HIP IMPAIRMENT OF

B. MULLINS · 2026 · Case ID: 26003006

DENIED

Summary

The veteran, who served honorably in the U.S. Army from October 1982 to November 1991, including receiving a parachutist badge, appeals the denial of service connection for a left hip strain and pseudofolliculitis barbae. The claim for left hip strain was presented as secondary to service-connected osteoarthritis of the lumbar spine, with the veteran alleging an altered gait from the back condition caused the hip strain. The Board denied this claim, finding the evidence persuasively weighed against service connection. A June 2024 VA examination diagnosed a left hip strain but found it less likely than not related to service, noting no in-service complaints or treatment and no medical literature supporting a link between lumbar osteoarthritis and hip strain. The Board also denied service connection for pseudofolliculitis barbae, finding that while the condition was confirmed by a June 2024 VA exam, the veteran's service treatment records did not document in-service complaints or treatment, and no competent evidence linked the condition to service. The Board considered the veteran's testimony regarding in-service onset for both conditions but found it insufficient to establish service connection, particularly for the hip strain's etiology, which was deemed outside the veteran's competence to opine on. The benefit of the doubt doctrine was not applied as the evidence weighed against the claims.

Rationale

No evidence of in-service onset or aggravation of left hip condition.; VA examiner opined less likely than not related to service.; No medical literature supports lumbar osteoarthritis causing hip strain or gait alteration leading to hip strain.

Service Branch

ARMY

Special Benefit

NO SPECIAL BENEFIT

Docket No.

15-40 854

Full Decision Text

Citation Nr: 26003006
Decision Date: 03/05/26 Archive Date: 03/05/26

DOCKET NO. 15-40 854
DATE: March 5, 2026

ORDER

Entitlement to service connection for left hip strain, claimed as left hip condition, to include as secondary to osteoarthritis lumbar spine is denied.

Entitlement to service connection for pseudofolliculitis barbae is denied.

FINDINGS OF FACT

1. The competent evidence of record does not establish that the Veteran's left hip strain is causally related to his military service, to include as secondary to osteoarthritis lumbar spine.

2. The competent evidence of record fails to show that the Veteran's pseudofolliculitis barbae was caused by, aggravated by, or is otherwise causally related to the Veteran's military service.

CONCLUSIONS OF LAW

1. The criteria for establishing entitlement to service connection for left hip strain to include as secondary to osteoarthritis lumbar spine have not been met. 38 U.S.C. §§ 1110, 1116, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.310.

2. The criteria for establishing entitlement to service connection for pseudofolliculitis barbae have not been met. 38 U.S.C. §§ 1110, 1116, 5107; 38 C.F.R. §§ 3.102, 3.303.

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Veteran served honorably on active duty in the United States Army from October 1982 to November 1991. Among his awards the Veteran received a parachutist badge.

This matter comes before the Board of Veterans' Appeals (Board) on appeal from an April 2014 rating decision issued by a Department of Veterans Affairs (VA) regional office (RO).

This matter has previously been remanded for further development in November 2019, October 2022, and November 2023.

Service Connection.

Service connection is warranted where the evidence of record establishes that a particular injury or disease resulting in disability was incurred in the line of duty in the active military service or, if pre-existing such service, was aggravated thereby. 38 U.S.C. § 1110, 1131; 38 C.F.R. § 3.303 (a).

Establishing service connection generally requires (1) evidence of a current disability; (2) evidence of in-service incurrence or aggravation of a disease or injury; and (3) evidence of a nexus between the claimed in-service disease or injury and the present disability. Shedden v. Principi, 381 F. 3d 1163, 1167 (Fed. Cir. 2004); see also Caluza v. Brown, 7 Vet. App. 498, 506 (1995), aff'd per curiam, 78 F. 3d 604 (Fed. Cir. 1996); 38 C.F.R. § 3.303.

Service connection may also be granted for any disease diagnosed after the military discharge, when all the evidence, including that pertinent to the period of military service, establishes that the disease was incurred during the active military service. 38 U.S.C. § 1113 (b); 38 C.F.R. § 3.303 (d).

Service connection may also be established on a secondary basis for a disability which is proximately due to, or aggravated by, a service-connected disease or injury. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.310. In order to prevail on the theory of secondary service connection, there must be evidence of a current disability; evidence of a service-connected disability; and evidence establishing a connection between the service-connected disability and the current disability. See Wallin v. West, 11 Vet. App. 509, 512 (1998).

In determining whether service connection is warranted for a disability, the 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 evidence persuasively weighs against the claim, in which case the claim is denied. 38 U.S.C. § 5107; Gilbert v. Derwinski, 1 Vet. App. 49 (1990). 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 to the Veteran.

1. Entitlement to service connection for left hip strain, claimed as
v. West, 11 Vet. App. 509, 512 (1998).

1. Entitlement to service connection for left hip strain, claimed as left hip condition, to include as secondary to osteoarthritis lumbar spine is denied.

