Citation Nr: 22016469 Decision Date: 03/22/22 Archive Date: 03/22/22 DOCKET NO. 18-27 936 DATE: March 22, 2022 REMANDED Entitlement to service connection for a left hip disorder, to include as secondary to a left knee disorder is remanded. REASONS FOR REMAND The Veteran served during the Gulf War Era and Peacetime on active duty in the Navy from March 1979 to March 1983 and the Air Force from July 1997 to September 17, 1997 and from March 2003 to March 2004. This matter is before the Board of Veterans' Appeals (Board) on appeal of an April 2018 rating decision of the Department of Veterans Affairs (VA) Regional Office. The Veteran was afforded a hearing before the undersigned Veterans Law Judge in November 2021. A transcript of the hearing has been associated with the Veteran's electronic claims file. The Board notes that a separate decision under a separate docket number will be issued under the AMA review system with respect to the issue of entitlement to service connection for a bilateral foot condition. Having reviewed the record, the Board finds remand is warranted for the issue of entitlement to service connection for a left hip disorder, to include as secondary to a left knee disorder. At the November 2021 Board hearing, the Veteran testified that he fell and injured his knee during active duty service, and that his knee injury led to a hip injury. The Veteran testified that after military service he worked in transportation, and that his hip condition is aggravated by his in-service knee injury. The Veteran also testified that during his military service he manually loaded heavy cargo loads of 500 to 10,000 pounds during 12 hour shifts. The Veteran stated that "With all the manual pushing and squatting, bending, tying stuff down, trucks, everything you can name to man, we had to put on that airplane...We had to tie it down manually with chains and bending down...Jumping and all this stuff and pushing pallets, you know. It, it wore on my body." The Veteran testified that these actions caused his current left hip condition. The Board notes that the Veteran has a current diagnosis of left hip osteoarthritis and was provided a VA examination in April 2018, and that a private medical opinion was also associated with the record in April 2018. However, the Board finds remand is warranted because the medical evidence as it currently stands is insufficient for adjudication. First, the April 2018 private opinion states that the Veteran's in-service knee injuries contributed to his current left hip condition, but does not provide a rationale. The Court has held that a medical examination report must contain not only clear conclusions with supporting data, but also a reasoned medical explanation connecting the two. See Nieves- Rodriguez, 22 Vet. App. 295; Stefl v. Nicholson, 21 Vet. App. 120, 124 (2007) ("[A] medical opinion ... must support its conclusion with an analysis that the Board can consider and weigh against contrary opinions"). Second, the April 2018 VA examiner opined that the Veteran's current radiologic findings of advanced hip pathology are unlikely caused by his mild osteoarthritis of the left knee as there is no objective medical evidence to support such a finding. However, the VA examiner did not address whether the Veteran's claimed hip disability was aggravated by his service-connected left knee disability. As such, a remand is warranted to obtain an addendum opinion which adequately addresses whether the Veteran's currently diagnosed left hip condition is aggravated by his service-connected left knee disability. Also, as the Veteran has raised the theory of direct service connection, the examiner should address whether the Veteran's left hip condition is directly related to his military service. The Board notes that the most recent VA treatment records associated with the Veteran's file are from December 2021. Any additional VA treatment records should be obtained on remand. The matters are REMANDED for the following action: 1. Obtain the Veteran's VA treatment records for the period from December 2021 to present. 2. Obtain an addendum opinion from an appropriate clinician regarding the Veteran's claimed left hip disability, to include as due to left knee disability. The examiner must provide the following opinions: a) Whether it is at least as likely as not related to an in-service injury, event, or disease, to include the Veteran's description of manually loading heavy cargo loads of 500 to 10,000 pounds during active duty service, to include 12 hour shifts requiring manual pushing, squatting, and bending. The examiner should consider the Veteran's statement that "With all the manual pushing and squatting, bending, tying stuff down, trucks, everything you can name to man, we had to put on that airplane...We had to tie it down manually with chains and bending down...Jumping and all this stuff and pushing pallets, you know. It, it wore on my body." The Veteran contends that the cumulative effect of his activities caused his left hip condition. The examiner should indicate whether any pathology/disease process associated with the Veteran's left hip is consistent with the mechanism of injury claimed by the Veteran. b) Whether the diagnosed left hip condition is at least as likely as not (1) proximately due to the service-connected left knee disability, or (2) aggravated beyond its natural progression by the service-connected left knee disability. TANYA SMITH Veterans Law Judge Board of Veterans' Appeals Attorney for the Board T. Bynum, 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.