CERVICAL SPINE LIMITATION OF MOTION

Summary

The Veteran, who served in the U.S. Navy from April 1995 to September 2007, appeals the denial of service connection for neck pain, degenerative disc disease (DDD) of the lumbar spine, right trochanteric pain syndrome, and left trochanteric pain syndrome. The Board found that the Veteran has a current diagnosis of neck disability and experienced in-service neck symptomology, but denied presumptive service connection due to a lack of continuity of symptoms from service. The Board also denied direct service connection for neck pain, assigning minimal probative weight to a VA opinion that relied on the absence of service treatment records (STRs) for its negative conclusion, but ultimately found the persuasive weight of the evidence against a nexus. For the lumbar spine claims, the Board found current disability, favorable findings of in-service symptomology (numbness/tingling), and that DDD qualifies for presumptive service connection. However, the Board denied presumptive service connection due to a lack of continuous symptomology from service, noting STRs were silent on back issues. The Board then considered secondary service connection, acknowledging the Veteran's service-connected knee and ankle disabilities. Despite favorable findings on these elements, the Board denied secondary service connection for the lumbar spine, assigning minimal probative weight to one VA opinion and finding the persuasive weight of the evidence against a nexus, citing controversial medical literature and the lack of objective evidence linking the conditions. Similar reasoning was applied to the hip claims, denying secondary service connection due to lack of nexus and absence of STR evidence for hip pain.

Rationale

Lack of continuity of symptoms from service; Persuasive weight of evidence against nexus; VA opinion found less likely than not related to service

Full Decision Text

Citation Nr: A26003178
Decision Date: 01/13/26	Archive Date: 01/13/26

DOCKET NO. 250326-528501
DATE: January 13, 2026

ORDER

Entitlement to service connection for neck pain is denied.

Entitlement to service connection for degenerative disc disease (DDD) other than intervertebral disc syndrome (IVDS) and lumbosacral strain is denied.

Entitlement to service connection for right trochanteric pain syndrome (includes trochanteric bursitis) and other than post-traumatic degenerative arthritis is denied.

Entitlement to service connection for left trochanteric pain syndrome (includes trochanteric bursitis) and other than post-traumatic degenerative arthritis is denied.

FINDING OF FACT

1. The persuasive weight of the probative evidence of record at this time is against a medical nexus between the Veteran's in-service neck symptomology and his current neck disability.

2. The persuasive weight of the probative evidence of record at this time is against a medical nexus between the Veteran's service-connected left knee, right knee, right ankle, left ankle, and/or foot disabilities, and his current DDD other than IVDS and lumbosacral strain.

3. The persuasive weight of the probative evidence of record at this time is against a medical nexus between the Veteran's service-connected left knee, right knee, right ankle, left ankle, and foot disabilities, and/or his current right trochanteric pain syndrome and other than post-traumatic degenerative arthritis.

4. The persuasive weight of the probative evidence of record at this time is against a medical nexus between the Veteran's service-connected left knee, right knee, right ankle, left ankle, and/or foot disabilities and his current left trochanteric pain syndrome and other than post-traumatic degenerative arthritis.

CONCLUSION OF LAW

1. The criteria for entitlement to service connection for neck pain have not been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.304.

2. The criteria for entitlement to service connection for DDD other than IVDS and lumbosacral strain have not been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.304, 3.310.

3. The criteria for entitlement to service connection for right trochanteric pain syndrome and other than post-traumatic degenerative arthritis have not been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.304, 3.310.

4. The criteria for entitlement to service connection for left trochanteric pain syndrome and other than post-traumatic degenerative arthritis have not been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.304, 3.310.

REASONS AND BASES FOR FINDING AND CONCLUSION

The Veteran served in the U.S. Navy from April 1995 to September 2007.

