HIP IMPAIRMENT OF

DUSTIN L. WARE · 2026 · Case ID: A26034668

MIXED

Summary

The veteran, who served in the U.S. Army from March 1975 to March 1995, appeals the denial of service connection for a right hip condition and the denial of service connection for a left hip condition. The Board granted service connection for the left hip condition, finding that the evidence was at least approximately balanced in favor of the veteran. The veteran submitted a private medical opinion stating that the left hip condition was at least as likely as not secondary to his service-connected back and bilateral knee conditions. Service treatment records were silent regarding any in-service complaints or treatment for hip conditions. The Board found the private opinion sufficiently established the nexus for the left hip. However, the claim for the right hip condition was remanded. While the veteran has a diagnosed right hip condition and claims it is secondary to his service-connected back and knee conditions, he did not provide a nexus opinion specifically for the right hip. The Board found this to be a pre-decisional duty to assist error and remanded the case for a VA medical examination to determine the nature and etiology of the right hip condition, specifically asking whether it is caused by or aggravated by his service-connected back and knee conditions. The Board noted that the veteran's service treatment records were silent regarding any in-service hip complaints.

Rationale

Private medical opinion found left hip secondary to service-connected back and bilateral knee conditions; Satisfied elements for secondary service connection; Benefit of the doubt resolved in veteran's favor

Service Branch

ARMY

Special Benefit

NO SPECIAL BENEFIT

Docket No.

210803-176500

Full Decision Text

Citation Nr: A26034668
Decision Date: 04/14/26 Archive Date: 04/14/26

DOCKET NO. 210803-176500
DATE: April 14, 2026

ORDER

Entitlement to service connection for a left hip condition is granted.

REMANDED

Entitlement to service connection for a right hip condition is remanded.

FINDING OF FACT

The evidence of record is at least approximately balanced or nearly equal that the Veteran's left hip condition had its onset in or is otherwise etiologically related to military service.

CONCLUSION OF LAW

Resolving any doubt in favor of the Veteran, the criteria for entitlement to service connection for a left hip condition have been met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.304, 3.307, 3.309, 3.326, 4.1, 4.3.

REASONS AND BASES FOR FINDING AND CONCLUSION

The Veteran served on active duty in the U.S. Army from March 1975 to March 1995.

This matter comes to the Board of Veterans' Appeals (Board) on appeal from an April 2021 rating decision issued by a Department of Veterans Affairs (VA) Regional Office (RO), which is the agency of original jurisdiction (AOJ).

In the August 2021 notice of disagreement, the Veteran selected the Hearing docket. Therefore, the Board may only consider the evidence of record at the time of the AOJ rating decision on appeal, any evidence submitted by the Veteran or the accredited representative at the Board hearing, to include testimony provided at the hearing, and any evidence submitted by the Veteran or the accredited representative within 90 days following the Board hearing. See 38 C.F.R. § 20.302.

The Veteran appeared before the undersigned Veterans law Judge for a virtual Board hearing in December 2024. A copy of the transcript is associated with the claims file and evidence of record.

The matter is now before the Board for consideration.

Service Connection

Service connection may be granted if the evidence demonstrates that a current disability resulted from an injury or disease incurred or aggravated in active military service. See 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303. It may be granted for any disease diagnosed after discharge, when the evidence, including that pertinent to service, establishes that the disease was incurred in service. See 38 U.S.C. § 1113(b); 38 C.F.R. § 3.303(d).

To establish entitlement to service connection, there must be: (1) competent and credible evidence confirming the Veteran has the claimed disability or at least has since filing the claim; (2) competent and credible evidence of in-service incurrence or aggravation of a relevant disease or injury; and (3) competent and credible evidence of a nexus or link between the in-service injury or disease and the current disability. See Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004).

Service connection may also be established on a secondary basis for a disability which is due to or the result of a service-connected disease or injury. See generally 38 C.F.R. § § 3.310(a). Establishing service connection on a secondary basis requires evidence sufficient to show (1) that a current disability exists and (2) that the current disability was either (a) caused by or (b) aggravated by a service-connected disability. See Allen v. Brown, 7 Vet. App. 439 (1995) (en banc).

1. Entitlement to service connection for a left hip condition.

Evidence and Analysis

The Veteran has been diagnosed with a disability. See October 2020 VA Primary Care Telephone Encounter Note. Therefore, the first element of service connection has been satisfied.

Regarding an in-service event, service treatment records are silent for complaints of, treatment for, or a diagnosis related to a hip condition. See March 1975 to March 1995 Veteran service treatment records, April 1986 Report of Medical Exam, June 1993 Report of Medical Examination, September 1994 Report of Medical Examination, September 1994 Report of Medical History, and November 1991, August 1992, January 1993, January 1994, and October 1994 Dental Health Questionnaires.

However, the Veteran is claiming service connection secondary to other service-connected conditions. See December 2024 Virtual Board Hearing Transcript.

