POSTTRAUMATIC STRESS DISORDER (PTSD)

G. WILLIAM RIGGS · 2025 · Case ID: A25069809

MIXED

Summary

The veteran, who served in the United States Marine Corps from September 1998 to August 2003, appeals a May 2023 rating decision. The veteran sought service connection for PTSD, an increased rating for a psychiatric disorder (major depressive disorder with severe anxious distress and insomnia), service connection for left hip bursitis, a compensable rating for benign sessile osteochondroma of the distal left femur with surgical debridement, bursitis, and limitation of extension, and a compensable rating for right hip bursitis with limitation of extension. The Board denied service connection for PTSD, finding no current diagnosis. The claim for an increased rating for psychiatric disorder was denied, as the veteran's symptoms, while severe, did not meet the criteria for a 100 percent rating and more closely approximated a 70 percent rating. The claim for left hip bursitis was dismissed as moot because the veteran was already service-connected for that condition. The claims for left and right hip bursitis with limitations were denied as the veteran's range of motion did not meet the criteria for a compensable rating. Service connection for a back condition, ilium tumor, and left shoulder condition were remanded for further development, including VA examinations and opinions to clarify the nexus to service and the nature of the conditions.

Rationale

No current diagnosis of PTSD; Lay statements not competent for diagnosis; Treatment record excerpt lacked provider information

Service Branch

MARINE CORPS

Special Benefit

NO SPECIAL BENEFIT

Docket No.

230526-349701

Full Decision Text

Citation Nr: A25069809
Decision Date: 08/19/25 Archive Date: 08/19/25

DOCKET NO. 230526-349701
DATE: August 19, 2025

ORDER

Entitlement to service connection for posttraumatic stress disorder (PTSD) is denied.

Entitlement to a disability rating greater than 70 percent for psychiatric disorder, to include major depressive disorder with severe anxious distress and insomnia is denied.

Service connection for left hip bursitis is dismissed as moot.

Entitlement to a compensable disability rating for benign sessile osteochondroma of the distal left femur with surgical debridement with bursitis and limitation of extension is denied.

Entitlement to a compensable initial disability rating for bursitis right hip with limitation of extension is denied.

REMANDED

Service connection for back condition is remanded.

Service connection for ilium tumor is remanded.

Service connection for left shoulder condition is remanded.

FINDINGS OF FACT

1. Evidence of record does not support a finding that the Veteran has a current diagnosis of PTSD.

2. The severity, frequency, and duration of the Veteran's symptoms did not more closely approximate total occupational and social impairment.

3. The Veteran is in receipt of service connection for left hip bursitis.

4. The Veteran's benign sessile osteochondroma of the distal left femur with surgical debridement with bursitis and limitation of flexion manifests with limitation of flexion greater than 45 degrees.

5. The Veteran's range of motion for extension of his right hip is not limited to 5 degrees.

CONCLUSIONS OF LAW

1. The criteria for service connection for PTSD are not met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303.

2. The criteria for a disability rating in excess of 70 percent for psychiatric disorder, to include major depressive disorder with severe anxious distress and insomnia have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.3, 4.7, 4.126, 4.130, Diagnostic Code 9434.

3. The issue of entitlement to service connection for left hip bursitis is moot. 38 U.S.C. §§ 1114, 1155, 5107; 38 C.F.R. §§ 3.340, 3.350, 4.16.

4. The criteria for a compensable rating for benign sessile osteochondroma of the distal left femur with surgical debridement with bursitis and limitation of extension have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.3, 4.7, 4.71a, Diagnostic Code 5251.

5. The criteria for a compensable rating for right hip bursitis and limitation of extension have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.3, 4.7, 4.71a, Diagnostic Code 5251.

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Veteran served on active duty in the United States Marine Corps from September 1998 until his honorable discharge in August 2003.

This matter is before the Board of Veterans' Appeals (Board) on appeal of a May 2023 rating decision issued by a Department of Veterans Affairs (VA) Regional Office (RO).