A January 2, 2024 rating decision denied service connection for degenerative arthritis with lumbosacral spine strain, left trochanteric pain syndrome, and right trochanteric pain syndrome. A January 25, 2024 rating decision denied service connection for neck pain. The Veteran requested a Higher-Level Review (HLR) of his neck, low back, and right and left hip claims, and received a decision on June 14, 2024. The Agency of Original Jurisdiction (AOJ) denied the Veteran's neck claim, and remanded his low back, right hip, and left hip claims. After correcting the identified pre-decisional duty-to-assist errors, a November 12, 2024 rating decision again denied the Veteran's low back, right hip, and left hip claims on appeal.

The Veteran timely appealed this decision to the Board by requesting the Appeals Modernization Act (AMA) Direct Review Lane for a reevaluation of the evidence considered by the AOJ. As this is a Direct Review appeal under the AMA, the record closed on the date of the January 25, 2024 rating decision preceding the appealed June 14, 2024 HLR decision for the Veteran's neck claim, and the November 12, 2024 rating decision for his low back, right hip, and left hip claims. See 38 C.F.R. § 20.301. The Board cannot consider evidence submitted after
 2024 rating decision again denied the Veteran's low back, right hip, and left hip claims on appeal.

The Veteran timely appealed this decision to the Board by requesting the Appeals Modernization Act (AMA) Direct Review Lane for a reevaluation of the evidence considered by the AOJ. As this is a Direct Review appeal under the AMA, the record closed on the date of the January 25, 2024 rating decision preceding the appealed June 14, 2024 HLR decision for the Veteran's neck claim, and the November 12, 2024 rating decision for his low back, right hip, and left hip claims. See 38 C.F.R. § 20.301. The Board cannot consider evidence submitted after the respective AOJ decision. See id. If evidence was associated with the claims file during a period of time when additional evidence was not allowed, the Board has not considered it in its decision on the claim(s) on appeal. 38 C.F.R. § 20.300.

Service Connection, Including Presumptive Service Connection

Service connection may be granted for disability resulting from disease or injury incurred in or aggravated by active service. See 38 U.S.C. § 1110; 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. See Shedden v. Principi, 381 F.3d 1163, 1166-67 (Fed. Cir. 2004).

Certain chronic diseases will be presumed to have been incurred in service if manifested to a compensable degree of at least 10 percent disabling within one year after service. 38 U.S.C. §§ 1101, 1112, 1113; 38 C.F.R. §§ 3.307, 3.309. If a chronic disease enumerated in 38 U.S.C. § 1101(a) or 38 C.F.R. § 3.309 is diagnosed after separation from service, the nexus requirement of a claim for service connection can be proven by evidence of a continuity of symptomatology. Walker v. Shinseki, 708 F.3d 1331 (Fed. Cir. 2013).

When there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, VA shall give the benefit of the doubt to the claimant. 38 U.S.C. § 5107(b). It follows that when the evidence persuasively favors one side or the other, the benefit-of-the-doubt rule is not applied. Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021).

Secondary Service Connection

Service connection is also warranted for disability that is "but-for" due to or the result of service-connected disease or injury, and where a non-service-connected disability would have been less severe "but-for" a service-connected disability, either because there is an etiological link (to include worsening of functionality) between the two, or because the service-connected disability resulted in the inability to treat the non-service-connected disability. See 38 C.F.R. § 3.310(a); Spicer v. McDonough, 61 F.4th 1360, 1364-66 (2023) (invalidating the requirement of "proximate cause" and instead held a "but-for" causation or aggravation is enough to show entitlement to secondary service connection).

Establishing service connection on a secondary basis requires evidence sufficient to show: (1) a current disability; (2) a primary, service-connected disability; and (3) a nexus between the current disability and the service-connected disability. See Wallin v. West, 11 Vet. App. 509, 512 (1988).

