Case A26040122

L. M. BARNARD · 2026 · Case ID: A26040122

DENIED

Summary

The veteran, who served from August 3, 2005, to August 2, 2009, appeals the denial of entitlement to an earlier effective date for the grant of separate ratings for bilateral hip strain, specifically concerning impairment of thigh and limitation of thigh extension. The veteran initially sought a higher-level review, which was transferred to a supplemental claim for further development. The Board reviewed evidence of record up to the April 2025 AOJ supplemental claim decision. The veteran underwent a VA hip examination in March 2025, which diagnosed bilateral hip strain. The examination noted painful motion and limitations in range of motion, including an inability to cross legs due to limited adduction on the left. The Board found that prior to March 28, 2025, the veteran's hip conditions did not meet the minimum criteria for separate compensable ratings under the applicable diagnostic codes, with the highest rating being 10 percent for painful motion. The Board concluded that the specific limitations required for separate ratings under Diagnostic Codes 5251 (limitation of extension) and 5253 (limitation of adduction/rotation) were not factually ascertainable until March 28, 2025, the date of the updated examination. Therefore, the Board denied entitlement to earlier effective dates for these specific ratings, finding the evidence against the claims for dates prior to March 28, 2025.

Rationale

No indication of limitation of adduction preventing crossing legs prior to March 28, 2025.; Minimum criteria for Diagnostic Code 5253 not met prior to March 28, 2025.

Special Benefit

NO SPECIAL BENEFIT

Docket No.

251007-593406

Full Decision Text

Citation Nr: A26040122
Decision Date: 04/29/26 Archive Date: 04/29/26

DOCKET NO. 251007-593406
DATE: April 29, 2026

ORDER

Entitlement to an effective date prior to March 28, 2025, for the grant of a separate rating for left hip strain, impairment of thigh, is denied.

Entitlement to an effective date prior to March 28, 2025, for the grant of a separate rating for right hip strain, impairment of thigh, is denied.

Entitlement to an effective date prior to March 28, 2025, for the grant of a separate rating for left hip strain, limitation of thigh extension, is denied.

Entitlement to an effective date prior to March 28, 2025, for the grant of a separate rating for right hip strain, limitation of thigh extension, is denied.

FINDINGS OF FACT

1. Prior to March 28, 2025, the Veteran's bilateral hip disability was manifest by painful motion.

2. From March 28, 2025, the Veteran's bilateral hip disability was manifest by limitation of adduction of the thigh due to being unable to cross legs.

CONCLUSIONS OF LAW

1. The criteria for entitlement to an effective date prior to March 28, 2025, for the grant of a separate rating for left hip strain, impairment of thigh, have not been met. 38 U.S.C. §§ 1155, 5107, 5110(a); 38 C.F.R. §§ 3.102, 3.400, 4.1, 4.3, 4.7, 4.71a, Diagnostic Code 5253.

2. The criteria for entitlement to an effective date prior to March 28, 2025, for the grant of a separate rating for right hip strain, impairment of thigh, have not been met. 38 U.S.C. §§ 1155, 5107, 5110(a); 38 C.F.R. §§ 3.102, 3.400, 4.1, 4.3, 4.7, 4.71a, Diagnostic Code 5253.

3. Entitlement to an effective date prior to March 28, 2025, for the grant of a separate rating for left hip strain, limitation of thigh extension, have not been met. 38 U.S.C. §§ 1155, 5107, 5110(a); 38 C.F.R. §§ 3.102, 3.400, 4.1, 4.3, 4.7, 4.71a, Diagnostic Code 5251.

4. Entitlement to an effective date prior to March 28, 2025, for the grant of a separate rating for left hip strain, limitation of thigh extension, have not been met. 38 U.S.C. §§ 1155, 5107, 5110(a); 38 C.F.R. §§ 3.102, 3.400, 4.1, 4.3, 4.7, 4.71a, Diagnostic Code 5251.

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Veteran served on active duty from August 3, 2005, to August 2, 2009.

Although the Veteran initially requested Higher-Level Review when submitting the August 2024 VA Form 20-0996, Decision Review Request: Higher-Level Review, the Higher-Level Reviewer determined that there had been a duty to assist error and transferred the claim to the Supplemental Claim decision review option for additional development.

In the October 2025 VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement), the Veteran elected the Direct Review docket.