Given the date of the rating decision on appeal, the Veteran's appeal is governed by the modernized review system, known by the Board as the AMA. 38 C.F.R. §§ 3.2400, 19.2.

In his Notice of Disagreement to the Board, the Veteran selected the evidence docket. Accordingly, the Board may only review evidence of record at the time of the rating decision on appeal, and that which was submitted with the Notice of Disagreement or within 90 days of its receipt. 38 C.F.R. § 20.303.

Evidence was added to the claims file during a period of time when new evidence was not allowed. As the Board is deciding the claims of service connection for PTSD, entitlement to an increased rating for psychiatric disorder, to include major depressive disorder with severe anxious distress and insomnia, service connection for left hip bursitis, and entitlement to a compensable rating for benign sessile osteochondroma of the dist
Disagreement to the Board, the Veteran selected the evidence docket. Accordingly, the Board may only review evidence of record at the time of the rating decision on appeal, and that which was submitted with the Notice of Disagreement or within 90 days of its receipt. 38 C.F.R. § 20.303.

Evidence was added to the claims file during a period of time when new evidence was not allowed. As the Board is deciding the claims of service connection for PTSD, entitlement to an increased rating for psychiatric disorder, to include major depressive disorder with severe anxious distress and insomnia, service connection for left hip bursitis, and entitlement to a compensable rating for benign sessile osteochondroma of the distal left femur with surgical debridement with bursitis and limitation of extension and bursitis right hip with limitation of extension it may not consider this evidence in its decision. 38 C.F.R. § 20.300. The Veteran may file a Supplemental Claim and submit or identify this evidence. 38 C.F.R. § 3.2501. If the evidence is new and relevant, VA will issue another decision on the claim, considering the new evidence in addition to the evidence previously considered. Id. Specific instructions for filing a Supplemental Claim are included with this decision.

As the Board is remanding the claims of service connection for back condition, ilium tumor, and left shoulder condition for further development, this additional evidence will be considered by the RO in the adjudication of those claims.

1. Service connection for PTSD.

The Veteran is seeking service connection for PTSD. See January 2023 VA 21-526EZ and May 2023 VA 10182.

Service connection may be granted for disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. § 3.303. The three-element test for service connection requires evidence of: (1) a current disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the current disability and the in-service disease or injury. Shedden v. Principi, 381 F.3d 1163, 1166 -67 (Fed. Cir. 2004).

The question for the Board is whether the Veteran has a current disability that began during service or is at least as likely as not related to an in-service injury, event, or disease.

The Board concludes that the Veteran does not have a current diagnosis of PTSD and has not had one at any time during the pendency of the claim or recent to the filing of the claim. Romanowsky v. Shinseki, 26 Vet. App. 289, 294 (2013); McClain v. Nicholson, 21 Vet. App. 319, 321 (2007).

At the time the Veteran submitted his claim for service connection for PTSD, the Veteran was already service-connected for a psychiatric disorder. See January 2023 VA 21-526EZ and June 2008 Rating Decision-Narrative. The RO requested a mental disorders examination for the Veteran's claims for anxiety condition, depressive disorder, and sleep disturbances. See January 2023 Exam request. The February 2023 VA examiner identified the Veteran's diagnoses as major depressive disorder, recurrent, severe with anxious distress, unspecified trauma and stressor related disorder, and insomnia disorder. See February 2023 VA Examination. The examiner reported there was no change in the Veteran's service-connected diagnosis and no additional diagnosis was rendered.

The Veteran submitted lay statements which reference his PTSD. See June 2023 Buddy/Lay Statement and June 2023 Medical Treatment Record-Non-Government Facility. In his own statement, the Veteran did not report that he was diagnosed with PTSD. In his son's statement, his son did not report that the Veteran was diagnosed with PTSD or demonstrate competence to diagnose psychiatric disorders. His daughter's statement similarly lacked report of a diagnosis or competence to diagnose psychiatric disorders.