Compensation may be established for any incremental increase in disability or any additional impairment of earning capacity in nonservice-connected disabilities resulting from service-connected disabilities above the degree of disability existing before the increase regardless of its permanence. See Ward v. Wilkie, 31 Vet. App. 233, 239 (2019). There is no requirement for objective measurement or numeric quantification for VA to ascertain an increase in disability for compensation purposes. See id. Compensation may also be established for "the natural progression of a condition not caused by a service-connected injury or disease, but that nonetheless would have been less severe were it not for the service-connected disability." See Spicer v. McDonough, 61 F.4th 1364 (Fed. Cir. 2023).

1. Entitlement to service connection for neck pain is denied.

The Veteran contends that his
 from service-connected disabilities above the degree of disability existing before the increase regardless of its permanence. See Ward v. Wilkie, 31 Vet. App. 233, 239 (2019). There is no requirement for objective measurement or numeric quantification for VA to ascertain an increase in disability for compensation purposes. See id. Compensation may also be established for "the natural progression of a condition not caused by a service-connected injury or disease, but that nonetheless would have been less severe were it not for the service-connected disability." See Spicer v. McDonough, 61 F.4th 1364 (Fed. Cir. 2023).

1. Entitlement to service connection for neck pain is denied.

The Veteran contends that his current neck pain is related to an injury he sustained during his active-duty service. See August 2023 VA Form 21-526EZ.

The AOJ made the favorable findings that the Veteran has a current disability diagnosis of degenerative arthritis of the cervical spine, and that he experienced a qualifying in-service incurrence of neck symptomology. See June 2024 HLR Decision. Therefore, the Board finds these elements of service connection have been established.

Additionally, the AOJ made the favorable findings that the Veteran meets the minimum service requirements for presumptive service connection, and that his neck disability manifested to a compensable degree by 2023. See June 2024 HLR Decision. Therefore, the Board finds these elements of presumptive service connection have been established.

The Board first considers whether service connection for the Veteran's neck disability can be established on a presumptive basis connected as a form of arthritis under 38 C.F.R. § 3.309(a).

Besides the Veteran's neck disability symptomology documented in a March 9, 2001 STR and his favorably found symptomology dating back to at least 2023, the Veteran reported during a November 2023 VA Neck examination that his neck disability symptomology began in 2013. The Veteran clarified his symptoms began as "gradual neck pain, but denies any trauma." The Board finds the Veteran credible and competent to describe the nature and history of his neck symptomology. See Layno, 6 Vet. App. 470. Considering the Veteran's STR's reflect a lack of symptomology after March 2001, and the Veteran reported his symptoms began approximately 6 years after his 2007 discharge, the Board finds the persuasive weight of the probative evidence of record at this time weighs against continuity of the Veteran's neck disability symptomology from within one year of his discharge, and entitlement to service connection on presumptive grounds is denied.

The Board next considers whether a medical nexus between the Veteran's current neck disability and his in-service neck symptomology can be established on a direct basis.

In a November 2023 VA medical opinion, the examiner opined that the Veteran's current neck disability is "less likely than not" related to his military service because "there is a lack of substantiating evidence" demonstrating "chronicity during service or after service" of the Veteran's neck symptomology, instead attributing the disability to "a post-service event, illness, or injury." The Board assigns this opinion probative weight to the nexus between the Veteran's current neck disability and his in-service neck symptomology. 

The Board finds the persuasive weight of the evidence is against a finding of service connection for the Veteran's neck pain. For the above reasons, the evidence is neither evenly balanced nor approximately so with regard to whether service connection for the cause of the Veteran's death is warranted. See Lynch v. McDonough, 21 F.4th 776, 781-82 (Fed. Cir. 2021) (en banc) (only when the evidence persuasively favors one side or another is the benefit of the doubt doctrine not for application).

Therefore, entitlement to service connection for neck pain is denied.

2. Entitlement to service connection for DDD other than IVDS and lumbosacral strain is denied.

The Veteran contends that his current lower back disability is related to his service-connected knee and ankle disabilities. See February 2022 VA Form 21-526EZ.

