Femoroacetabular Impingement
Load-bearing, training overuse, and post-traumatic mechanisms driving femoroacetabular impingement and hip osteoarthritis in service members.
38 CFR diagnostic codes 5250, 5251, 5252, 5253, 5254, 5255
Peer-reviewed evidence (5)
The verified studies behind a Femoroacetabular Impingement claim — each links to its real PubMed or DOI record. These are sources our nexus drafts can draw from; none are invented.
- Cameron KL, Driban JB, Svoboda SJ. Osteoarthritis and the Tactical Athlete: A Systematic Review. J Athl Train. 2016;51(11):952-961. PMID:27115044. doi:10.4085/1062-6050-51.5.03.
- Jorgensen AY, Waterman BR, Hsiao MS, Belmont PJ. Functional outcomes of hip arthroplasty in active duty military service members. J Surg Orthop Adv. 2013;22(1):16-22. PMID:23449050. doi:10.3113/jsoa.2013.0016.
- Thomas DD, Bernhardson AS, Bernstein E, Dewing CB. Hip Arthroscopy for Femoroacetabular Impingement in a Military Population. Am J Sports Med. 2017;45(14):3298-3304. PMID:28937803. doi:10.1177/0363546517726984.
- Jochimsen KN, Jacobs CA, Duncan ST. Femoroacetabular impingement is more common in military veterans with end-stage hip osteoarthritis than civilian patients: a retrospective case control study. Mil Med Res. 2019;6(1):27. PMID:31439033. doi:10.1186/s40779-019-0218-5.
- Hillery BL, Goldman AH, Velosky AG, Amoako MY, Leggit JC, Highland KB. Time to Total Hip Arthroplasty Among Patients in the US Military Health System. JAMA Netw Open. 2025;8(10):e2539971. PMID:41148135. doi:10.1001/jamanetworkopen.2025.39971.
Controlling law
The CFR sections and cases the theories relevant to this condition rest on — the legal standard raters evaluate against, never a prediction about any claim.
Direct (§ 3.303)
Regulation
38 C.F.R. § 3.303
Direct service connection — a current disability linked to service. (Continuity of symptomatology under § 3.303(b) is limited by case law to the § 3.309(a) chronic diseases — Walker.)
Case law
Shedden v. Principi, 381 F.3d 1163 (Fed. Cir. 2004)
The three-element test: current disability, in-service event, and a nexus between them.
Holton v. Shinseki, 557 F.3d 1363 (Fed. Cir. 2009)
Federal Circuit restatement of the same three direct-service-connection elements.
Caluza v. Brown, 7 Vet. App. 498 (1995)
The evidentiary framework a rater weighs each element against.
Walker v. Shinseki, 708 F.3d 1331 (Fed. Cir. 2013)
Continuity of symptomatology (§ 3.303(b)) is available ONLY for a chronic disease listed in § 3.309(a); any other condition must use the medical-nexus pathway.
Davidson v. Shinseki, 581 F.3d 1313 (Fed. Cir. 2009)
A categorical 'a medical opinion is always required for nexus' is legal error — competent lay evidence can suffice.
Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007); Layno v. Brown, 6 Vet. App. 465 (1994)
A veteran is competent to report symptoms they personally observe (Layno), and lay evidence can even establish a simple diagnosis in the right case (Jandreau).
McLendon v. Nicholson, 20 Vet. App. 79 (2006)
A LOW threshold — evidence that merely indicates a nexus MAY exist obligates VA to provide a C&P exam.
38 U.S.C. § 5107(b); Gilbert v. Derwinski, 1 Vet. App. 49 (1990)
When the evidence is in relative equipoise, the tie goes to the veteran — the preponderance must be AGAINST the claim to deny it.
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