11-20 487
11-20 487
| Board of Vet. App. | Aug 31, 2017Background
- Veteran served on active duty May 1978–June 1992 and appealed a March 2011 RO denial; Board remanded multiple times and held a Travel Board hearing in June 2013.
- Claim: service connection for a left hip labral tear, alternatively as secondary to service‑connected low back strain and/or left knee retropatellar (patellofemoral) pain syndrome.
- Earliest medical evidence of a diagnosed left hip labral tear appears in private records in December 2010 (reported work injury with a "pop"); the Veteran had left hip arthroscopy in March 2011.
- Service treatment records contain no diagnosis or treatment for a left hip condition and no evidence of a hip disability within one year after separation.
- Multiple VA examinations and addendum opinions (2011, 2014, 2015, 2017) evaluated causation and aggravation; VA examiners consistently concluded the labral tear was not caused or aggravated by service or by the service‑connected conditions.
- Private physician offered opinions that the hip could relate to service or to the Veteran’s other conditions, but those opinions lacked rationale or did not review service records; Board gave more probative weight to VA examiners.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Service connection for left hip labral tear | Veteran: hip injury began in service or is secondary to service‑connected low back/knee conditions (overcompensation) | VA: no in‑service hip diagnosis, gap of decades before diagnosis; VA medical opinions find no causal nexus or aggravation | Denied — preponderance of evidence against service connection |
| Secondary service connection (aggravation) by service‑connected low back strain/left knee | Veteran: overcompensating for back/knee caused or worsened hip | VA: no objective gait alteration or documentation showing chronic aggravation; literature and exams don't support causation | Denied — insufficient evidence of aggravation |
| Adequacy of VA development/examinations | Veteran: requested further development/remand (claimed prior remand issues) | VA/Board: duty to notify and assist satisfied; multiple adequate exams and addenda; substantial compliance with remands | Board found duty to assist satisfied; examinations/opinions adequate |
| Weight of lay/private opinions vs. VA examiners | Veteran/private physician: history supports in‑service injury or secondary causation | VA: private opinions lack adequate rationale or review of records; lay testimony not competent for medical etiology | Board afforded greater weight to VA examiners and found private/lay opinions not persuasive |
Key Cases Cited
- Davidson v. Shinseki, 581 F.3d 1313 (Fed. Cir. 2009) (elements for service connection include current disability, in‑service event, and nexus)
- Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007) (scope of competent lay evidence regarding observable symptoms)
- Barr v. Nicholson, 21 Vet. App. 303 (Vet. App. 2007) (requirements for adequacy of VA medical examinations/opinions)
- Buchanan v. Nicholson, 451 F.3d 1331 (Fed. Cir. 2006) (assessment of competence and credibility of veteran testimony)
- Gilbert v. Derwinski, 1 Vet. App. 49 (Vet. App. 1990) (benefit‑of‑the‑doubt rule and preponderance standard)