Citation Nr: 18142567 Decision Date: 10/16/18 Archive Date: 10/16/18 DOCKET NO. 16-23 807 DATE: October 16, 2018 ORDER Entitlement to service connection for a bilateral ankle disorder is granted. FINDING OF FACT The evidence is in relative equipoise as to whether the Veteran’s bilateral ankle disorder, diagnosed as left ankle sinus tarsi syndrome, status post arthroscopic subtalar debridement and bossa excision and right ankle small exostosis or calcification in the interosseous membrane, is attributable to in-service left and right ankle injuries. CONCLUSION OF LAW The criteria for service connection for a bilateral ankle disorder, diagnosed as left ankle sinus tarsi syndrome, status post arthroscopic subtalar debridement and bossa excision and right ankle small exostosis or calcification in the interosseous membrane, are met. 38 U.S.C. §§ 1110, 5107(b); 38 C.F.R. §§ 3.102, 3.303(a). REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from July 1992 to October 1992 and from March 1994 to September 1999. The Veteran testified at a Board hearing at the local Regional Office before the undersigned Veterans Law Judge in August 2017. A transcript of the hearing has been associated with the record. Entitlement to service connection for a bilateral ankle disorder The Veteran contends that his bilateral ankle disorder is due to injuries that he suffered to both ankles in service. In the alternative, he has asserted that his bilateral ankle disorder is secondary to his service-connected bilateral knee and foot disabilities. Service connection will be granted if the evidence demonstrates that a current disability resulted from an injury or disease incurred in or aggravated by active service, even if the disability was initially diagnosed after service. 38 U.S.C. § 1110; 38 C.F.R. § 3.303. Service connection may also be established on a secondary basis for a disability which is proximately due to or the result of service-connected disease or injury. 38 C.F.R. § 3.310 (a). Establishing service connection on a secondary basis requires evidence sufficient to show (1) that a current disability exists and (2) that the current disability was either (a) proximately caused by or (b) proximately aggravated by a service-connected disability. Allen v. Brown, 7 Vet. App. 439, 448 (1995) (en banc). The Board concludes that the Veteran has a current diagnosis of left ankle sinus tarsi syndrome, status post arthroscopic subtalar debridement and bossa excision and right ankle small exostosis or calcification in the interosseous membrane. In this regard, the June 2013 VA examination shows such diagnoses. Turning to the question of whether there is a nexus, or link, between the current shown disability and service, the Board finds that the evidence is, at least, in relative equipoise. The Board notes that the Veteran has reported continuing ankle pain since service. Service treatment records document both incidents of right and left ankle pain. In this regard, an October 1994 record documented right ankle pain after the Veteran twisted his ankle the day before. Further, in October 1996, the Veteran presented with left ankle pain and the assessment was possible ankle strain. Likewise, in May 1998, the Veteran was diagnosed with right ankle sprain. Importantly, in a June 2014 opinion, the private examiner found that both the left and right ankle problems were more likely than not related to the trauma in service and was also caused by the severity of the Veteran’s service-connected pes planus. The examiner rationalized that the complaints in service were consistent with the Veteran’s initial presentation when seeking treatment with the examiner. The examiner also indicated that ankle surgery in 2012 was necessary because of the severity of the pes planus and foot deformity that caused reoccurring ankle problems. Likewise, in August 2017, the same examiner opined that the Veteran’s left and right left ankle disabilities were related to trauma experienced in military service. The opinion was based on review of service treatment records, the Veteran’s presentation of pain and the reported twisting injuries. However, in contrast, the June 2013 VA examiner found that the Veteran’s right and left ankle disorders were less likely than not incurred in or caused by ankle pains shown in service. The examiner rationalized that the service treatment records were silent with respect to findings of the current disabilities. He indicated that the problems in service resolved without residuals. The examiner found that the left ankle injury was most like caused by a post-service injury and the right ankle disorder was most likely age related. The Board is thus faced with a conflicting record as to whether the Veteran’s bilateral ankle disorder is related to service. All of the examiners were aware of the Veteran’s medical history and offered rationales for their opinions. Moreover, the Veteran has reported continuing pain since service and denied any post-service ankle injuries. Significantly, the private examiner has also indicated that the Veteran’s service-connected pes planus has contributed to his bilateral ankle disorder. As such, the Board finds that the evidence is at least in equipoise as to whether the Veteran’s bilateral ankle disorder is related to service. In light of the foregoing, the Board is satisfied that the criteria for entitlement to service connection for bilateral ankle disorder, diagnosed as left ankle sinus tarsi syndrome, status post arthroscopic subtalar debridement and bossa excision and right ankle small exostosis or calcification in the interosseous membrane, have been met. The evidence, at a minimum, gives rise to a reasonable doubt on the matter. 38 U.S.C. 5107 (b); 38 C.F.R. § 3.102. L. M. BARNARD Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD J.N. Moats