The AOJ made the favorable finding that the Veteran has a current disability diagnosis of DDD other than IVDS and lumbosacral strain, therefore, the Board finds this element of service connection has been established. See January 2, 2024 Rating Decision.

The AOJ also made the favorable findings that the Veteran meets the minimum service requirements to qualify for presumptive service connection, and that the Veteran's low back disability manifested to a compensable degree by 2022. See id. Therefore, the Board finds these elements of presumptive service connection have been established. 

Additionally, the Board finds that DDD other than IVDS and lumbosacral strain qualify as a presumptively service-connected
21-526EZ.

The AOJ made the favorable finding that the Veteran has a current disability diagnosis of DDD other than IVDS and lumbosacral strain, therefore, the Board finds this element of service connection has been established. See January 2, 2024 Rating Decision.

The AOJ also made the favorable findings that the Veteran meets the minimum service requirements to qualify for presumptive service connection, and that the Veteran's low back disability manifested to a compensable degree by 2022. See id. Therefore, the Board finds these elements of presumptive service connection have been established. 

Additionally, the Board finds that DDD other than IVDS and lumbosacral strain qualify as a presumptively service-connected form of arthritis under 38 C.F.R. § 3.309(a).

The Board next considers whether there is sufficient evidence of record to establish service connection for the Veteran's low back disability on a presumptive basis.

The Veteran's available STR's do not explicitly record that the Veteran suffered a lower back diagnosis, injury, nor symptomology, but do note in his 2007 separation exam that he had begun experiencing numbness and tingling in his extremities. Compare October 17, 1994 STR (reporting no current nor history of back trouble); January 20, 1999 STR (reporting no recurrent back pain); March 2, 2001 STR (reporting no recurrent back pain or any back injury, nor nerve trouble) with May 23, 2007 STR (reporting no recurrent back pain or any back problem, but "numbness in legs, feet, arm" and "lower ext[remity] 'tingling' with prolonged sitting," signed June 4, 2007). In his VA Back examinations, the Veteran attested that his lumbar symptomology began as early as 2014, and has gradually progressed since then. See March 2022 VA Back Examination; October 2024 VA Back Examination. The Board finds the Veteran credible and competent to describe the nature and history of his back symptomology. See Layno v. Brown, 6 Vet. App. 465, 470 (1994) (non-expert witnesses are competent to report that which they have observed with their own senses). The Veteran's available post-service treatment records do not appear to contain additional detail indicating the Veteran experienced back symptomology between 2007 and 2014. Therefore, the persuasive weight of the probative evidence of record is against the Veteran having continuous back disability symptomology from within one year of his 2007 discharge.

As service connection cannot be established on a presumptive basis based on the evidence of record at this time, the Board next considers whether it can be established on a secondary basis, as initially claimed by the Veteran.

In addition to its favorable finding of a current back disability diagnosis, the AOJ made the favorable finding that the Veteran is service-connected for left knee, right knee, right ankle, left ankle, and foot disabilities. See November 2024 Rating Decision. Therefore, the Board finds that this element of secondary service connection has been established.

The Board next considers whether the evidence of record supports a medical nexus between the Veteran's current back disability and his service-connected knee, ankle, and foot disabilities.

In a March 2022 VA medical opinion, the examiner opined the Veteran's back disability is "less likely than not proximately due to or the result of" his service-connected right knee, left knee, or right ankle disabilities, instead attributing his back disability to "frequent overuse injury" not related to service as "the Veteran was not seen for back pain throughout his military service." The Board assigns this opinion minimal probative weight as it appears to rely on the absence of STR evidence to support its negative conclusion. See Dalton v. Nicholson, 21 Vet. App. 23 (2007) (holding an examiner cannot rely on the absence of STR evidence to provide a negative opinion).

