Citation Nr: 23019063 Decision Date: 03/28/23 Archive Date: 03/28/23 DOCKET NO. 18-03 843 DATE: March 28, 2023 REMANDED Entitlement to service connection for a left hip condition, to include as secondary to a service-connected disability is remanded. REASONS FOR REMAND Although the Board regrets the additional delay, a remand is necessary to ensure that due process is followed and that there is a complete record upon which to decide the Veteran's claim so that he is afforded every possible consideration. See 38 U.S.C. § 5103A; 38 C.F.R. § 3.159. The Veteran had active military service from August 1978 to July 1983. This matter comes before the Board of Veterans' Appeals (Board) from the April 2015 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO). The Veteran appeared at an October 2019 hearing before the undersigned Veterans Law Judge. A transcript of the hearing is associated with the record. Entitlement to service connection for a left hip condition, to include as secondary to a service-connected disability is remanded. The Veteran contends that his left hip condition is related to his service-connected right knee condition. Specifically, at the Veteran's Board hearing, he testified that due to the lack of extension in his right knee, his right leg is actually shortened, which results in arthritis of his left hip. This matter was previously before the Board in October 2022 and was remanded for the Veteran to undergo a VA examination. Subsequently, in November 2022, the Veteran underwent a VA hip and thigh condition examination and a medical opinion was provided in January 2023. The examiner opined that the Veteran's left hip condition is less likely than not caused or aggravated by the Veteran's right knee condition. In response to the Veteran's etiology contention, the examiner stated that according to a May 2018 VA treatment note, the Veteran has full extension of his right knee and therefore did not elaborate on this theory of entitlement. exam However, in March 2023 correspondence from the Veteran and his representative, the Veteran requested a new VA examination stating that the examiner did not consider the entire history concerning the Veteran's limitation of extension in his right knee and solely relied on the May 2018 notation stating that no limitation of extension was present. (The Board notes that the Veteran's VA treatment records note right knee weakness pre- and post-knee replacement). The Board further notes that the evidence which is of record reflects a long history of limitation of extension involving the right knee. For example, a service medical board report dated in March 1983 notes that the Veteran had a history of a severe knee injury requiring surgery. After both surgery and physical rehabilitation, range of motion testing revealed that he lacked the last 4 degrees of extension and the last 8 degrees of flexion. The report of an orthopedic examination conducted by VA in September 1983 noted that the knee had slight deformity due to being in slight flexion. There was crepitus on extension of the knee. There was pain on resisted extension. The range of motion was limited by 5 degrees on extension and 15 degrees on flexion. Therefore, the Board finds that an addendum opinion must be obtained addressing the Veteran's contentions that due to the lack of extension in his right knee, his right leg became shortened, which resulted in arthritis of his left hip. 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 left hip condition. The examiner must opine as to the following a) Is it at least as likely as not (50 percent or greater probability) that the Veteran's left hip condition is related to an in-service injury, event, or disease. b) Is it at least as likely as not (a 50 percent or higher probability) that the Veteran's left hip condition, was caused by the Veteran's service-connected right knee condition? The examiner must consider the Veteran's contention that due to the right knee disability, his right leg became shortened, and this resulted in arthritis or other disability of his left hip. The examiner should consider the above referenced service and post service medical records documenting a history of limitation of both extension and flexion. c) Is it at least as likely as not (a 50 percent or higher probability) that the Veteran's left hip condition, was aggravated by the Veteran's service-connected right knee condition? It is at the discretion of the examiner if an in-person hip and/or knee examination must be performed. All opinions provided must be thoroughly explained and an adequate rationale for any conclusions reached must be provided. The examiner should not rely solely on the absence of evidence of in-service treatment or injury in the Veteran's service treatment records as a basis for any given opinion. If any requested opinion cannot be provided without resort to speculation, the medical professional should state and explain why an opinion cannot be provided without resort to speculation. 2. After completing the above, and any other development as may be indicated by any response received as a consequence of the actions taken in the preceding paragraphs, the issues on appeal should be readjudicated based on the entirety of the evidence. If any benefit sought remains denied, the Veteran and his representative should be issued a supplemental statement of the case. An appropriate period of time should be allowed for response. MICHAEL MARTIN Veterans Law Judge Board of Veterans' Appeals Attorney for the Board S. Mountford 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.