The Veteran also submitted a document which appears to be an excerpt from treatment. See June 2023 Medical Treatment Record-Non-Government Facility and January 2023 Correspondence. The record is not signed by a provider nor is it provided on a letterhead indicating the facility or provider which maintained the record. For this reason, the Board assigns it no probative value.

While the Veteran and his children believe there is a current diagnosis of PTSD, the Veteran and his children are not competent to provide a diagnosis in this case. The issue is medically complex, as it requires specialized medical education. Jandreau v. Nicholson, 492 F.3d 1372, 1377,
competence to diagnose psychiatric disorders.

Accordingly, the Veteran's claim for service connection for PTSD is denied. However, as discussed below, the Veteran's reported symptoms are accounted for in his service-connected psychiatric disorder.

2. Increased rating for psychiatric disorder

The Veteran submitted a claim for service connection for posttraumatic stress disorder (PTSD) and anxiety condition secondary to depression. See January 2023 VA 21-526EZ. At the time of this submission, the Veteran was service connected for depressive disorder as secondary to service-connection disability of benign tumor left ilium and benign sessile osteochondroma distal left femur, with surgical debridement. See June 2008 Rating Decision-Narrative. The Veteran was granted an increased disability rating of 70 percent for major depressive disorder with severe anxious distress and insomnia. See May 2023 Rating Decision-Narrative. Because the scope of a mental health disability claim includes any mental disability that may reasonably be encompassed by the claimant's description of the claim and reported symptoms and all other information of record, the Board finds that it is more appropriate to characterize the Veteran's mental health claims broadly, as a single claim of entitlement to an increased rating for psychiatric disorder, to include major depressive disorder with severe anxious distress and insomnia. See Clemons v. Shinseki, 23 Vet. App. 1 (2009).

The Veteran is seeking a higher rating for his service-connected psychiatric disorder, to include major depressive disorder with severe anxious distress and insomnia. See January 2023 VA 21-526EZ and May 2023 VA 10182.

Under the General Formula for Mental Disorders (General Formula), the Board must conduct a "holistic analysis" that considers all associated symptoms, regardless of whether they are listed as criteria. Bankhead v. Shulkin, 29 Vet. App. 10, 22 (2017); 38 C.F.R. § 4.130. The Board must determine whether unlisted symptoms are similar in severity, frequency, and duration to the listed symptoms associated with specific disability percentages. Then, the Board must determine whether the associated symptoms, both listed and unlisted, caused the level of impairment required for a higher disability rating. Vazquez-Claudio v. Shinseki, 713 F.3d 112, 114-118 (Fed. Cir. 2013).

The issue in this appeal is whether the Veteran's associated symptoms caused the level of impairment required for a disability rating of 100 percent.

The Board concludes that the Veteran's symptoms did not cause the level of impairment required for a disability rating of 100 percent. The Veteran's symptoms more closely approximated the symptoms associated with a 70 percent rating, and resulted in a level of impairment that most closely approximated the level of impairment associated with a 70 percent rating.

A 70 percent rating is assigned when symptoms such as suicidal ideation; obsessional rituals which interfere with routine activities; intermittently illogical, obscure, or irrelevant speech; near-continuous panic or depression affecting the ability to function independently, appropriately and effectively; impaired impulse control (such as unprovoked irritability with periods of violence); spatial disorientation; neglect of personal appearance and hygiene; difficulty in adapting to stressful circumstances (including work or a worklike setting); or inability to establish and maintain effective relationships cause occupational and social impairment with deficiencies in most areas, such as work, school, family relations, judgment, thinking, or mood.

A 100 percent rating is assigned for total occupational and social impairment, due to such symptoms as: gross impairment in thought processes or communication; persistent delusions or hallucinations; grossly inappropriate behavior; persistent danger of hurting self or others; intermittent inability to perform activities of daily living (including maintenance of minimal personal hygiene); disorientation to time or place; or memory loss for names of close relatives, own occupation or own name.

