Persistence And The

[Berta]

This BVA case caught my eye this AM-

http://www.va.gov/vetapp06/files5/0634966.txt

It looks to me that the VA obtained 5 opinions against the claim-

they narrowed it down to assessing two of these opinions.

Dr. Bash opined for the claim using a different approach-

then he provided an additional expanded opinion which another doctor agreed with-

This claim was initially remanded in 1996-10 years before this decision last year- it also went to COVA and was remanded back to the BVA----

The BVA weighed two of the VA opinions and two of the IMO opinions and granted under Relative equipoise.

WHat I feel is important in this case ( the veteran waited for over 10 years for his proper award)

is that Dr. Bash presented the aspect of the veteran's medications as the nexus to his disability.

"The Board further notes, however, that to establish service

connection for a hip disability, there must be competent

medical evidence linking either AVN or arthritis to service.

In this regard, while there is no evidence that links a

current diagnosis of arthritis to service or a period of one

year after service (in fact, there are two opinions of record

that are against a relationship between existing arthritis of

the hips and service), there are two medical opinions that

opine a relationship between the veteran's AVN and the

veteran's first period of service. More specifically, Dr.

Craig Bash has opined such a relationship based on drugs that

the veteran was prescribed during service and/or the

likelihood that the veteran's left knee pain during service

was associated with a hip/hips disorder."

This is the value of a good IMO- because a IMO doctor is paid to take the time to consider every potential factor that could lead to service connection.

"ORDER

Entitlement to service connection for avascular necrosis of

the hips is granted."