Citation Nr: 21031460 Decision Date: 05/21/21 Archive Date: 05/21/21 DOCKET NO. 18-34 690 DATE: May 21, 2021 ORDER Service connection for left hip disability is granted. FINDING OF FACT The evidence is at least in equipoise as to whether the Veteran's left hip disability is secondary to his service-connected right ankle disability. CONCLUSION OF LAW The criteria for service connection for left hip disability are met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.310. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from July 1961 to February 1966. In November 2018, the Veteran testified before the undersigned Veterans Law Judge. A transcript of the hearing is associated with the record. Service connection for left hip disability Service connection may be granted for disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. § 3.303. The three-element test for service connection requires evidence of: (1) a current disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the current disability and the in-service disease or injury. Shedden v. Principi, 381 F.3d 1163, 1166 -67 (Fed. Cir. 2004). Establishing service connection on a secondary basis requires evidence sufficient to show (1) that a current disability exists and (2) that the current disability was either (a) proximately caused by or (b) proximately aggravated by a service-connected disability. See Allen v. Brown, 7 Vet. App. 439, 448 (1995) (en banc). The Board recognizes the Veteran has current left hip disability, to include arthritis and trochanteric pain syndrome. The Veteran is service connected for bilateral pes planus, right ankle disability, left ankle disability, right knee disability, and left knee disability. The question for the Board is whether the Veteran's left hip disability is secondary to his service-connected disabilities. The Board finds the evidence is at least in equipoise as to whether the Veteran's left hip disability is at least as likely as not related to his service-connected right ankle disability. A May 2011 VA medical opinion found the Veteran's left hip arthritis is at least as likely as not related to his service-connected right ankle disability. The clinician stated that the gait abnormality caused by his right ankle disability could have triggered strain in his lower extremity, eventually causing degenerative changes. An October 2020 VA medical opinion found the Veteran's left hip disability was less likely than not caused or aggravated beyond its natural progression by his left knee, right knee, bilateral pes planus, right ankle, or left ankle. The clinician stated there is no way for his feet, knees, or ankles to cause a unilateral hip condition. The clinician stated there was no indication his knee, ankle, or foot conditions caused gait disturbance that was so abnormal and prolonged that it could have caused or aggravated a left hip condition. The Board gives probative weight to the above medical opinions. These opinions are based on an accurate medical history and provided a clear conclusion and supporting data. Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 304 (2008). The opinions differ on whether the Veteran's service-connected right ankle disability caused altered gait significant enough to cause or aggravate his left hip disability. The finding that his left hip disability is secondary to his right ankle disability is consistent with treatment records showing altered gait and use of a cane throughout the appeal period. The finding is consistent with a November 2019 VA examiner, in an opinion about the etiology of his right knee disability, stating the Veteran's right ankle condition would cause extra pressure and awkward gait. Accordingly, as the probative evidence is at least in equipoise, service connection for left hip disability is granted. KELLI A. KORDICH Veterans Law Judge Board of Veterans' Appeals Attorney for the Board T. Winkler, 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.