The February 2023 VA examination and the Veteran's lay statements show that the Veteran's psychiatric
circumstances (including work or a worklike setting); or inability to establish and maintain effective relationships cause occupational and social impairment with deficiencies in most areas, such as work, school, family relations, judgment, thinking, or mood.

The February 2023 VA examination and the Veteran's lay statements show that the Veteran's psychiatric disorder, to include major depressive disorder with severe anxious distress and insomnia was manifested by symptoms associated with a 50 percent rating (panic attacks more than once a week; disturbances of motivation and mood; difficulty in establishing and maintaining effective work and social relationships), and symptoms associated with a 70 percent rating (suicidal ideation; obsessional rituals which interfere with routine activities; neglect of personal appearance and hygiene). The Veteran also had symptoms that are not listed with a specific rating, such as irritability, social withdrawal, and lack of concentration.

The Board finds the severity, frequency, and duration of the Veteran's unlisted symptoms more closely approximate the symptoms contemplated by a 70 percent rating, which are less severe, less frequent, and shorter in duration than those contemplated by a 100 percent rating. See 38 C.F.R. § 4.126. The symptoms of irritability, social withdrawal, and lack of concentration are most similar to impaired judgment and disturbances of mood and motivation, which are symptoms associated with a 50 percent rating, or impulse control (such as unprovoked irritability with periods of violence), a symptom associated with a 70 percent rating. Giving the Veteran the benefit of the doubt, the Board finds that the Veteran's unlisted symptoms most closely approximate the symptoms contemplated by a 70 percent rating.

The February 2023 VA examiner checked the box to indicate that the Veteran experienced occupational and social impairment with deficiencies in most areas, such as work, school, family relations, judgment, thinking and/or mood. In behavioral observations, the examiner observed the Veteran to be dressed casually with average hygiene although the Veteran has periods of poor hygiene due to negative mood symptoms. At the examination, the Veteran was oriented to person, place, and time. The Veteran's speech was slightly lower in volume and tone and slower in rate, and his mood appeared slightly anxious and depressed but congruent to topics. The Veteran denied any perceptual abnormalities in visual and auditory hallucinations.

In the February 2023 VA examination, the Veteran reported that he had been divorced since June 2021 and had five children. He reported that his ex-wife had seen attempted suicide a few times. He said he doesn't like his kids to see his vulnerability so he holds back and becomes more introverted. He said that his relationship with his kids is getting worse. About his anxiety, he said he feels like he can't eat so he drinks a protein shake and gets panicky and just wants to sit in a room with the lights off. He has had outbursts, lashed out at his kids, and repeats a cycle of depression and anxiety. He doesn't talk to his parents about anything. He doesn't sleep well which brings him back into a cycle of depression and anxiety. He has bad dreams about a friend who committed suicide during service. He reported that he can't cope with things, that he doesn't know how to function and just wants to sit there and doesn't want to eat a lot, resulting in weight loss. He has no motivation or interest in doing anything. He doesn't like having his back toward things, and if he can't see his way out of a place, he thinks of worst case scenarios which leads to nausea and near hyperventilating. He goes days without showering.

The Veteran's son wrote a statement about how the Veteran's symptoms manifest. See June 2023 Buddy/Lay Statement. He wrote that his dad often feels anxious and on edge, making it hard for the Veteran to be present for the family. The Veteran has nightmares and trouble sleeping which takes a toll on his energy and mood. At times, the Veteran is overwhelmed by situations, and he can be easily startled or agitated.

The Board notes that the Veteran expressed suicidal ideation, which is similar to persistent danger of self-harm, which is contemplated by the 100 percent criteria. Bankhead v. Shulkin, 29 Vet. App. 10, 19 (2017). However, the severity, frequency, and duration of the Veteran's suicidal ideation has not risen to the level contemplated by the 100 percent disability
Statement. He wrote that his dad often feels anxious and on edge, making it hard for the Veteran to be present for the family. The Veteran has nightmares and trouble sleeping which takes a toll on his energy and mood. At times, the Veteran is overwhelmed by situations, and he can be easily startled or agitated.