Therefore, the Board may only consider the evidence of record at the time of the April 2025 agency of original jurisdiction (AOJ) supplemental claim decision on appeal. 38 C.F.R. § 20.301. If evidence was submitted after the AOJ issued the supplemental claim decision on appeal, the Board did not consider it in its decision. 38 C.F.R. §§ 20.300, 20.301, 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 claims, considering the new evidence in addition to the evidence previously
claim decision on appeal. 38 C.F.R. § 20.301. If evidence was submitted after the AOJ issued the supplemental claim decision on appeal, the Board did not consider it in its decision. 38 C.F.R. §§ 20.300, 20.301, 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 claims, considering the new evidence in addition to the evidence previously considered. Id. Specific instructions for filing a Supplemental Claim are included with this decision.

EARLIER EFFECTIVE DATES

1. Entitlement to an effective date prior to March 28, 2025, for the grant of a separate rating for left hip strain, impairment of thigh

2. Entitlement to an effective date prior to March 28, 2025, for the grant of a separate rating for right hip strain, impairment of thigh

3. Entitlement to an effective date prior to March 28, 2025, for the grant of a separate rating for left hip strain, limitation of thigh extension

4. Entitlement to an effective date prior to March 28, 2025, for the grant of a separate rating for right hip strain, limitation of thigh extension

The Veteran has requested earlier effective date for grant of service connection for hips.

The effective date shall be the later of either the date of receipt of the claim, or the date entitlement arose. 38 U.S.C. § 5110(a); 38 C.F.R. § 3.400(o). An effective date for a claim for increase may also be granted prior to the date of claim if it is factually ascertainable that an increase in disability has occurred within one year from the date of the claim. 38 U.S.C. § 5110(b)(2); 38 C.F.R. §§ 3.400(o)(1), (2). Therefore, the ultimate question in determining the effective date for an increased rating claim is when it was factually ascertainable that the service-connected disabilities increased in severity.

By way of history, the Veteran filed an initial claim for entitlement to service connection for "hips b/l" in May 2019. These claims were denied in an August 2019 rating decision.

Following a May 2024 Board decision granting entitlement to service connection for left hip strain and right hip strain, a May 2024 rating decision granted a 10 percent rating for each hip effective May 28, 2019, based on painful motion under 38 C.F.R. 4.71a, Diagnostic Code 5252.

The Veteran filed a request for Higher Level Review in August 2024. The reviewer determined that updated VA examinations were needed for a current rating. The Veteran underwent an updated VA hip examination on March 28, 2025.

Based on that examination, an April 2025 rating decision granted a separate rating at 10 percent for bilateral hip strain, impairment of thigh, under 38 C.F.R. 4.71a, Diagnostic Code 5253, effective March 28, 2025; a separate noncompensable rating for bilateral hip strain, limitation of thigh extension, under Diagnostic Code 5251, effective March 28, 2025; and reduced the Veteran's rating to noncompensable under Diagnostic Code 5252, effective March 28, 2025.

The Veteran appealed the effective dates for the grants of service connection but did not appeal the ratings assigned.

As noted above, the earliest possible effective date is either the date of the claim or the date that the entitlement arose. 38 U.S.C. § 5110(a); 38 C.F.R. § 3.400(o).

Under 38 C.F.R. § 4.71a, Diagnostic Code 5251, for limitation of extension of the thigh, 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.

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.

Under Diagnostic Code 525
, for limitation of extension of the thigh, 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.

Under Diagnostic Code 5253, a 10 percent rating is warranted for limitation of rotation of affected leg, cannot toe out more than 15 degrees. A 10 percent rating is also warranted for limitation of adduction, cannot cross legs. A maximum 20 percent rating is warranted for limitation of abduction, motion lost beyond 10 degrees. 38 C.F.R. § 4.71a, Diagnostic Code 5253.

Additionally, VA is prohibited from pyramiding (rating the same disability, or the same manifestation of a disability, under different diagnostic codes). 38 C.F.R. § 4.14. When disabilities have duplicative or overlapping symptoms, the rule against pyramiding prohibits VA from compensating the veteran more than once for the same symptom or impairment. Esteban v. Brown, 6 Vet. App. 259, 261-62 (1994); Lyles v. Shulkin, 29 Vet. App. 107 (2017).

For the reasons discussed below, the Board finds that the Veteran's bilateral hip disability did not manifest as limitation of extension of the thigh or impairment of the thigh prior to March 28, 2025. 38 C.F.R. § 4.71a, Diagnostic Codes 5251, 5252, 5253.

