Citation Nr: 1102602 Decision Date: 01/21/11 Archive Date: 01/26/11 DOCKET NO. 40-42 118 ) DATE ) ) On appeal from the Department of Veterans Affairs Regional Office in Cleveland, Ohio THE ISSUE 1. Entitlement to an increased rating for a left foot disability to include residuals of left foot bunionectomy, currently evaluated as 10 percent disabling. 2. Entitlement to an increased rating for a right foot disability to include residuals of right foot bunionectomy and calcaneal spur. REPRESENTATION Appellant represented by: Disabled American Veterans ATTORNEY FOR THE BOARD J. Barone, Counsel INTRODUCTION The Veteran had active service from July 1985 to May 1986. She also had various periods of active duty for training (ACDUTRA) and inactive duty for training (INACDUTRA) from 1987 to 1997. This matter came before the Board of Veterans' Appeals (Board) from a rating decision of the Department of Veterans Affairs (VA) Regional Office (RO) in Cleveland, Ohio. The appeal is REMANDED to the RO via the Appeals Management Center (AMC), in Washington, DC. VA will notify the appellant if further action is required. REMAND In March 2009 the Board reopened claims of entitlement to service connection to include that for bilateral disabilities of the feet and legs (aside from residuals of bilateral bunionectomies and a right calcaneal spur) and granted service connection for bilateral foot disabilities to include bilateral chronic tendonitis and bilateral plantar fasciitis. It noted that the evaluation of residuals of bunionectomies and right calcaneal spur were inextricably intertwined with the initial evaluation to be assigned by the agency of original jurisdiction (AOJ) to the other bilateral foot conditions. The Board indicated that the evaluation of the evaluation of the Veteran's residuals of bilateral bunionectomies and a right calcaneal spur must be deferred pending an initial rating determination for the newly service-connected disabilities. On remand, the AOJ granted service connection for bilateral chronic tendonitis and plantar fasciitis, granting a 10 percent evaluation for each foot. It also continued the 10 percent evaluations in place for separate foot disabilities to include residuals of bunionectomy. Notably, no development specifically referable to the Veteran's foot disabilities was conducted. The Board observes that the Veteran has not been afforded a VA foot examination since January 2005. As noted, the Veteran has a lengthy and significant history of bilateral foot complaints and treatment. Since the 2005 examination, the records show the Veteran's continued problems and complaints referable to her bilateral foot disability. The Board acknowledges that its March 2009 grant of service connection for bilateral foot disabilities to include bilateral chronic tendonitis and bilateral plantar fasciitis significantly complicates the proper evaluation of the disabilities at issue. Accordingly, it finds that the most appropriate course is to order a current VA examination to determine the manifestations and severity of the Veteran's foot disabilities. In light of the above discussion, the Board finds that additional development of the record is required. Accordingly, the case is REMANDED for the following action: 1. Schedule the Veteran for a VA examination to determine the severity of the service- connected bilateral bunionectomy with chronic foot pain. Any and all studies, tests and evaluations deemed necessary by the examiner should be performed. The examiner should elicit a complete history, the pertinent details of which should be included in the examination report. The examiner should be advised that in addition to bunionectomy residuals with chronic foot pain, evaluated pursuant to 38 C.F.R. § 4.71a, Diagnostic Code 5284, for other foot injuries, the Veteran is also in receipt of service-connection for chronic tendonitis and plantar fasciitis, evaluated pursuant to Diagnostic Code 5024, for tenosynovitis (based on limitation of motion). It should be noted that the evaluation for chronic tendonitis and plantar fasciitis is not currently on appeal. As such, the examiner should be requested to specifically identify the manifestations of the Veteran's bilateral bunionectomy residuals with chronic foot pain as separate and distinct from the other service-connected foot disability to the extent possible. Following examination of the Veteran and review of the claims file, the examiner should identify all currently present manifestations of bunionectomy and chronic foot pain. The examiner should specifically indicate whether associated foot disability is moderate, moderately severe, or severe. The examiner should identify any objective evidence of pain and assess the extent of any pain. The extent of any incoordination, weakened movement and excess fatigability on use should be described. To the extent possible, the functional impairment due to incoordination, weakened movement and excess fatigability should be assessed in terms of additional degrees of limitation of motion. Stated differently, the examiner should indicate the point at which pain or any other factor limits motion. A discussion of the complete rationale for all opinions expressed should be included in the examination report. 2. The Veteran is hereby notified that it is her responsibility to report for any examination, and to cooperate in the development of the claim. The consequences for failure to report for a VA examination without good cause may include denial of the claim. 38 C.F.R. §§ 3.158, 3.655. 4. Then, readjudicate the Veteran's claim, with application of all appropriate laws, regulations, and case law, and consideration of any additional information obtained as a result of this remand. If the decision remains adverse to the Veteran, she and her representative should be furnished a supplemental statement of the case and afforded an appropriate period of time within which to respond thereto. The appellant has the right to submit additional evidence and argument on the matter or matters the Board has remanded. Kutscherousky v. West, 12 Vet. App. 369 (1999). This claim must be afforded expeditious treatment. The law requires that all claims that are remanded by the Board of Veterans' Appeals or by the United States Court of Appeals for Veterans Claims for additional development or other appropriate action must be handled in an expeditious manner. See 38 U.S.C.A. §§ 5109B, 7112 (West Supp. 2010). _________________________________________________ MICHAEL LANE Veterans Law Judge, Board of Veterans' Appeals Under 38 U.S.C.A. § 7252 (West 2002), only a decision of the Board of Veterans' Appeals is appealable to the United States Court of Appeals for Veterans Claims. This remand is in the nature of a preliminary order and does not constitute a decision of the Board on the merits of your appeal. 38 C.F.R. § 20.1100(b) (2010).