The Board notes that the Veteran expressed suicidal ideation, which is similar to persistent danger of self-harm, which is contemplated by the 100 percent criteria. Bankhead v. Shulkin, 29 Vet. App. 10, 19 (2017). However, the severity, frequency, and duration of the Veteran's suicidal ideation has not risen to the level contemplated by the 100 percent disability rating. In the February 2023 VA examination, the Veteran reported past suicide attempts and the examiner checked the box to indicate the Veteran experienced suicidal ideation.

The Board also finds the level of impairment caused by the Veteran's symptoms more closely approximates the level associated with a 70 percent rating. The Veteran experienced occupational and social impairment with reduced reliability and productivity with deficiencies in most areas.

The veteran did not experience symptoms contemplated by a 100 percent rating. As noted above, the Veteran's other remaining symptoms were either contemplated by or more consistent with a 70 percent rating.

In short, the evidence of record persuasively weighs against finding that the severity, frequency, and duration of the Veteran's symptoms resulted in the level of impairment required for a 100 percent rating. The criteria for a 100 percent or higher rating are not met and the appeal must be denied.

3. Service connection for left hip left hip bursitis.

The Veteran is seeking service connection for a left hip condition. See January 2023 VA 21-526EZ. More specifically, the Veteran is seeking service connection for bursitis in his left hip. See May 2023 VA 10182. In the May 2023 VA 10182, the Veteran stated he was service-connected for bursitis of his right hip, but not his left hip.

The Veteran is service-connected for benign sessile osteochondroma of the distal left femur with surgical debridement with bursitis and limitation of flexion and benign sessile osteochondroma of the distal left femur with surgical debridement with bursitis. See May 2023 Rating Decision-Codesheet. Thus, The Veteran is already in receipt of the benefit sought on appeal. Consequently, the claim has been rendered moot and is no longer in appellate status. 38 U.S.C. §§ 7104, 7105; 38 C.F.R. §§ 20.101, 20.200, 20.202.

The Board may dismiss any appeal which fails to allege specific error of fact or law in the determination being appealed. 38 U.S.C. § 7105. As the Veteran is already in receipt of the benefit sought on appeal, the issue has become moot, and the claim is dismissed. See Grantham v. Brown, 114 F.3d 1156 (Fed. Cir. 1997).

4. Entitlement to a compensable disability rating for benign sessile osteochondroma of the distal left femur with surgical debridement with bursitis and limitation of extension.

The Veteran is seeking a compensable rating for his benign sessile osteochondroma of the left distal femur with surgical debridement with bursitis and limitation of extension. See May 2023 VA 10182.

In the May 2023 VA 10182, the Veteran stated his right hip was rated 10 percent but his left hip was not. However, for his service connected bursitis right hip with limitation of extension, the Veteran is also rated 0 percent. See July 2024 Rating Decision-Codesheet.

With regard to his left hip, the Veteran is currently service connected for his benign sessile osteochondroma of the distal left femur with surgical debridement with bursitis, rated 10 percent under Diagnostic Code 5015-5255; benign sessile osteochondroma of the distal left femur with surgical debridement with bursitis and limitation of extension, rated 0 percent under Diagnostic Code 5019-5251; and benign sessile osteochondroma of the distal left femur with surgical debridement with bursitis and limitation of flexion, rated 0 percent under Diagnostic Code 5019-5252.

With regard to his right hip, the Veteran is service connected for bursitis right hip associated with benign osteochondroma of the distal left femur with surgical debridement with bursitis, rated 10 percent under Diagnostic Code 5019-5252;
percent under Diagnostic Code 5015-5255; benign sessile osteochondroma of the distal left femur with surgical debridement with bursitis and limitation of extension, rated 0 percent under Diagnostic Code 5019-5251; and benign sessile osteochondroma of the distal left femur with surgical debridement with bursitis and limitation of flexion, rated 0 percent under Diagnostic Code 5019-5252.