The Veteran contends that his left hip strain is causally related to his military service to include as secondary to his service-connected osteoarthritis lumbar spine. Specifically, the Veteran contends that he walks with an altered gait due to his service-connected osteoarthritis lumbar spine and his altered gait has caused his left hip strain. Having carefully reviewed the evidence of record, and considering all applicable laws and regulations, the Board finds that the Veteran's contention is not warranted.

While the Board recognizes that the Veteran has claimed this condition on a secondary basis, the Board has also considered whether service connection may be established on a direct basis. However, as outlined below, the evidence of record is pervasively against service connection for a left hip condition under any theory of causation.

In order to prevail on the theory of direct causation, there must be evidence of a current disability; evidence of in-service incurrence or aggravation of a disease or injury; and evidence of a nexus between the claimed in-service disease or injury and the present disability. In the case at hand, the Veteran has not suggested that he suffers from a left hip condition that otherwise manifested during, or as a result of, active duty military service. Accordingly, service connection on a direct causation basis is not available.

As stated previously, in order to prevail on the theory of secondary service connection, there must be evidence of a current disability; evidence of a service-connected disability; and evidence establishing a connection between the service-connected disability and the current disability.

In the case at hand, the June 2024 VA examiner diagnosed the Veteran as suffering from a left hip strain. Further, the Veteran's osteoarthritis lumbar spine was found to be service-connected by way of a June 2013 rating decision. The remaining issue to be decided is whether the Veteran's service-connected osteoarthritis lumbar spine caused his left hip strain.

The Veteran testified at an August 2018 Board hearing. At hearing, the Veteran stated that his back condition causes him to walk with an altered gait which has caused his hip pain. The Veteran indicated that he cannot lay on his hip. The Veteran also indicated that he has not been provided with a diagnosis for his left hip, he just suffers from left hip pain.

The Veteran was previously afforded a VA examination for his left hip in August 2020. The examiner opined against service connection under any theory of causation on the grounds that the examiner could not identify a current left hip condition. The examiner opined that the Veteran's symptoms were related to the Veteran's service-connected radiculopathy left lower extremity.

The Veteran was afforded a VA examination in June 2024. The examiner diagnosed the Veteran as suffering from a left hip strain. The examiner opined that it is less likely than not that the Veteran's left hip strain was incurred in or caused by an in-service injury, event, or illness. The examiner found that there are no service treatment records documenting left hip complaints or treatment. As such, the examiner found no evidence of an in-service onset or a chronicity of left hip symptoms. The examiner further opined that it is less likely than not that the Veteran's left hip strain was due to or the result of the Veteran's service-connected osteoarthritis lumbar spine. The examiner found that medical literature does not support the theory that osteoarthritis of the lumbar spine can cause a left hip strain. The examiner additionally indicated that there is no medical literature or examination findings which show that the Veteran's osteoarthritis of the lumbar spine aggravated the Veteran's left hip strain beyond its natural progression. The examiner also specifically considered the Veteran's argument put forth at the August 2018 Board hearing at which the Veteran testified that his osteoarthritis lumbar spine resulted in an altered gait which caused the Veteran's left hip strain. The examiner found that there is no evidence to suggest that a back condition would impact the
the Veteran's service-connected osteoarthritis lumbar spine. The examiner found that medical literature does not support the theory that osteoarthritis of the lumbar spine can cause a left hip strain. The examiner additionally indicated that there is no medical literature or examination findings which show that the Veteran's osteoarthritis of the lumbar spine aggravated the Veteran's left hip strain beyond its natural progression. The examiner also specifically considered the Veteran's argument put forth at the August 2018 Board hearing at which the Veteran testified that his osteoarthritis lumbar spine resulted in an altered gait which caused the Veteran's left hip strain. The examiner found that there is no evidence to suggest that a back condition would impact the Veteran's leg or hip unless the back injury caused major muscle or nerve damage which resulted in partial or complete paralysis. Further, the examiner found that a hip strain is typically caused by trauma to the hip, as opposed to an altered gait.

The Veteran has not provided a medical report or any other competent evidence indicating that the Veteran's left hip condition, diagnosed as left hip strain, is related to his active-duty military service to include as secondary to his service-connected osteoarthritis lumbar spine. The Veteran has submitted statements, an October 2023 brief, a February 2025 brief, and provided testimony at an August 2018 Board hearing in support of the claim. The Board acknowledges that the Veteran is competent to report his symptoms and on matters of which he has personal knowledge. Layno v. Brown, 6 Vet. App. 465, 470 (1994). However, there is no evidence that the Veteran in this case is competent to provide an opinion as to the etiology of his left hip strain. The etiology of the Veteran's left hip condition is a medically complex issue. As such, it is outside the competence of the Veteran in this case because the record does not show that he has the medical training or credentials to make such a determination. Jandreau v. Nicholson, 492 F.3d 1372, 1377 n.4 (Fed. Cir. 2007); see also Kahana v. Shinseki, 24. Vet. App. 428 (2011).

