Citation Nr: 18141362 Decision Date: 10/10/18 Archive Date: 10/10/18 DOCKET NO. 16-19 423 DATE: October 10, 2018 REMANDED Entitlement to service connection for a right ankle disorder. Entitlement to service connection for a right Achilles tendon disorder. Entitlement to service connection for a left fifth toe disorder. Entitlement to service connection for a low back disorder. REASONS FOR REMAND The Veteran served on active duty from March 1996 to March 2000. This matter is before the Board of Veterans’ Appeals (Board) on appeal from a May 2013 rating decision issued by the Department of Veterans Affairs (VA) Regional Office (RO). The claims must be remanded for a VA examination. VA’s duty to assist includes providing a medical examination when is necessary to make a decision on a claim. 38 U.S.C. § 5103A(d); 38 C.F.R. § 3.159(c)(4). Such development is necessary if the information and evidence of record does not contain sufficient competent medical evidence to decide the claim, but (1) contains competent evidence of diagnosed disability or symptoms of disability, (2) establishes that the veteran suffered an event, injury or disease in service, or has a presumptive disease during the pertinent presumptive period, and (3) indicates that the claimed disability may be associated with the in-service event, injury, or disease, or with another service-connected disability. 38 C.F.R. § 3.159(c)(4) (2017); McLendon v. Nicholson, 20 Vet. App. 79, 83-86 (2006) (noting that the third element establishes a low threshold and requires only that the evidence “indicates” that there “may” be a nexus between the current disability or symptoms and active service, including credible lay evidence of continuity of symptomatology). The Veteran asserts that she has a current right ankle disorder, right achilles tendon disorder, and a left fifth big toe disorder related service. She also claims that she has a low back gait disorder secondary to her right ankle problems. The Veteran reported in her substantive appeal that her right ankle pain, right ankle tendon pain, and left fifth toe pain continued after service. A May 2010 private medical record noted left fifth toe symptoms and a right Achilles tendon disorder. A June 2009 VA medical record indicates that the Veteran has sought treatment for complaints of right ankle pain. Service treatment records (STRs) show that the Veteran sprained her right ankle in September 1996, and a December 1997 STR shows that the Veteran complained of left fifth toe pain resulting from bumping into a chair. Based on the foregoing, the Board finds that remand is required to obtain a medical examination and opinion that addresses the medical matters raised by this appeal. The matters are REMANDED for the following action: 1. Contact the appropriate VA Medical Center and obtain and associate with the claims file all outstanding records of treatment on and after June 14, 2013. If any requested records are not available, or the search for any such records otherwise yields negative results, that fact must clearly be documented in the claims file. Efforts to obtain these records must continue until it is determined that they do not exist or that further attempts to obtain them would be futile. The non-existence or unavailability of such records must be verified and this should be documented for the record. Required notice must be provided to the Veteran and the representative. 2. Contact the Veteran and afford her the opportunity to identify by name, address and dates of treatment or examination any relevant medical records. Subsequently, and after securing the proper authorizations where necessary, make arrangements to obtain all the records of treatment or examination from all the sources listed by the Veteran which are not already on file. All information obtained must be made part of the file. All attempts to secure this evidence must be documented in the claims file, and if, after making reasonable efforts to obtain named records, they are not able to be secured, provide the required notice and opportunity to respond to the Veteran and the representative. 3. After any additional records are associated with the claims file, provide the Veteran with the appropriate examination to determine the etiology of the claimed right ankle disorder, right Achilles tendon disorder, and left fifth toe disorder. The claims file must be made available to and reviewed by the examiner. Any indicated tests and studies must be accomplished and all clinical findings must be reported in detail and correlated to a specific diagnosis. An explanation for all opinions expressed must be provided. The examiner must provide an opinion as to whether it is at least as likely as not (50 percent or greater) that each currently diagnosed right ankle disorder, right Achilles tendon disorder, and left fifth toe disorder had its onset in service or within one year of service discharge, or is etiologically related to the Veteran’s active service. The examiner must address the Veteran’s lay statements regarding in-service symptoms and symptoms thereafter, including in the July 2013 NOD, and the service treatment records. If the examiner determines that a right ankle disorder is related to service, the examiner must provide an opinion as to whether it is at least as likely as not (50 percent or greater) that any currently diagnosed low back disorder was caused or aggravated by the right ankle disorder. 4. Notify the Veteran that it is her responsibility to report for any scheduled examination and to cooperate in the development of the claims, and that the consequences for failure to report for a VA examination without good cause may include denial of the claims. 38 C.F.R. §§ 3.158, 3.655 (2018). In the event that the Veteran does not report for any scheduled examination, documentation must be obtained which shows that notice scheduling the examination was sent to the last known address. It must also be indicated whether any notice that was sent was returned as undeliverable. K. MILLIKAN Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD David Nelson