With regard to his right hip, the Veteran is service connected for bursitis right hip associated with benign osteochondroma of the distal left femur with surgical debridement with bursitis, rated 10 percent under Diagnostic Code 5019-5252; bursitis right hip with limitation of adduction of the thigh, rated 10 percent under Diagnostic Code 5019-5253; and bursitis right hip with limitation of extension rated 0 percent under Diagnostic Code 5019-5251.

Based on the Veteran's comparison in his May 2023 VA 10182, the Board finds that he is seeking an increased rating for his service connected left hip condition rated under Diagnostic Code 5019-5252.

The Veteran's benign sessile osteochondroma of the distal left femur with surgical debridement with bursitis and limitation of extension is rated under 38 C.F.R. § 4.71a, Diagnostic Code 5019-5252, for limitation of flexion of the thigh.

Hyphenated diagnostic codes are used when a rating under one diagnostic code requires use of an additional diagnostic code to identify the basis for the rating assigned. The additional code is shown after a hyphen. 38 C.F.R. § 4.27. In this case, DC 5019 reflects that bursitis (the primary disability) is to be rated as degenerative arthritis based on limitation of motion of the affected parts, while DC 5252 is used to rate limitation of flexion of the thigh.

Under Diagnostic Code 5252, a 10 percent rating is warranted for flexion limited to 45 degrees. A 20 percent rating is warranted for flexion limited to 30 degrees. A 30 percent rating is warranted for flexion limited to 20 degrees. A maximum 40 percent rating is warranted for flexion limited to 10 degrees. 38 C.F.R. § 4.71a, Diagnostic Code 5252.

When evaluating musculoskeletal disabilities based on limitation of motion, 38 C.F.R. § 4.40 requires consideration of functional loss caused by pain or other factors listed in that section that could occur during flare-ups or after repeated use and, therefore, not be reflected on range-of-motion testing. 38 C.F.R. § 4.45 requires consideration also be given to less movement than normal, more movement than normal, weakened movement, excess fatigability, incoordination, and pain on movement. See DeLuca v. Brown, 8 Vet. App. 202 (1995); see also Mitchell v. Shinseki, 25 Vet. App. 32, 44 (2011). Nonetheless, even when the background factors listed in § 4.40 or 4.45 are relevant when evaluating a disability, the rating is assigned based on the extent to which motion is limited, pursuant to 38 C.F.R. § 4.71a; a separate or higher rating under § 4.40 or 4.45 itself is not appropriate. See Thompson v. McDonald, 815 F.3d 781, 785 (Fed. Cir. 2016) ("[I]t is clear that the guidance of § 4.40 is intended to be used in understanding the nature of the veteran's disability, after which a rating is determined based on the § 4.71a criteria.").

Under 38 C.F.R. § 4.59, painful motion is a factor to be considered with any form of arthritis; however, 38 C.F.R. § 4.59 is not limited to disabilities involving arthritis. See Burton v. Shinseki, 25 Vet. App. 1 (2011).

In the February 2023 VA examination for hip and thigh, the Veteran's active range of motion for his left hip for flexion was 120 degrees, same for passive range of motion, 115 degrees for an estimated range of motion after repeated use over time, and 105 degrees for an estimated range of motion during a flare-up. The Board finds that the Veteran's limitation for flexion in his left hip exceeded 45 degrees.

The Board has also considered the other Diagnostic Codes pertaining to the hip and thigh. Other disability
, 38 C.F.R. § 4.59 is not limited to disabilities involving arthritis. See Burton v. Shinseki, 25 Vet. App. 1 (2011).

The Board has also considered the other Diagnostic Codes pertaining to the hip and thigh. Other disability ratings may be assigned only if the symptomatology for a disability is not duplicative or overlapping with the symptomatology of any other disability. See Esteban v. Brown, 6 Vet. App. 259, 261-62 (1994); see also Lyles v. Shulkin, 29 Vet. App. 107 (2017) (holding that 38 C.F.R. § 4.14 prohibits paying compensation twice for the same symptoms or functional impairment). In this case, the Veteran is already in receipt of service connection for other disability ratings for the left thigh.