As noted above, the evidence must show that the Veteran's hip condition was either caused by or aggravated by his service-connected
records are silent for complaints of, treatment for, or a diagnosis related to a hip condition. See March 1975 to March 1995 Veteran service treatment records, April 1986 Report of Medical Exam, June 1993 Report of Medical Examination, September 1994 Report of Medical Examination, September 1994 Report of Medical History, and November 1991, August 1992, January 1993, January 1994, and October 1994 Dental Health Questionnaires.

However, the Veteran is claiming service connection secondary to other service-connected conditions. See December 2024 Virtual Board Hearing Transcript.

As noted above, the evidence must show that the Veteran's hip condition was either caused by or aggravated by his service-connected musculoskeletal conditions.

To address the question of secondary service connection, the Veteran provided a private medical opinion in March 2025. In pertinent part, the report concluded: "[I]t is my professional opinion that it is at least as likely as not (50% or greater probability) that the claimed condition, Left Hip, is secondary to the Veteran's Back and Bilateral Knee Conditions, which were incurred in or caused by military service." See March 2025 M.M., DNP, Report.

Therefore, the second element for secondary service connection has been satisfied.

Conclusion

In summary, the Veteran has satisfied the required elements for secondary service connection of a left hip condition.

Resolving any doubt in favor of the Veteran, the evidence is at least approximately balanced or nearly equal that the Veteran's left hip condition is the result of his service-connected musculoskeletal conditions.

Therefore, service connection for a left hip condition is warranted, and the appeal is hereby granted.

REASONS FOR REMAND

1. Entitlement to service connection for a right hip condition is remanded.

The Veteran has been diagnosed with a disability. See October 2020 VA Primary Care Telephone Encounter Note. Therefore, the first element of service connection has been satisfied.

However, the Veteran is claiming service connection secondary to other service-connected conditions. See December 2024 Virtual Board Hearing Transcript.

As noted above, the evidence must show that the Veteran's hip condition was either caused by or aggravated by his service-connected musculoskeletal conditions.

Unfortunately, the Veteran only provided a nexus opinion for the left hip. There is no medical opinion of record for the right hip. Therefore, the evidence of record is not sufficient to make a decision on the claim. See McLendon v. Nicholson, 20 Vet. App. 79 (2006).

Therefore, a remand is required to address the pre-decisional duty to assist error in not obtaining a medical opinion regarding service connection. See 38 U.S.C. § 5103A.

The matter is REMANDED for the following actions:

1. Schedule a VA medical examination to address the nature and etiology of the Veteran's right hip condition. The Veteran's record should be made available to and reviewed by the examiner.

An opinion as follows is requested:

a. Whether the Veteran's right hip condition is caused by his service-connected lumbar spine condition and/or bilateral knee condition?

b. Whether the Veteran's right hip condition is aggravated by his service-connected lumbar spine condition and/or bilateral knee condition?

Secondary service connection exists if the claimed condition-here, a right hip condition-was caused by a service-connected disability-including back and knee conditions, singularly or in the aggregate. See Spicer v. McDonough, 61 F.4th 1360, 1364 (Fed. Cir. 2023). (describing "caused by" as simple but-for causation, a not only broad but even "sweeping" concept that requires unbroken links in the causal chain); see also El-Amin v. Shinseki, 26 Vet. App. 136 (2012);

A condition is aggravated if it is worsened by a service-connected disability. See Allen, supra at 448 ("[W]hen aggravation of a veteran's non-service-connected condition is [] due to or the result of a service-connected condition, such veteran shall be compensated for the degree of disability (but only that degree) over and above the degree of disability existing prior to the aggravation.").

Provide a detailed rationale, citing to data in the record, for any conclusions reached,
as simple but-for causation, a not only broad but even "sweeping" concept that requires unbroken links in the causal chain); see also El-Amin v. Shinseki, 26 Vet. App. 136 (2012);

Provide a detailed rationale, citing to data in the record, for any conclusions reached, noting that a VA medical opinion is considered inadequate when it relies exclusively on the lack of evidence in the service treatment records to dissociate a claimed condition from the veteran's military service. See Buchanan v. Nicholson, 451 F.3d 1331, 1336 (Fed. Cir. 2006).

The VA examiner must consider and address the statements of the Veteran and set forth a clear and reasoned analysis, the source of the most probative value in a medical report, including generally accepted medical opinion, applicable studies and literature, and evidence from the record, to include more than the absence of evidence, for all conclusions reached. See Nieves-Rodriguez v. Peake, 22 Vet. App. 295 (2008).

Note: Despite its request for development that includes "due consideration" of the Veteran's lay evidence, in accordance with 38 U.S.C. § 1154(a) and 38 C.F.R. §§ 3.303(a) and 3.307(b), the Board emphasizes that it is not making a determination regarding the credibility of the Veteran or his statements at this time.

If any of the requested responses cannot be made without resorting to speculation, the examiner must state as much and provide a rationale for this conclusion, including an explanation of whether there is any potentially available information that, if obtained, would allow for a non-speculative opinion.

DUSTIN L. WARE

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board B.S.S., Counsel

The Board's decision in this case is binding only with respect to the instant matter decided. This decision is not precedential and does not establish VA policies or interpretations of general applicability. 38 C.F.R. § 20.1303.

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