HIP IMPAIRMENT OF

Summary

The Veteran, an Army veteran who served from February 2004 to April 2008, including service in Southwest Asia and receipt of the Combat Action Badge and Purple Heart, appeals the denial of service connection for a right hip disability. The Veteran claims his current hip condition began in service due to multiple IED blast exposures in Iraq, leading to ongoing hip pain since separation. The Board found that the Veteran's reports of a right hip injury and subsequent hip pain noted in service treatment records, coupled with his testimony and lay evidence of continuity of symptoms, established an in-service injury. However, the Board found the private medical opinion submitted by the Veteran to be conclusory and lacking probative value due to an incomplete review of the record. The VA examiner's negative nexus opinion was also discounted as it was based on an inaccurate factual premise that the Veteran had not sought ongoing treatment since service, which the Board found contradicted by the evidence. The Board determined that had the VA examiner reviewed the complete record, a positive nexus opinion would likely have been returned. Therefore, the Board granted service connection for the right hip disability.

Rationale

In-service injury established by IED exposure and service records; Lay evidence supports continuity of symptoms; VA examiner's negative nexus opinion discounted due to factual inaccuracy

Full Decision Text

Citation Nr: A26037515
Decision Date: 04/22/26	Archive Date: 04/22/26

DOCKET NO. 210615-166041
DATE: April 22, 2026

ORDER

Entitlement to service connection for a right hip disability is granted.

FINDING OF FACT

The evidence is in approximate equipoise as to whether the Veteran's current right hip disability is the result of in-service injury.   

CONCLUSION OF LAW

The criteria for entitlement to service connection for a right hip osteoarthritis have been met.  38 U.S.C. §§ 1110, 1112, 1113, 1154(b), 5107; 38 C.F.R. §§ 3.102, 3.303.  

REASONS AND BASES FOR FINDING AND CONCLUSION

The Veteran served on active duty in the United States Army from February 2004 to April 2008.  He had service in Southwest Asia and is a recipient of the Combat Action Badge and Purple Heart, among other awards and decorations.  

This matter comes before the Board of Veterans' Appeals (Board) on appeal from a March 2021 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO), the Agency of Original Jurisdiction (AOJ), which denied service connection for a right hip disability.

In June 2021, the Veteran, through his attorney, Jan D. Dils, submitted a VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement) on which Ms. Dils identified the March 2021 rating decision, the issue set forth above, and elected the Hearing docket.  A Board hearing was held on July 30, 2024.  A transcript of the hearing is of record.

By way of background, in an April 2008 rating decision, the RO denied service connection for a right hip disability.  In November 2020, the Veteran submitted a VA Form 20-0995, Decision Review Request: Supplemental Claim, seeking readjudication of the April 2008 rating decision.  In the March 2021 rating decision on appeal, the AOJ determined that new and relevant evidence had been received, readjudicated the claim on the merits, and denied service connection for a right hip disability.  As indicated above, VA received the Veteran's Board appeal in June 2021, on which Ms. Dils identified the March 2021 rating decision.

Therefore, the Board may only consider the evidence of record at the time of the March 2021 AOJ decision, as well as any evidence submitted by the Veteran or his representative at the July 30, 2024 hearing or within 90 days following the hearing.  38 C.F.R. § 20.302(a).  If evidence was submitted either (1) during the period after the March 2021 AOJ decision and prior to the Board hearing, or (2) more than 90 days following the hearing, the Board did not consider it in its decision.  38 C.F.R. §§ 20.300, 20.302(a), 20.801.

If the Veteran would like VA to consider any evidence that was submitted that the Board could not consider, the Veteran may file a Supplemental Claim (VA Form 20-0995) 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. 

1. Entitlement to service connection for a right hip disability.  

The Veteran contends that his current hip disability began in service because he injured his right hip after being exposed to several IED blasts while deployed to Iraq and has experienced right hip symptoms since that time.  See July 2024 Board hearing transcript.

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).

With respect to the first element of a service connection claim, the record demonstrates that the Veteran has diagnoses of right hip osteoarthritis, right hip b
 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).

With respect to the first element of a service connection claim, the record demonstrates that the Veteran has diagnoses of right hip osteoarthritis, right hip bursitis, and right hip strain.  See private treatment records dated May 2020 and January 2021; March 2021 VA examination report.  