As the Veteran's disability does not meet criteria for a 10 percent rating under Diagnostic Code 2019-5252, the appeal is denied.

5. Entitlement to a compensable initial disability rating for bursitis right hip with limitation of extension.

The Veteran is seeking a compensable rating for his bursitis right hip with limitation of extension. See May 2023 VA 10182.

The Veteran's bursitis right hip with limitation of extension is rated under 38 C.F.R. § 4.71a, Diagnostic Code 5019-5251, for limitation of extension of the thigh.

Hyphenated diagnostic codes are used when a rating under one diagnostic code requires use of an additional diagnostic code to identify the basis for the rating assigned. The additional code is shown after a hyphen. 38 C.F.R. § 4.27. In this case, DC 5019 reflects that bursitis (the primary disability) is to be rated as degenerative arthritis based on limitation of motion of the affected parts, while DC 5251 is used to rate limitation of extension of the thigh.

Under Diagnostic Code 5251, a maximum 10 percent rating is warranted for extension of the thigh limited to 5 degrees. 38 C.F.R. § 4.71a, Diagnostic Code 5251.

In the February 2023 VA examination for hip and thigh, the Veteran's active range of motion for his right hip for extension was 25 degrees and 25 degrees for passive range of motion. There was no loss of function or range of motion after three repetitions. The Veterans estimated range of motion after repeated use over time for extension was 20 degrees. The Board finds that the Veteran's range of motion for extension of his right hip is not limited to 5 degrees.

As the Veteran's disability does not meet criteria for a 10 percent rating under Diagnostic Code 5019-5251, the appeal is denied.

REASONS FOR REMAND

A medical examination or medical opinion is necessary in a claim for service connection when there is (1) competent evidence of a current disability or persistent or recurrent symptoms of a disability, (2) evidence establishing that an event, injury, or disease occurred in service or establishing certain diseases manifesting during an applicable presumptive period for which the claimant qualifies, and (3) an indication that the disability or persistent or recurrent symptoms of a disability may be associated with the Veteran's service or with another service-connected disability, but (4) insufficient competent medical evidence on file for the Secretary to make a decision on the claim. McLendon v. Nicholson, 20 Vet. App. 79, 81-86 (2006). See also 38 U.S.C. § 5103A(d)(2); 38 C.F.R. § 3.159(c)(4)(i).

A Veteran's mere conclusory generalized lay statement that a service event or illness caused the claimants current condition is insufficient to require an examination. Waters v. Shinseki, 601 F.3d 1274, 1278 (Fed. Cir. 2010).

1. Service connection for back condition.

The Veteran is seeking service-connection for back condition. See January 2023 VA 21-526EZ and May 2023 VA 10182.

These McLendon elements are satisfied with regard to the claim of service connection for back condition. Regarding the first element, the RO
5103A(d)(2); 38 C.F.R. § 3.159(c)(4)(i).

1. Service connection for back condition.

The Veteran is seeking service-connection for back condition. See January 2023 VA 21-526EZ and May 2023 VA 10182.

These McLendon elements are satisfied with regard to the claim of service connection for back condition. Regarding the first element, the RO made a favorable finding that the Veteran has a current diagnosis of sprain of ligaments of thoracic spine. See May 2023 Rating Decision-Narrative. The Board is bound by this favorable finding. 38 C.F.R. § 3.104(c). Regarding the second element, the Veteran has attributed his back pain to carrying 60 pounds in his backpack during service. See January 2023 VA 21-526EZ and May 2023 VA 10182. Regarding the third and fourth elements, there is an indication that Veteran's back condition could be related to his service, but there is insufficient evidence of record by which the Board can make a decision.

It was a pre-decisional duty to assist error to not obtain a VA examination and medical opinion where the McLendon elements are satisfied. Remand is required.

