Citation Nr: 23014601 Decision Date: 03/10/23 Archive Date: 03/10/23 DOCKET NO. 17-48 320A DATE: March 10, 2023 ORDER Service connection for left hip disability, total left hip replacement, is granted. Service connection for right hip disability, degenerative arthritis of the right hip, is granted. FINDINGS OF FACT 1. The Veteran's left hip disability, diagnosed total left hip replacement, had its onset in and is related to service. 2. The Veteran's right hip disability, diagnosed degenerative arthritis of the right hip, had its onset in and is related to service CONCLUSIONS OF LAW 1. The criteria to establish service connection for the left hip disability, diagnosed total left hip replacement, have been met. 38 U.S.C. §§ 1131, 5107; 38 C.F.R. §§ 3.102, 3.303. 2. The criteria to establish service connection for the right hip disability, diagnosed degenerative arthritis of the right hip, have been met. 38 U.S.C. §§ 1131, 5107; 38 C.F.R. §§ 3.102, 3.303. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty in the United States Army from July 1985 to April 1988 as a fighting vehicle infantryman, to include service in Germany. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a November 2014 rating decision issued by a Department of Veterans Affairs (VA) Regional Office (RO). The Board issued a decision in September 2022, remanding the matter to the Agency of Original Jurisdiction (AOJ) for additional development, to include obtaining outstanding treatment records and an examination of the Veteran. The matter has been returned to the Board. Service Connection Establishing service connection generally requires medical or, in certain circumstances, lay evidence of (1) a current disability; (2) an in-service incurrence or aggravation of a disease or injury; and (3) a nexus between the claimed in-service disease or injury and the present disability). See Davidson v. Shinseki, 581 F.3d 1313 (Fed. Cir. 2009); Hickson v. West, 12 Vet. App. 247, 253 (1999); 38 C.F.R. § 3.303 (a). In determining whether service connection is warranted for a disability, VA is responsible for determining whether the evidence supports the claim or is in relative equipoise, with the Veteran prevailing in either event, or whether the weight of the evidence is against the claim, in which case the claim is denied. 38 U.S.C. § 5107. When there is an approximate balance of positive and negative evidence regarding any issue material to the determination, the benefit of the doubt is afforded the claimant. To deny a claim on its merits, the weight of the evidence must persuasively stand against a finding that the evidence is in "approximate balance" or "nearly equal" to the evidence that supports the claim. Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021) (en banc). Here, all three elements of service connection are established by the competent and credible lay and medical evidence of record as to these claims. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303; Shedden v. Principi, 381 F.3d 1163, 1166-67 (Fed. Cir. 2004). 1. Service connection for left hip disability, total left hip replacement, is granted. 2. Service connection for right hip disability, degenerative arthritis of the right hip, is granted. The Veteran contends that his bilateral hip disability, now diagnosed as left total hip replacement and right hip degenerative joint disease, is due to his service. Specifically, he states that he injured his hips on November 22, 1987, when he fell during a unit run. See May 2015 NOD; June 2015 Statement in Support of Claim. During his November 2022 examination, he elaborated that in what was West Germany, he injured his hips during a 12-mile road march (while training for EIB) that needed to be completed in 3 hours. He reported that inclement weather on the day of march caused "treacherous footing" on the course. At around the 10-mile mark, he lost his footing and went down into the splits while carrying a 60-pound bag with his weapon. He felt that he injured both hips but was able to finish the march and his training. He reported that he went to sick call for hip pain and believes he was placed on a temporary profile. See November 2022 Hip and Thighs DBQ. The Veteran also reported at the November 2022 VA examination that bilateral hip pain continued since the incident and worsened over the years. In 2015 he required left hip replacement. His right hip also needs to be replaced now and he is in the process of arranging that surgery with his doctors. The evidence shows diagnosis of degenerative arthritis of the bilateral hips, dating to approximately 2013. See March 2013VA Treatment Record. Thus, there is current disability diagnosed in approximately 2013. The Veteran's service treatment records (STR) show that he was treated for groin complaints in December 1987 and February 1988. He was treated in December 1987 for back and knee pain related to a 12-mile road march. The Board notes parenthetically that service connection is in effect for back, bilateral knee and right ankle disabilities. There was no separation examination in the STR. The Veteran's consistent statements as to bilateral hip injury document problems with the bilateral hips since rigorous activity in service as described. The Board finds the reports generally consistent with his MOS. The Board finds that the statements constituted competent and credible evidence that his current bilateral hip symptoms began during service and have been recurrent since that time. See Charles v. Principi, 16 Vet. App. 370, 374 (2002); see also Layno v. Brown, 6 Vet. App. 465 (1994); Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007). For the above reasons, the evidence is, at worst, evenly balanced or approximately so with regard to whether the Veteran's current right and left hip disabilities had their onset during service. See Flynn v. Brown, 6 Vet. App. 500, 503 (1994). See Flynn v. Brown, 6 Vet. App. 500, 503 (1994) (noting that "the element of cause and effect has been totally by-passed in favor of a simple temporal relationship between the incurrence of the disability and the period of active duty"); see also 38 C.F.R. § 3.303 (a) (Service connection connotes many factors but basically it means that the facts, shown by evidence, establish that a particular injury or disease resulting in disability was incurred coincident with service in the Armed Forces). Here, the above evidence shows that the Veteran's consistently reported in-service fall caused the current bilateral hip disability. While the Board is mindful of the negative 2022 medical opinion, the Board finds that a review of the entire record, to include the Veteran's detailed recitation of the events when viewed in the context of his in-service duties and his other documented injuries, does support a relationship between the bilateral hip issues and the reported fall in service in the form of continuous symptoms since service. In light of the foregoing, and after resolving any doubt in the Veteran's favor, the Board finds that service connection for the above left hip disability, total left hip replacement, and right hip disability, degenerative arthritis of the right hip, is warranted. See Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021) (en banc). STEVEN D. REISS Veterans Law Judge Board of Veterans' Appeals Attorney for the Board N. Rippel, 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.