Entitlement to a rating in excess of 30 percent for right hip avascular necrosis, status post right total hip arthoplasty and revision, right hip greater trochanteric bursitis for the appeal period prior to December 9,…

Citation Nr: 26001397 Decision Date: 01/30/26 Archive Date: 01/30/26 DOCKET NO. 20-02 094 DATE: January 30, 2026 REMANDED Entitlement to a rating in excess of 30 percent for right hip avascular necrosis, status post right total hip arthoplasty and revision, right hip greater trochanteric bursitis for the appeal period prior to December 9, 2020 is remanded. Entitlement to special monthly compensation under 38 U.S.C. § 1114(s) is remanded. REASONS FOR REMAND The Veteran served on active duty from August 1986 to January 1993. These matters come to the Board of Veterans' Appeals (Board) on appeal from a January 2018 rating decision issued by the Department of Veterans Affairs (VA) Regional Office (RO), agency of original jurisdiction (AOJ). In September 2023, the Board issued a decision denying entitlement to a compensable rating for scar, residual of status post right hip arthroplasty, denying an increased rating for right hip avascular necrosis, status post right total hip arthroplasty and revision and right hip greater trochanteric bursitis (right hip disability), rated as 30 percent disabling prior to December 9, 2020, and 70 percent thereafter, and denying a special monthly compensation under 38 U.S.C. §1114(s). The Veteran subsequently appealed the Board's September 2023 decision to the United States Court of Appeals for Veterans Claims (Court). In a July 2024 Order, the Court granted a Joint Motion for Partial Remand of the parties that vacated and remanded the Board's September 2023 decision as to the issues of entitlement to a rating in excess of 30 percent for right hip avascular necrosis for the appeal period prior to December 9, 2020 as well as entitlement to special monthly compensation. The Veteran did not challenge the Board's denial of entitlement to a compensable rating for a scar, residual of status post right hip arthroplasty or a rating higher than 70 percent for right hip avascular necrosis since December 9, 2020; and these decisions are final. In December 2024, the Board issued a decision denying entitlement to an increased rating for right hip avascular necrosis, status post right total hip arthroplasty and revision and right hip greater trochanteric bursitis (right hip disability), rated as 30 percent disabling prior to December 9, 2020, and a special monthly compensation under 38 U.S.C. §1114(s). The Veteran subsequently appealed the Board's December 2024 decision to the Court. In an August 2025 Order, the Court granted a Joint Motion for Remand of the parties that vacated and remanded the Board's December 2024 decision as to the issues of entitlement to a rating in excess of 30 percent for right hip avascular necrosis for the appeal period prior to December 9, 2020 as well as entitlement to special monthly compensation. The matters now return to the Board for adjudication. An August 2025 letter to the Veteran informed him that the Court had issued a decision that remanded (sent back) his case to the Board for readjudication and the issuance of a new decision. The September 2025 letter further indicated that the Board would wait to make a decision on his appeal for 90 days from the date of the letter to provide the Veteran with the opportunity to submit additional argument and/or evidence in support of his appeal or to request a hearing before a Veterans Law Judge. This time period has expired and the Board will therefore proceed with its adjudication. 1. Entitlement to a rating in excess of 30 percent for right hip avascular necrosis, status post right total hip arthoplasty and revision, right hip greater trochanteric bursitis for the appeal period prior to December 9, 2020 is remanded. The parties in the August 2025 Joint Motion for Remand agreed that the Board did not adequately discuss whether the Veteran's use of Lortab, Soma, Naprosyn, a transcutaneous electrical nerve stimulation (TENS) Unit, Norco, Naproxen, and a Lidocaine cream provided any relief for the Veteran's right hip disability, and/or discount any beneficial effects of the Veteran's use of medication and a TENS Unit. Specifically, the parties agreed that the Board did not adequately address whether the Veteran's use of medication and a TENS Unit lessened the severity of his right hip disability and, if so, whether it may be evaluated as more severe under the relevant diagnostic codes without the use of that medication or without consideration of its ameliorative effects. In Jones v. Shinseki, the Court held that the Board may not consider the ameliorative effects of medication when assigning a disability evaluation when those effects are not explicitly contemplated by the rating criteria. 