In an August 2024 VA medical opinion, the examiner opined the Veteran's bac disability is "less likely than not proximately due to or the result of" the Veteran's service-connected lower body disabilities because "there is no objective evidence to show that veteran's lumbar spine condition has been caused by" such disabilities, indicating the Veteran's medical records reflect "normal gait and ambulation" and medical scholarship is "controversial" on whether abnormal gait can impact one's back. 

As a finder of fact, the Board routinely must assess the competence, veracity, accuracy, materiality, probity, and weight of evidence. See, e.g., Jandreau v. Nicholson, 492 F.3d 1372, 1376 (Fed. Cir. 2007); Wise v. Shinseki, 26 Vet. App. 
 the result of" the Veteran's service-connected lower body disabilities because "there is no objective evidence to show that veteran's lumbar spine condition has been caused by" such disabilities, indicating the Veteran's medical records reflect "normal gait and ambulation" and medical scholarship is "controversial" on whether abnormal gait can impact one's back. 

As a finder of fact, the Board routinely must assess the competence, veracity, accuracy, materiality, probity, and weight of evidence. See, e.g., Jandreau v. Nicholson, 492 F.3d 1372, 1376 (Fed. Cir. 2007); Wise v. Shinseki, 26 Vet. App. 517, 526 (2014). This necessarily requires the Board to sometimes resolve apparent conflicts and discrepancies in the evidence. See, e.g., Buchanan v. Nicholson, 451 F.3d 1331, 1336-1337 (Fed. Cir. 2006); Parseeya-Picchione v. McDonald, 28 Vet. App. 171, 175-76 (2016).

The Board does not seek to intrude on the province of scientific or medical experts by exercising independent judgment on matters requiring specialized knowledge such as determining an initial diagnosis for a medical condition. See, e.g., Colvin v. Derwinski, 1 Vet. App. 171, 175 (1991). There are certain disabilities, however, which do not require a formal medical diagnosis. See Charles v. Principi, 16 Vet. App. 370 (2014) (holding tinnitus may be established by lay diagnosis). See also Kahana v. Shinseki, 24 Vet. App. 428 (2011); Jandreau v. Nicholson, 492 F.3d 1372, 1376-77 (Fed. Cir. 2007).

On the other hand, determining whether service connection applies in a particular case is not a medical diagnosis-it is a question of fact. See, e.g., Wood v. Derwinski, 1 Vet. App. 190, 191 (1991). While the Board carefully considers input from medical professionals and other experts, it does not "outsource" its role as the finder of fact to them. See, e.g., Sizemore v. Principi, 18 Vet. App. 264 (2004); Delrio v. Wilkie, 32 Vet. App. 232, 242 (2019) Miller v. Wilkie, 32 Vet. App. 249, 259 (2020). Therefore, adjudicating whether a disability is service-connected is well within the scope of the Board. See, e.g., Madden v. Gober, 125 F.3d 1477, 1481 (Fed. Cir. 1997); Owens v. Brown, 7 Vet. App. 429, 433 (1995). 

Despite the August 2024 opinion's shortcoming in using the wrong causation standard, the Board still finds it credible and probative. There is no factual evidence that the examiner recorded incorrect information in the report, to include recording the Veteran's lay testimony and the objective evidence observed by the examiner. Monzingo v. Shinseki, 26 Vet. App. 97, 107 (2012) ("[E]ven if a medical opinion is inadequate to decide a claim, it does not necessarily follow that the opinion is entitled to absolutely no probative weight.").

