Citation Nr: 21030574 Decision Date: 05/19/21 Archive Date: 05/19/21 DOCKET NO. 18-05 054 DATE: May 19, 2021 REMANDED Service connection for a right hip disability is remanded. Service connection for a right knee disability is remanded. REASONS FOR REMAND The Veteran served honorably in the United States Navy from May 1975 to May 1995. These matters come to the Board of Veterans' Appeals (Board) on appeal from a January 2015 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO). This appeal is being adjudicated under the legacy appellate framework. The Veteran testified at a personal hearing before the Board in August 2020, and a transcript of the hearing is of record. The Board also notes that in July 2010 the Veteran appealed the disability rating for his previously service-connected back disability. Nevertheless, the Veteran withdrew this appeal in May 2014 after a RO increased the Veteran's disability rating for his back disability in January 2014. Therefore, the Board shall not address this matter any further. The Board also notes that the Veteran attempted to commence an appeal of the effective date for his increased back disability rating in April 2015. This attempt, however, did not commence until more than one year after the Veteran was notified of the January 2014 rating decision. It is therefore untimely, and the Board shall not address the matter any further. 1. Service connection for a right hip disability is remanded. 2. Service connection for a right knee disability is remanded. At issue is whether the Veteran should be granted service connection for a right hip disability and a right knee disability. Specifically, the Veteran has alleged that his right hip and right knee disabilities are secondary to his previously service-connected back disability. The Veteran underwent VA examinations evaluating his right hip and right knee in January 2015. The examiner diagnosed the Veteran with a right hip disability, but the examiner opined that the Veteran's right hip disability was not caused by the Veteran's back disability. The examiner also diagnosed the Veteran with a right knee disability, but the examiner also opined that the Veteran's right knee disability was not caused by the Veteran's right knee disability. Nevertheless, the Veteran's treatment records indicate that the Veteran has been diagnosed with morbid obesity. Although VA does not recognize obesity as a disability or an in-service injury, obesity may serve as a linking condition between a previously service-connected disability and an in-service incurrence, and a back disability is explicitly contemplated as the type of disability that could cause the kind of obesity that would serve as a linking condition to a secondary disability. VAOPGCPREC 1-2017 (January 6, 2017). Therefore, this matter must be remanded in order to provide a VA examination that is sufficiently detailed in order ensure that VA's evaluation of the Veteran's claim is fully formed to include being detailed enough to evaluate the possibility of obesity serving as a linking condition. Barr v. Nicholson, 21 Vet. App. 303 (2007). The matters are REMANDED for the following action: Arrange to provide the Veteran with a VA examination (or if necessary, a phone interview and a medical opinion based on the evidence of record in order to address the following): (a.) Is it at least as likely as not (50 percent or more) that a medical nexus exists between an in-service incurrence and a right hip disability? Why or why not? (b.) Is it at least as likely as not (50 percent or more) that a medical nexus exists between an in-service incurrence and a right knee disability? Why or why not? (c.) When did the Veteran's current right hip disability first begin to manifest? Why? (d.) When did the Veteran's current right knee disability first begin to manifest? Why? (e.) Is it at least as likely as not (50 percent or more) that the Veteran's right hip disability was proximately due to any previously service-connected disability or combination thereof? Why or why not? (f.) Is it at least as likely as not (50 percent or more) that the Veteran's right knee disability was proximately due to any previously service-connected disability or combination thereof? Why or why not? (g.) Is it at least as likely as not (50 percent or more) that the Veteran's right hip disability was aggravated beyond its natural progression by any previously service-connected disability or combination thereof? Why or why not? If so, then please estimate the baseline severity of the Veteran's right hip disability absent any aggravating factors as well as a rationale for the estimate. (h.) Is it at least as likely as not (50 percent or more) that the Veteran's right knee disability was aggravated beyond its natural progression by any previously service-connected disability or combination thereof? Why or why not? If so, then please estimate the baseline severity of the Veteran's right knee disability absent any aggravating factors as well as a rationale for the estimate. (i.) Have any of the Veteran's previous service-connected disabilities or any combination thereof caused the Veteran to become obese? Why or why not? (j.) Was obesity a substantial factor in the Veteran developing a right hip disability? Why or why not? (k.) Was obesity a substantial factor in the Veteran developing a right knee disability? Why or why not? (l.) But for the Veteran's obesity, would the Veteran have developed a right hip disability? Why or why not? (m.) But for the Veteran's obesity, would the Veteran have developed a right knee disability? Why or why not? DAVID L. WIGHT Veterans Law Judge Board of Veterans' Appeals Attorney for the Board D. Seaton 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.