Citation Nr: 18143287 Decision Date: 10/18/18 Archive Date: 10/18/18 DOCKET NO. 16-22 698 DATE: October 18, 2018 REMANDED The issue of entitlement to service connection for bilateral pes planus is remanded for additional development. REASONS FOR REMAND The Veteran served on active duty in the Marine Corps from February 1969 to November 1970. This case is before the Board of Veterans’ Appeals (Board) on appeal from a June 2013 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO) in St. Petersburg, Florida. The Veteran is seeking service connection for bilateral pes planus, or flat feet. He contends that his pes planus was either caused by his active duty service or aggravated thereby. The Veteran’s pes planus was noted on his enlistment medical examination as second degree. His service treatment records reflect complaints of foot pain in January and March of 1970, with a one-year history of fallen arches and an impression of pes planus. The Veteran was advised to wear arch support. His separation medical examination noted pes planus, not considered disqualifying. Veterans are normally presumed to be in sound physical and psychological condition upon entrance into service. However, this presumption only attaches “where there has been an induction examination in which the later-complained-of disability was not detected.” Crowe v. Brown, 7 Vet. App. 238, 245 (1994). Where, as here, a pre-existing condition is noted on the induction examination, the Veteran may bring a claim for aggravation of that condition. If the evidence indicates that the claimed disability increased during service, it will be presumed that it was aggravated by service. 38 U.S.C. § 1153; 38 C.F.R. § 3.306(a); see also Falzone v. Brown, 8 Vet. App. 398, 404-405 (1995) (finding that if in-service symptoms indicate an increase in the severity of the claimed disability, the presumption of aggravation attaches). The Veteran has been afforded two VA examinations during the claim period. Following a May 2013 VA examination, the examiner opined that the Veteran’s pes planus was neither caused nor aggravated by service. Regarding the question of aggravation, the examiner observed that the Veteran’s separation examination indicated that his pes planus was “not considered disqualifying.” The examiner concluded that the Veteran’s pes planus had temporarily worsened with increased in-service activity, but had resumed being asymptomatic with the cessation of these activities by the time of his separation examination. A November 2017 VA examination did not include a medical nexus opinion. Both VA examinations diagnosed pes planus, but indicated that the condition was asymptomatic. In contrast, VA treatment records in June 2016 and August 2017 note complaints of left and bilateral foot pain, respectively. In addition, a September 2017 letter from a private physician states “[the Veteran] started to have bilateral arch and foot pain since 1971.” These records indicate both that the Veteran’s disability is currently symptomatic and that he has experienced these symptoms from the time of his separation from service. Because the May 2013 VA examination did not address either of these pieces of evidence, the Board finds that the medical evidence of record is insufficient to adjudicate the claim. Therefore, a remand is necessary for a new VA examination and opinion, to take into account the Veteran’s current symptoms and his statements alleging continuity of symptomatology since service. The matter is REMANDED for the following action: 1. Obtain any outstanding VA treatment records and associate them with the claims file. 2. After completing the development outlined in item 1, schedule the Veteran for a VA examination and opinion regarding his claim for service connection for bilateral pes planus. Upon full review of the claims file, including the Veteran’s current symptoms and his statements alleging continuity of symptomatology since service, and physical examination of the Veteran, the examiner should respond to the following: (a.) Is it at least as likely as not (50 percent probability or more) that the Veteran’s bilateral pes planus increased in severity during his active duty service? (Continued on the next page)   The examiner must provide a fully articulated medical rational for the opinion, citing to peer-reviewed medical literature referenced in formulating it, if any. If the examiner finds that an opinion cannot be provided, this conclusion should also be clearly explained (e.g. lack of sufficient information/evidence in this case, or a lack of knowledge among the medical community at large, and not the insufficient knowledge of the individual examiner). S. C. KREMBS Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD P. Timmerman, Associate Counsel