It was argued in February 2025 that the October 2020 VA examiner did not consider the Veteran's testimony. However, this testimony was clearly addressed by the examiner on June 4, 2024.

Considering the foregoing, the evidence persuasively weighs against the claim. Lynch v. McDonough, 21 F.4th 776, 781-82 (Fed. Cir. 2021). The benefit of the doubt doctrine, see 38 U.S.C. § 5107 (b), is therefore not applicable to this claim. Accordingly, service connection for left hip strain to include as secondary to osteoarthritis lumbar spine is denied.

2. Entitlement to service connection for pseudofolliculitis barbae is denied.

The Veteran contends that he is entitled to service connection for pseudofolliculitis barbae. Having carefully reviewed the evidence of record, and considering all pertinent laws and regulations, the Board finds that the Veteran's contention is not warranted.

Initially, the June 2024 VA examination confirmed the diagnosis pseudofolliculitis barbae. Therefore, the first element of service connection is met. However, the Veteran's service records do not indicate that the Veteran was treated for, or complained of, pseudofolliculitis barbae in-service. Further, there is no medical or other evidence demonstrating that the Veteran's pseudofolliculitis barbae was caused by, aggravated by, or is otherwise causally related to the Veteran's military service. Accordingly, the Board finds that the second and third elements of service connection have not been satisfied.

The Veteran attended an August 2018 Board hearing at which he testified that his pseudofolliculitis barbae arose in-service as a result of shaving. Specifically, the Veteran testified that he does not have much, if any, facial hair. During basic training, a sergeant instructed the Veteran to shave anyway. The Veteran stated that he did not know he was supposed to use shaving cream so he just scraped a razor over his face. Sometime later, when the Veteran was assigned to his duty station, a couple of bumps appeared on his face. The Veteran stated that he was not permitted to go on sick call for 2 or 3 bumps on his skin. The Veteran testified that his pseudofolliculitis barbae has continued to this day.

The Veteran attended VA examinations in August 2020 and March 2023. The
shaving. Specifically, the Veteran testified that he does not have much, if any, facial hair. During basic training, a sergeant instructed the Veteran to shave anyway. The Veteran stated that he did not know he was supposed to use shaving cream so he just scraped a razor over his face. Sometime later, when the Veteran was assigned to his duty station, a couple of bumps appeared on his face. The Veteran stated that he was not permitted to go on sick call for 2 or 3 bumps on his skin. The Veteran testified that his pseudofolliculitis barbae has continued to this day.

The Veteran attended VA examinations in August 2020 and March 2023. The examiners both ultimately opined against service connection for pseudofolliculitis barbae. However, both reports were found inadequate for adjudication purposes for the reason that neither of these reports considered the Veteran's testimony of an in-service onset of pseudofolliculitis barbae put forth at the August 2018 Board hearing.

The Veteran attended a VA examination in June 2024. The examiner confirmed the diagnosis pseudofolliculitis barbae. The Veteran reported that his condition had an in-service onset, but acknowledged that he did not seek treatment. The examiner found that the Veteran's pseudofolliculitis barbae did not require treatment other than systemic or topical medications. The examiner further found that the Veteran's condition affected less than 5 percent of his total body area. The examiner opined that it is less likely than not that the Veteran's pseudofolliculitis barbae was incurred in or caused by an in-service injury, event, or illness. The examiner found that there was no treatment for or complaints of pseudofolliculitis barbae in the Veteran's service treatment records. The examiner did consider the Veteran's testimony at the August 2018 Board hearing in which the Veteran testified that his pseudofolliculitis barbae began in-service due to shaving. The examiner found that the Veteran's treatment records did not support that contention.

The Veteran has not provided a medical report or any other competent evidence indicating that his pseudofolliculitis barbae is related to his active-duty military service. The Board has considered the Veteran's statements including his March 2014 statement, his October 2023 brief, his February 2025 brief, and his testimony at the August 2018 Board hearing. The Board acknowledges that the Veteran is competent to report his symptoms and on matters of which he has personal knowledge. Layno v. Brown, 6 Vet. App. 465, 470 (1994). However, there is no evidence that the Veteran in this case is competent to provide an opinion as to the etiology of his pseudofolliculitis barbae. The etiology of the Veteran's pseudofolliculitis barbae is a medically complex issue. As such, it is outside the competence of the Veteran in this case because the record does not show that he has the medical training or credentials to make such a determination. Jandreau v. Nicholson, 492 F.3d 1372, 1377 n.4 (Fed. Cir. 2007); see also Kahana v. Shinseki, 24. Vet. App. 428 (2011).

B. MULLINS

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board Litts, Norman W. Jr

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.

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