Citation Nr: 22016590 Decision Date: 03/22/22 Archive Date: 03/22/22 DOCKET NO. 17-15 493 DATE: March 22, 2022 REMANDED Entitlement to service connection for a right hip disability is remanded. REASONS FOR REMAND The Veteran served on active duty in the U.S. Army from January 2008 to January 2009 and from July 2010 to September 2011. He had additional service in the Army National Guard. In April 2021, the Board remanded the issue of entitlement to service connection for a right shoulder disability. In an October 2021 rating decision, however, the agency of original jurisdiction (AOJ) granted the claim of entitlement to service connection for right shoulder strain. As the benefit sought on appeal has been granted, this issue is no longer before the Board. The Veteran appeals the denial of service connection for a right hip disability. When this issue was last before the Board in April 2021, it was determined that further development was required on this issue to include affording the Veteran a VA examination. The Veteran was afforded such an examination in July 2021. At that time, the VA examiner opined: It is less likely than not that the Veterans current hip complaints are related to claimed complaints during service. While there are abnormalities on physical exam suggestive of strain there is a lack of documentation supporting chronicity of diagnosis and treatment. E File with radiographic imaging showing no evidence of damage to the joint and lack of chronicity of complaint. A nexus is not established. In a January 2022 addendum opinion, another examiner found: The Veteran has a diagnosis of right hip strain. The medical record indicates the Veteran was active 2008-2009 and 2010-2011. During those periods of time there are no medical records for right hip pain. The Veteran was first noted to have right hip pain in 2015 which has been chronic since then. During the rigors of service, the Veteran was exposed to various activities that could cause a hip strain. That being said, hip strains do not occur years later. The Veteran claimed symptoms began while in service however the medical documentation does not support this as there is no documentation of right hip pain until several years after separation from service. Without clear evidence of symptoms from time in service and with a time gap of several years since documentation of hip pain, I would opine that the current diagnosis of right hip strain was not related to time in service. Therefore, based on the body of current medical knowledge and the evidence of record it is my medical opinion that it is less likely than not (50 percent or greater probability) that any right hip disability, that is diagnosed on examination and/or in the record, is related to an in-service injury, event, or disease. The Board notes that the January 2022 rationale, in part, was that there is no medical documentation of the ongoing complaints. The Board notes, however, that the Veteran reports that he injured his hip during deployment and that he has had a continuous disability since then. In his March 2017 VA Form 9, the Veteran expressed that he has been taking some kind of pain medication for his hip since 2008. The Veteran is competent to establish the presence of observable symptomatology and when they began to occur, and there is no evidence these statements are not credible. See Layno v. Brown, 6 Vet. App. 465, 469. Therefore, upon remand, the examiner is instructed to specifically consider the Veteran's lay statements regarding the onset and continuity of his symptoms. The matters are REMANDED for the following action: 1. Obtain an addendum opinion by an appropriate clinician to determine the nature and etiology of the Veteran's right hip sprain. Access to the electronic record must be made available to the examiner in conjunction with the examination. If, after review of the electronic file, the examiner determines that another VA examination is necessary, such must be scheduled, and the Veteran must be notified. The examiner must render an opinion as to whether it is a nearly equal or greater chance that the Veteran's right hip strain arose during active service or is otherwise related to service. In doing so, the examiner must address the Veteran's claim that: (a) his right hip problems were caused by wearing his vest and gear and going down bumpy roads, and favoring the right side during service, (b) the Veteran's reports that he injured his hip during deployment and that he has had a continuous disability since that time and (c) the Veteran's report that he has been on medication for hip pain since 2008. The examiner should explain whether there is any medical reason to accept or reject the Veteran's belief that his symptoms of recurrent right hip pain since service represented the onset of a chronic disability. The examiner is reminded that the absence of treatment, alone, is not a sufficient basis to find that a chronic right hip disability has not existed since service and that the Veteran reports self-treatment for his symptoms. The VA examiner should provide a complete rationale for any opinions provided. The examiner must reconcile any opinion with the service treatment and personnel records, any post-service diagnoses, lay statements and testimony of the Veteran. If he or she rejects the lay evidence, an explanation must be provided, and the examiner should note that the mere passage of time without treatment is not a sufficient basis for finding that no relationship between a current disability and service exists. 2. Upon completion of the above, and any additional development deemed appropriate, the AOJ should readjudicate the remanded issue(s). If any benefit sought on appeal remains denied, the Veteran should be provided with a supplemental statement of the case. An appropriate period of time should be allowed for response, the appeal must be returned to the Board for appellate review. T. MAINELLI Veterans Law Judge Board of Veterans' Appeals Attorney for the Board T. S. Willie 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.