Citation Nr: 21042245 Decision Date: 07/12/21 Archive Date: 07/12/21 DOCKET NO. 17-44 633 DATE: July 12, 2021 REMANDED Entitlement to service connection for a right hip disability, to include on a secondary basis is remanded. Entitlement to a total disability rating based on individual unemployability (TDIU) due to service-connected disabilities prior to September 1, 2015 is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Navy from September 1977 to December 1978. This case comes before the Board of Veterans' Appeals (Board) on appeal of a June 2015 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO). When this case was last before the Board in March 2021, it was remanded for additional development. The case has now been returned to the Board for further appellate consideration. 1. Entitlement to service connection for a right hip disability, to include on a secondary basis is remanded. This issue was remanded to obtain adequate direct and secondary medical opinions, specifically to address the Veteran's contentions that his hip has worsened due to his poor posture due to favoring his service-connected left knee for so long. During the May 2021 VA examination, the examiner opined that the Veteran's right hip disability was less likely than not caused by his service-connected knee disabilities. The examiner opines that the Veteran's poor posture is more likely due to his non-service-connected lumbar spine condition. However, the examiner did not adequately address whether the Veteran's hip disability was aggravated by the service-connected knee disabilities, which could also result in a grant of service connection. 38 C.F.R. § 3.310(b); see generally El-Amin v. Shinseki, 26 Vet. App. 136, 140-41 (2013). In that regard, the examiner stated that "treatment records concerning the right hip do not support a permanent worsening of the right hip," and again opined the Veteran's right hip pain was due to his lumbar spine condition. However, the standard only requires any increase in severity of a nonservice-connected disease, not a permanent worsening. See Ward v. Wilkie, 31 Vet. App. 233 (2019). As such, a remand is warranted to obtain an adequate aggravation opinion. 2. Entitlement to a total disability rating based on individual unemployability due to service-connected disabilities prior to September 1, 2015 is remanded. In its March 2021 decision, the Board remanded the Veteran's claim for entitlement to a TDIU prior to July 1, 2019 because it was inextricably intertwined with the right hip disability which had been remanded. A rating decision was issued in May 2021. The RO granted entitlement to TDIU, effective September 1, 2015. However, a supplemental statement of the case was issued in which the RO found that the Veteran's service-connected disabilities are evaluated as 100 percent disabling prior to September 1, 2015, rendering the issue of entitlement to a TDIU prior to September 1, 2015 moot. While the Veteran was in receipt of a 100 percent disability rating for right total knee arthroplasty effective July 17, 2014, the issue of entitlement to a TDIU is not necessarily rendered moot. See Buie v. Shinseki, 24 Vet. App. 242, 250 (2011); Bradley v. Peake, 22 Vet. App. 280, 294 (2008). Specifically, special monthly compensation (SMC) may be awarded if the Veteran has a 100 percent disability rating for a single disability, and VA finds that TDIU is warranted based solely on service-connected disabilities other than the disability that is rated at 100 percent. Id. at 280. However, adjudication of the claims for entitlement to service connection for a right hip disability may impact adjudication of the claim for entitlement to a TDIU, as determination of these issues may result in the Veteran meeting the criteria for SMC. Consequently, these claims are inextricably intertwined. See Harris v. Derwinski, 1 Vet. App. 180, 183 (1991). Remand of the inextricably intertwined TDIU claim is, thus, also required. The matters are REMANDED for the following action: 1. Forward the Veteran's claims file to an appropriate VA examiner who must review the claims file (to include this remand) and provide an addendum opinion as to whether the Veteran's right hip disability is at least as likely as not aggravated, i.e., worsened beyond its natural progression, by the Veteran's service-connected knee disabilities? Aggravation is defined as any increase in severity of a nonservice-connected disease or injury that is proximately due to or the result of a service-connected disease or injury, and not due to the natural progress of the nonservice-connected disease. The examiner is advised that a finding that the Veteran's right hip disability was aggravated beyond the normal progression due to a service-connected disability does not require evidence of permanent worsening and may encompass any additional impairment in earning capacity resulting from an already service-connected condition. 2. A complete rationale must be provided for all opinions presented. If the examiner cannot provide the requested opinion without resorting to speculation, he or she should provide an explanation stating why this is so. In so doing, the examiner should 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. B. G. LeMoine Acting Veterans Law Judge Board of Veterans' Appeals Attorney for the Board C. Townsend, 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.