Following the original claim, the Veteran underwent a VA examination in August 2019. The Veteran was diagnosed with bilateral hip strain. On initial range of motion testing on the right, the Veteran had flexion to 100 (125) degrees, extension to 30 (30) degrees, abduction to 45 (45) degrees, adduction to 25 (25) degrees, with full external and internal rotation. The Veteran was noted to be able to cross his legs. The Veteran had painful motion and localized tenderness. On initial range of motion testing on the left, the Veteran had flexion to 100 (125) degrees, extension to 30 (30) degrees, abduction to 45 (45) degrees, adduction to 25 (25) degrees, with full external and internal rotation. The Veteran was noted to be able to cross his legs. The Veteran had painful motion and localized tenderness. There was no additional functional loss with three repetitions, and the examiner indicated there would be no additional functional loss due to repeated use over time. The Veteran denied flare ups. The Veteran had full muscle strength and no atrophy bilaterally. There was no indication of ankylosis of either hip.

Subsequently Veteran underwent another VA examination in March 2025. The Veteran was diagnosed with bilateral hip strain. On initial range of motion testing on the right, the Veteran had flexion to 120 (125) degrees, extension to 20 (30) degrees, abduction to 40 (45) degrees, adduction to 20 (25) degrees, with 50 (60) degrees of external rotation and 30 (40) degrees of internal rotation. The Veteran was noted to be able to cross his legs. The Veteran had painful motion. On initial range of motion testing on the left, the Veteran had flexion to 100 (125) degrees, extension to 25 (30) degrees, abduction to 40 (45) degrees, adduction to 20 (25) degrees, with 50 (60) degrees of external rotation and 30 (40) degrees of internal rotation. The Veteran was noted to be unable to cross his legs due to a limitation in adduction. The Veteran had painful motion in active and passive motion. There was no additional functional loss with three repetitions, however, the examiner indicated there would be additional functional loss due to pain with repeated use over time. The examiner estimated the Veteran would have additional limitation to on the right, flexion to 90 (125) degrees, extension to 20 (30) degrees, abduction to 35 (45) degrees, adduction to 15 (25) degrees, with 40 (60) degrees of external rotation and 30 (40) degrees of internal rotation; and on the left, flexion to 90 (125)
of internal rotation. The Veteran was noted to be unable to cross his legs due to a limitation in adduction. The Veteran had painful motion in active and passive motion. There was no additional functional loss with three repetitions, however, the examiner indicated there would be additional functional loss due to pain with repeated use over time. The examiner estimated the Veteran would have additional limitation to on the right, flexion to 90 (125) degrees, extension to 20 (30) degrees, abduction to 35 (45) degrees, adduction to 15 (25) degrees, with 40 (60) degrees of external rotation and 30 (40) degrees of internal rotation; and on the left, flexion to 90 (125) degrees, extension to 20 (30) degrees, abduction to 35 (45) degrees, adduction to 15 (25) degrees, with 40 (60) degrees of external rotation and 20 (40) degrees of internal rotation. The examiner also estimated the Veteran would be similarly limited during flare ups, which the Veteran reported were moderate, occurred 1-2 times a week, and lasted a few hours. The Veteran had full muscle strength and no atrophy bilaterally. There was no indication of ankylosis of either hip.

For the period prior to March 28, 2025, the Veteran's bilateral hip disability did not meet the minimum criteria for any of the applicable diagnostic codes. Therefore, the maximum compensable rating was for 10 percent for each hip based on painful motion. 38 C.F.R. §§ 4.59, 4.71a. Furthermore, a finding of separate ratings for limitation of extension of the thigh under Diagnostic Code 5251, or impairment of thigh under Diagnostic Code 5253, are not supported prior to March 28, 2025, because there is no indication that the Veteran's extension is limited to 5 degrees or that the Veteran has limitation of abduction resulting in motion lost beyond 10 degrees or limitation of adduction preventing crossing legs, or a limitation of rotation preventing toe-out more than 15 degrees.

From March 28, 2025, the Veteran meets the criteria for a separate compensable rating under Diagnostic Code 5253 bilaterally because he is unable to cross his legs due to limitation of adduction. Thus, separate evaluations under DCs 5251, 5252, and 5253 are warranted from the date of the examination, because that is when the impairments became factually ascertainable, and, thus, the date entitlement arose. 38 C.F.R. § 3.400.

In conclusion, the Board finds that the evidence is against the claims for entitlement to effective dates earlier than March 28, 2025, for the grants of separate compensable ratings for right and left thigh impairments due to limitation of adduction and limitation of extension of the thigh. See 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102.

L. M. BARNARD

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board M.D. Taylor, 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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