26 Vet. App. 56, 61 (2012). Recently, in Ingram v. Collins, the Court reaffirmed its central holding in Jones and held that the Board must discount the beneficial effects of medication when assigning a rating for a musculoskeletal disability because the applicable diagnostic codes and regulations pertaining to musculoskeletal disabilities do not explicitly contemplate medication use. 38 Vet. App. 130 (2025). The Board observes that there is evidence during the period on appeal that the Veteran treated his right hip disorder. Indeed, during November 2015 VA examination, the Veteran reports that pain medication brings pain down from 7-8/10 to 2-3/10. Further, on November 2019 VA examination, the Veteran indicates that Norco, Naproxen, and Lidocaine cream are helpful in relieving his pain. Although the examination reports document the Veteran's statements, the reports do not comply with Jones v. Shinseki, which was recently reaffirmed in Ingram v. Collins, in assessing the severity of the Veteran's right hip condition. The Board notes that the Veteran's right hip condition is evaluated under Diagnostic Code 5054. This diagnostic code does not explicitly contemplate the use of medication to alleviate symptoms. Neither VA examiners indicate whether their findings as to the severity of the Veteran's right hip condition, including the range of motion measurements provided, accounted for the effects of medication. The Board is prohibited from making medical findings as to the severity of the Veteran's right hip condition without the use of medication. See Colvin v. Derwinski, 1 Vet. App. 171, 174 (1991). As such, the information is insufficient to allow the Board to make an informed decision as to the severity of the Veteran's right hip condition during the period on appeal. Accordingly, remand is warranted to obtain a retrospective medical opinion concerning the severity of the Veteran's right hip condition, without considering the ameliorative effects of medication, throughout the period on appeal. 2. Entitlement to special monthly compensation under 38 U.S.C. § 1114(s) is remanded. The issue of entitlement to special monthly compensation under 38 U.S.C. § 1114(s) is inextricably intertwined with the issue of an increased rating for right hip disorder, which is remanded herein. Harris v. Derwinski, 2 Vet. App. 180, 183 (1991). The matters are REMANDED for the following action: Obtain a retrospective opinion from an appropriately qualified clinician to determine what the severity of the Veteran's right hip disorder would be over the review period (from December 2008 to December 9, 2020) without the ameliorative effects of medications, pursuant to the Court's holdings in Jones v. Shinseki, 26 Vet. App. 56, 61 (2012) and Ingram v. Collins 38 Vet. App. 130 (2025). The record, to include a copy of this Remand, must be made available to and be reviewed by the examiner. All indicated testing should be accomplished and all symptomatology associated with the disability should be identified. The need for a physical examination is left to the discretion of the VA examiner. The clinician is asked to quantify the extent to which the Veteran's use of pain medication ameliorates the functional impairment of his right hip disorder to include limitation of flexion, limitation of abduction, limitation of extension, limitation of adduction and limitation of rotation. If possible, please estimate this in terms of degrees of range of motion. If any of the above is not feasible, the clinician must provide a detailed explanation and rationale for why this could not be accomplished. Specifically, if the clinician cannot provide an opinion without resorting to mere speculation, he or he must provide a complete explanation for why an opinion cannot be rendered. The medical opinion must support the conclusions reached with an analysis that is adequate to consider and weigh against other evidence of record; medical opinions must contain not only clear conclusions with supporting data, but also a reasoned medical explanation connecting the two. If an opinion cannot be expressed without resort to speculation, ensure that the clinician so indicates and discusses why an opinion is not possible, to include whether there is additional evidence that could enable an opinion to be provided, or whether the inability to provide the opinion is based on the limits of medical knowledge. KRISTY L. ZADORA Veterans Law Judge Board of Veterans' Appeals Attorney for the Board M. McPhaull, 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.