Citation Nr: 18140311 Decision Date: 10/02/18 Archive Date: 10/02/18 DOCKET NO. 16-33 190 DATE: October 2, 2018 REMANDED Entitlement to service connection for a right ankle disability is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Air Force from October 2002 to September 2006. Entitlement to service connection for a right ankle disability remanded. In this case, the Board finds that there are conflicting medical opinions as to the nature and etiology of the Veteran's current claimed right ankle condition; and therefore, requires a supplemental opinion to reconcile the conflicting medical opinions. The Veteran was afforded a VA examination in November 2013. At the time, the Veteran reported pain in his ankle when walking long distances, exercising, and during strenuous activity. The examiner indicated that the Veteran had previously received a diagnosis of a chronic right ankle sprain with a partial tear of the anterior talofibular ligament. The examiner then indicated that the Veteran did not have a current diagnosis of any right ankle condition, and opined that his current right ankle complaints were less likely than not related to his active duty service. The examiner cited the Veteran’s complaints and treatment for right ankle pain in service in December 2002 and January 2003, but noted that his separation examination was silent as to any right ankle condition. See VA Examination, dated November 18, 2013. The Veteran also submitted a March 2014 letter and medical records from his private podiatrist, Dr. S. The medical records showed a diagnosis for a partial tear of the right anterior talofibular ligament and noted recurrent ankle pain. The letter indicates that Dr. S. had treated the Veteran for his right ankle since 2011. Dr. S. cited the Veteran’s treatment during service for his right ankle, and indicated that the he currently suffered from throbbing pain along the lateral aspect of his right ankle. Dr. S. opined that the description of his pain sounded consistent with his presenting pain in 2002, and further indicated that his right ankle condition in service never truly resolved. See Medical Treatment Record – Non-Government Facility, dated June 21, 2016. The November 2013 and March 2014 medical opinions are conflicting as to whether the Veteran has a current diagnosis of a right ankle disability. Additionally, while both opinions note that the Veteran currently suffers from right ankle pain, the opinions are also conflicting as to whether the pain or any current claimed right ankle condition is related to his active service. Moreover, it is not entirely clear what the rationale is for the November 2013 VA examiner’s negative nexus opinion. Inadequate medical examinations include examinations that contain only data and conclusions, do not provide an etiological opinion, are not based upon a review of medical records, or provide unsupported conclusions. Nieves- Rodriguez v. Peake, 22 Vet. App. 295, 304 (2008); Stefl v. Nicholson, 21 Vet. App. 120, 124 (2007). Accordingly, the Veteran should be afforded a new VA examination to determine the nature and etiology of any right ankle condition. Additionally, the Board also notes the recent holding in Saunders v. Wilkie, which stated that where pain causes functional impairment, a disability for VA compensation purposes exists, even if there is no underlying diagnosis. Saunders v. Wilkie, No. 17-1466, 2018 U.S. App. LEXIS 8467 (Fed. Cir. Apr. 3, 2018). In sum, pain alone resulting in functional impairment is in fact a disability, and should not be summarily discounted as a bar to benefits based on a finding of no current diagnosis. Thus, on remand, should the examiner find that the Veteran does not have a current diagnosis of a right ankle condition, the opinion should then address whether the Veteran's right ankle pain results in functional impairment that affects his earning capacity. The matter is REMANDED for the following action: 1. Schedule the Veteran for an examination by a qualified VA medical professional to determine the nature and etiology of any right ankle conditions, to include, but not limited to, tear of the right anterior talofibular ligament and chronic right ankle sprain. The examiner should address the following questions: a.) Is it at least as likely as not (a 50 percent probability or more) that any right ankle condition is related to an in-service injury, event, or disease, including the Veteran’s December 2002 and January 2003 treatments for right ankle pain in service? (Continued on the next page)   b.) If there is no diagnosed disability, is it at least as likely as not (a 50 percent probability or more) that any pain of the right ankle reaches the level of a functional impairment of earning capacity? Why or why not? Describe the impairment caused. BISWAJIT CHATTERJEE Acting Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD A. Marsh II, Associate Counsel