney for the Board L. Sneeringer, 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.