In October 2024 VA medical opinions, the examiner opined the Veteran's current back disability "is less likely than not related" related to either the Veteran's service-connected lower extremity disabilities or his right and left hip disabilities because "there is no clear evidence" in "orthopedic literature to suggest that an injury to one joint would have any significant impact on another or opposite uninjured joint or limb" absent major muscle or nerve damage causing partial or complete paralysis or shortening an injured limb more than 5 centimeters. As noted above, the Board's duty as fact-finder permit it to properly adjudicate whether a disability is service-connected, informed by input from medical professionals and other experts. See, e.g., Wood v. Derwinski, 1 Vet. App. 191; Miller v. Wilkie, 32 Vet. App. 259; Madden v. Gober, 125 F.3d 1481. Despite the August 2024 opinion's shortcoming in using the wrong causation standard, the Board still finds it credible and probative. There is no factual evidence that the examiner recorded incorrect information during their examination or opinion drafting, including recording the Veteran's lay testimony and the objective evidence observed by the examiner. Mon
 As noted above, the Board's duty as fact-finder permit it to properly adjudicate whether a disability is service-connected, informed by input from medical professionals and other experts. See, e.g., Wood v. Derwinski, 1 Vet. App. 191; Miller v. Wilkie, 32 Vet. App. 259; Madden v. Gober, 125 F.3d 1481. Despite the August 2024 opinion's shortcoming in using the wrong causation standard, the Board still finds it credible and probative. There is no factual evidence that the examiner recorded incorrect information during their examination or opinion drafting, including recording the Veteran's lay testimony and the objective evidence observed by the examiner. Monzingo v. Shinseki, 26 Vet. App. 97, 107 (2012) ("[E]ven if a medical opinion is inadequate to decide a claim, it does not necessarily follow that the opinion is entitled to absolutely no probative weight.").

The Board finds the persuasive weight of the evidence is against a finding of service connection for the Veteran's DDD other than IVDS and lumbosacral strain, including as secondary to his left knee, right knee, right ankle, left ankle, and/or foot disabilities. For the above reasons, the evidence is neither evenly balanced nor approximately so. See Lynch v. McDonough, 21 F.4th 781-82 (only when the evidence persuasively favors one side or another is the benefit of the doubt doctrine not for application).

Therefore, entitlement to service connection for DDD other than IVDS and lumbosacral strain, including as secondary to left knee, right knee, right ankle, left ankle, and/or foot disabilities, is denied.

3. Entitlement to service connection for right trochanteric pain syndrome (includes trochanteric bursitis) and other than post-traumatic degenerative arthritis is denied.

4. Entitlement to service connection for left trochanteric pain syndrome (includes trochanteric bursitis) and other than post-traumatic degenerative arthritis is denied.

The Veteran contends that his current hip disabilities are related to his service-connected knee disabilities. See February 2022 VA Form 21-526EZ.

The AOJ made the favorable findings that the Veteran has current disability diagnoses of right and left trochanteric pain syndrome and other than post-traumatic degenerative arthritis, and that he experienced a qualifying in-service incurrence of tingling and numbness in his legs. Therefore, the Board finds these elements of service connection have been established.

The Board next considers whether the evidence of record supports a medical nexus between the Veteran's current hip disabilities and his in-service leg tingling and numbness.

In August 2024 VA medical opinions, the examiner opined that the Veteran's left and right hip pain "was less likely than not incurred in or caused by the lower extremities numbness during service" because "no complaints of hip pain [are] noted in the STR's or immediate post separation period." The Board assigns this opinion probative weight to the nexus between the Veteran's current hip disabilities and his in-service leg tingling and numbness. 

As the persuasive weight of the probative evidence of record at this time is against a medical nexus between the Veteran's current hip disabilities and favorably found in-service symptomology, the Board next considers whether service connection can be established on a secondary basis.

In addition to its favorable finding of a current hip disability, the AOJ made the favorable finding that the Veteran has the primary, service-connected disabilities of left knee degenerative arthritis, right knee patellofemoral pain syndrome, right ankle degenerative arthritis, left ankle tendonitis, and degenerative arthritis of both feet with right foot pes planus. Therefore, the Board finds this element of secondary service connection has been established.

The Board next considers whether there is sufficient evidence of record to establish a medical nexus between the Veteran's current hip disabilities and his service-connected lower extremity joint disabilities.