With respect to the second element of a service connection claim, an in-service disease or injury, the Board finds that this element has been satisfied.  The Veteran contends that he injured his right hip due to exposure to multiple IED blasts while deployed to Iraq.  See July 30, 2024 Board hearing transcript. Specifically, the Veteran testified that he was "the lead gun truck driver of a convoy security team.  And we had been in several IEDs that hit our vehicle.  But one in particular is the one that went off underneath our vehicle and caused a lot of what the majority of the hip, back injuries that I believe that I have today."  The Veteran's DD Form 214 reflects service in Iraq and receipt of the Combat Action Badge.  The Veteran's military personnel records also reflect that the Veteran was awarded the Purple Heart for wounds sustained in an IED explosion on May 9, 2007.  The Board finds that the Veteran's reports of a right hip injury in combat are consistent with the circumstances of his service in Iraq and are sufficient to establish an in-service injury.  38 C.F.R. § 1154(b).  Moreover, the Veteran's STRs reflect that his report of hip pain was noted on multiple occasions following the IED explosions.  See STRs dated October 2007, November 2007, December 2007, January 2008.  

The remaining question is whether there is a causal relationship between the current right hip disability and the in-service right hip injury.  

The record contains an October 2024 private opinion, solicited by the Veteran's attorney, from Maude Meulstee, a nurse practitioner associated with Zeeland Consulting.  Although Ms. Meulstee claimed to have "personally reviewed" the Veteran's medical records, such review appears incomplete as she did not note the Veteran's right hip osteoarthritis diagnosis, which was of record at the time of her opinion.  Instead, she referred to the disability in question simply as "a right hip condition."  With respect to the substance of her opinion, the Board finds it conclusory and not probative.  Ms. Meulstee quoted, without application to the Veteran's specific circumstances or the evidence, various medical articles, and then stated that it is at least as likely as not that the Veteran's "right hip condition" was incurred in or caused by military service.  Her opinion is devoid of any reasoned medical explanation discussing facts specific to the Veteran.  As such, the opinion is of little probative weight and insufficient to grant the benefit sought.  

The record also contains a March 2021 VA opinion in which the examiner opined that the Veteran's current right hip strain with arthritis is less likely than not incurred in or caused by the claimed in-service injury.  The examiner explained that this was because the STRs reflect a right hip condition that resolved, and the post-service medical records "did not reveal continuous ongoing medical treatment or aggravation of acute or chronic right hip joint condition during time of discharge from active military service to present date."  

The examiner's negative nexus opinion, however, is based on an inaccurate factual premise because the medical evidence reflects that the Veteran consistently reported hip pain in clinical settings following his separation from service.  In this regard, the Veteran's VA treatment records reflect that in June 2008, only two months after his separation from service, he reported a history of right hip pain as well as current right hip pain.  VA and private treatment records reflect the Veteran's continued reports of right hip pain as well as various treatments (including physical therapy and injections), and diagnoses including bursitis and osteoarthritis.  See VA treatment notes dated June 2008, July 2008, November 2008, December 2008, February 2009, December 2010, March 2011, and April 2016; private treatment notes dated December 2009, June 201
 settings following his separation from service.  In this regard, the Veteran's VA treatment records reflect that in June 2008, only two months after his separation from service, he reported a history of right hip pain as well as current right hip pain.  VA and private treatment records reflect the Veteran's continued reports of right hip pain as well as various treatments (including physical therapy and injections), and diagnoses including bursitis and osteoarthritis.  See VA treatment notes dated June 2008, July 2008, November 2008, December 2008, February 2009, December 2010, March 2011, and April 2016; private treatment notes dated December 2009, June 2018; May 2020, November 2020, and January 2021.  Moreover, the Veteran has provided lay evidence of continuity of right hip pain since the in-service injury.  As a result, the Board assigns the March 2021 negative nexus opinion little probative weight.  See Reonal v. Brown, 5 Vet. App. 458, 461 (1993) (a medical opinion based on an inaccurate factual premise is not probative); Nieves-Rodiguez v. Peake, 22 Vet. App. 295, 302-04 (2008) (holding that it is the factually accurate, fully articulated, sound reasoning for the conclusion that contributes to the probative value of a medical opinion).  

The Board, however, finds that remand to correct this deficiency is unnecessary.  This is because the Board finds that had the March 2021 VA examiner not overlooked the medical and lay evidence of record documenting treatment for right hip symptoms since service, a positive nexus opinion would have been returned given the rationale provided.  In other words, because the examiner concluded that a negative nexus opinion was necessary absent evidence of ongoing medical treatment since service, it follows that he would have provided an opinion in favor of nexus had he reviewed the medical records documenting exactly that, ongoing medical treatment for right hip pain since service.  

Accordingly, entitlement to service connection for a right hip disability is warranted, and the claim is granted.  

 

 

K. Conner

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	Madison, Siobhan K.

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.