2. Service connection for ilium tumor.

The Veteran is seeking service connection for ilium tumor as it is separate from the femur tumor. See May 2023 VA 10182. In his May 2023 VA 10182, the Veteran identified the "benign sessile osteochondroma of the distal left femur with surgical debridement (formerly evaluated as benign tumor of left ilium under DC 5015-5252 and benign sessile osteochondr" as the disability and the area of disagreement is service connection and disability evaluation. The Veteran also wrote a statement "The ilium and femur are 2 separate tumors."

The Board cannot make its own independent medical judgment. See Colvin v. Derwinski, 1 Vet. App. 171, 175 (1991). In this case, the Board does not have sufficient information to determine whether the Veteran has a separate tumor on the ilium and whether it should be rated separately.

The McLendon elements are satisfied with regard to the claim of service connection for ilium tumor. The Veteran's rating decisions indicate that his disability was previously identified as including the ilium. There is insufficient evidence of record by which the Board can determine whether the Veteran's ilium tumor is separate from the rest of his disability and make a decision on the Veteran's claim.

It was a pre-decisional duty to assist error to not obtain a VA examination and medical opinion where the McLendon elements are satisfied. Remand is required.

3. Service connection for left shoulder condition.

The Veteran is seeking service connection for his left shoulder condition. See January 2023 VA 21-526EZ and May 2023 VA 10182.

The McLendon elements are satisfied with regard to the claim of service connection for left shoulder condition. Regarding the first element, the Veteran and his son submitted a statement that the Veteran experiences left shoulder pain. See January 2023 VA 21-526EZ, June 2023 Buddy/Lay Statement, and June 2023 VA 10182. Regarding the second element, the Veteran has stated that he carried a 60 pound backpack during service and he was injured during Marine Combat Training in January 1999. See January 2023 VA 21-526EZ and June 2023 VA 10182. Regarding the third and fourth elements, there is an indication that the Veteran's left shoulder condition could be related to his service, but there is insufficient evidence of record by which the Board can make a decision.

It was a pre-decisional duty to assist error to not obtain a VA examination and medical opinion where the McLendon elements are satisfied. Remand is required.

The matters are REMANDED for the following action:

1. Schedule the Veteran for a VA examination for his claimed back condition. The examiner must review the claims file.

If a diagnosis cannot be provided but the Veteran's condition manifests in symptoms that cause functional impairment, then the examiner should consider them a "disability" for the purpose of providing the requested opinion(s) below.

The examiner is asked to provide a response to the following:

Is Veteran's claimed back condition at least as likely as not related to service, including carrying 60 pounds in a
a decision.

It was a pre-decisional duty to assist error to not obtain a VA examination and medical opinion where the McLendon elements are satisfied. Remand is required.

The matters are REMANDED for the following action:

1. Schedule the Veteran for a VA examination for his claimed back condition. The examiner must review the claims file.

The examiner is asked to provide a response to the following:

Is Veteran's claimed back condition at least as likely as not related to service, including carrying 60 pounds in a backpack during service?

Provide a rationale to support the opinion(s).

In providing the requested opinion, consider the Veteran's description of the in-service injury and symptoms as well as post-service symptoms. If there is any medical reason to accept or reject the proposition that the Veteran's reported injury and symptoms in service and thereafter represented the onset of the current disability, this should be noted. Stated another way, do the Veteran's reports about the symptoms align with how the currently diagnosed disability is known to develop or are the Veteran's reports generally inconsistent with medical knowledge or implausible?

2. Schedule the Veteran for a VA examination for the ilium tumor. The examiner must review the claims file.

The examiner is asked to provide a response to the following:

1) Is the Veteran's ilium tumor separate from the femur tumor?

2) Is the Veteran's ilium tumor at least as likely as not related to service?

Provide a rationale to support the opinion(s).

3. Schedule the Veteran for a VA examination for his claimed left shoulder condition. The examiner must review the claims file.

The examiner is asked to provide a response to the following:

Is the Veteran's claimed shoulder condition at least as likely as not related to service, including carrying a 60 pound backpack during service and his injury during Marine Combat Training?

Provide a rationale to support the opinion(s).

G. William Riggs

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board N.H.

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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