In a March 2022 VA medical opinion, the examiner opined the Veteran's bilateral hip disabilities are "less likely than not proximately due to or the result of" his service-connected right knee, left knee, or right ankle disabilities, instead attributing his back disability to "frequent overuse injury" not related to service as "the Veteran was not seen for bilateral hip [pain] throughout his military service." The Board assigns this opinion minimal probative weight as it appears to rely on the absence of STR evidence to support its negative conclusion. See Dalton v. Nicholson, 21 Vet. App. 23.

In August 2024 VA medical opinions, the examiner opined the Veteran's current left and right hip disabilities are "less likely than not proximately due to or the result of" the Veteran's service-connected left ankle,
 "less likely than not proximately due to or the result of" his service-connected right knee, left knee, or right ankle disabilities, instead attributing his back disability to "frequent overuse injury" not related to service as "the Veteran was not seen for bilateral hip [pain] throughout his military service." The Board assigns this opinion minimal probative weight as it appears to rely on the absence of STR evidence to support its negative conclusion. See Dalton v. Nicholson, 21 Vet. App. 23.

In August 2024 VA medical opinions, the examiner opined the Veteran's current left and right hip disabilities are "less likely than not proximately due to or the result of" the Veteran's service-connected left ankle, left knee, right knee, right ankle, and foot disabilities because "there is no objective evidence to show that" his hip disabilities were "caused by" his service-connected ankle, knee, and foot disabilities. The examiner indicated medical scholarship is "controversial" on whether musculoskeletal disabilities can impact other regions of the body, citing a 2005 article in particular. As described in the previous claim, the Board's duty as fact-finder allow it to adjudicate whether a disability is service-connected informed by input from medical professionals and other experts. See, e.g., Wood, 1 Vet. App. 191; Miller, 32 Vet. App. 259; Madden, 125 F.3d 1481. Despite the August 2024 opinions' shortcomings in using the wrong causation standard, the Board still finds it credible and probative. There is no factual evidence that the examiner recorded incorrect information during their examination or opinion drafting, including recording the Veteran's lay testimony and the objective evidence observed by the examiner. Monzingo v. Shinseki, 26 Vet. App. 107.

In an October 2024 VA medical opinion, the examiner opined it is "less likely than not" the Veteran's right and left hip disabilities are related to his service-connected knee, ankle, and foot disabilities because "there is no clear evidence from review of orthopedic literature to suggest that an injury to one joint would have any significant impact on another or opposite uninjured joint or limb" absent muscle or nerve damage leading to paralysis or limb length discrepancy of more than 5 centimeters. The examiner clarified that "it is not unusual for two joints to share properties in the same person, but one joint's disease does not 'spread' to another or cause damage to it." As above, despite the October 2024 opinion's shortcomings in using the wrong causation standard, the Board still finds it credible and probative. See, e.g., Wood, 1 Vet. App. 191; Miller, 32 Vet. App. 259; Madden, 125 F.3d 1481. There is no factual evidence that the examiner recorded incorrect information during their examination or opinion drafting, including recording the Veteran's lay testimony and the objective evidence observed by the examiner. Monzingo, 26 Vet. App. 107.

The Board finds the persuasive weight of the evidence is against a finding of service connection for both the Veteran's right and left hip disabilities, including as secondary to his left knee, right knee, right ankle, left ankle, and/or foot disabilities. For the above reasons, the evidence is neither evenly balanced nor approximately so. See Lynch v. McDonough, 21 F.4th 781-82 (only when the evidence persuasively favors one side or another is the benefit of the doubt doctrine not for application).

Therefore, entitlement to service connection for right and left trochanteric pain syndrome and other than post-traumatic degenerative arthritis, including as secondary to left knee, right knee, right ankle, left ankle, and/or foot disabilities, is denied.

 

 

Martin T. Mitchell

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	Galik, E.

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.