Citation Nr: 18143595 Decision Date: 10/19/18 Archive Date: 10/19/18 DOCKET NO. 15-21 605 DATE: October 19, 2018 ORDER Entitlement to service connection for a left ankle disability is denied. Entitlement to service connection for a right ankle disability is denied. REMANDED Entitlement to service connection for a left knee disability is remanded. Entitlement to service connection for a right knee disability is remanded. Entitlement to service connection for a left foot disability is remanded. Entitlement to service connection for a right foot disability is remanded. Entitlement to service connection for left lower extremity peripheral neuropathy is remanded. Entitlement to service connection for right lower extremity peripheral neuropathy is remanded. Entitlement to service connection for left lower extremity peripheral vascular disease, to include as secondary to a left knee disability, is remanded. FINDINGS OF FACT 1. The preponderance of the evidence of record is against finding that the Veteran has, or has had at any time during the appeal, a current diagnosis of a left ankle disability. 2. The preponderance of the evidence of record is against finding that the Veteran has, or has had at any time during the appeal, a current diagnosis of a right ankle disability. CONCLUSIONS OF LAW 1. The criteria for service connection for a left ankle disability are not met. 38 U.S.C. §§ 1110, 5107(b); 38 C.F.R. §§ 3.102, 3.303(a). 2. The criteria for service connection for a right ankle disability are not met. 38 U.S.C. §§ 1110, 5107(b); 38 C.F.R. §§ 3.102, 3.303(a). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS Generally, service connection may be granted for a disability or injury incurred in or aggravated by active military service. 38 U.S.C. § 1110; 38 C.F.R. § 3.303. In order to establish service connection for a claimed disability, there must be (1) medical evidence of a current disability; (2) medical, or in certain circumstances, lay evidence of in-service incurrence or aggravation of a disease or injury; and (3) medical evidence of a nexus between the claimed in-service disease or injury and the current disability. Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004). The Veteran seeks service connection for a left and right ankle disability. Having reviewed the record, the Board finds that service connection is not warranted. The first element of service connection, a current diagnosis, has not been met. Medical records do not contain any diagnosis relating to the left or right ankle. July 2013 VA examinations and VA treatment records do not reveal any ankle diagnoses. Additionally, a February 2016 disability benefits questionnaire (DBQ) submitted by the Veteran does not notate any ankle diagnoses. In the absence of proof of a current disability, there can be no valid claim for service connection. Brammer v. Derwinski, 3 Vet. App. 223 (1992); see also Gilpin v. West, 155 F.3d 1353 (Fed. Cir. 1998) (service connection may not be granted unless a current disability exists). Consequently, the claim fails as the evidence does not demonstrate a current disability. The claim for service connection for a left and right ankle disability must be denied. REASONS FOR REMAND Having reviewed the record, the Board finds that remand is warranted for the issues of entitlement to service connection for bilateral knees, bilateral feet, bilateral lower extremity peripheral neuropathy, and left lower extremity peripheral vascular disease. Remand is warranted for a new examination for the bilateral knee and feet claims. The Veteran was afforded an examination in July 2013, wherein an examiner opined that it was less likely than not that the Veteran had a knee or foot condition related to service. The examiner commented that there was no evidence of specific anterior knee pain or patellofemoral knee pain found in service records. However, a review of available service treatment records (STR) indicate that the Veteran received treatment for his knees and feet in July 1968. In light of this, remand is warranted for a new examination to determine the nature and etiology of the claimed knees and feet disabilities. On remand, the examiner should consider all July 1968 STRs discussing the knees and feet, to include a July 30, 1968 record noting crepitus on motion of patella, pain in the midtarsal region, and an impression of possible rheumatoid arthritis. Additionally, as the Veteran reported in the July 30, 1968 STR that he experienced pain in his left foot and left knee 2 to 3 years prior, the examiner should provide an opinion on whether a knee or foot disability preexisted service and/or was aggravated by service. Additionally, remand is warranted for an examination on the bilateral lower extremity peripheral neuropathy and the left lower extremity peripheral vascular disease claims. A February 2016 DBQ notes a history of severe venous insufficiency with pains since 1968. However, the DBQ did not provide a rationale. Accordingly, the Board finds that remand is warranted for an examination to determine the nature and etiology of the claimed peripheral neuropathy and peripheral vascular disabilities. Consideration should be given to the February 2016 DBQ. Finally, any outstanding VA treatment records should be obtained and associated with the claims file. The matters are REMANDED for the following actions: 1. Obtain the Veteran’s VA treatment records for the period from July 2013 to present. 2. Schedule the Veteran for an examination by an appropriate clinician to determine the nature and etiology of any bilateral knee and bilateral feet disabilities. The examiner must provide the following opinions: a) Identify any diagnosis of the bilateral knees and feet. Attention is invited to the July 2014 diagnosis of patellofemoral syndrome and the February 2016 DBQ diagnoses of knee osteoarthritis, knee deformity and “bowl legs,” metatarsalgia, and hammertoes. b) Whether a bilateral knee and/or bilateral feet disability clearly and unmistakably (undebatable) preexisted the Veteran’s service. c) If a bilateral knee and/or bilateral feet disability did clearly and unmistakably preexist service, state whether it was clearly and unmistakably not aggravated by service. d) If the examiner finds that a bilateral knee or bilateral feet disability did not clearly and unmistakably preexist or was aggravated by service, state whether it is at least as likely as not began in or is otherwise related to service, including the July 1968 knee and feet complaints. The examiner should consider all July 1968 STRs discussing treatment of the knee and feet, to include a July 30, 1968 record noting crepitus on motion of patella, pain in the midtarsal region, and an impression of possible rheumatoid arthritis. 3. Schedule the Veteran for an examination by an appropriate clinician to determine the nature and etiology of any bilateral lower extremity peripheral neuropathy and left lower extremity peripheral vascular disability. The examiner must opine whether any bilateral lower extremity peripheral neuropathy and left lower extremity peripheral vascular disability is at least as likely as not related to service. If, and only if, a left knee disability is service-connected, the examiner should also opine whether a left lower extremity peripheral vascular disability is at least as likely as not (1) proximately due to service-connected knee disability, or (2) was aggravated beyond its natural progression by service-connected knee disability. The examiner should consider the February 2016 DBQ notation of the Veteran’s history of severe venous insufficiency with pains since 1968. The phrase ‘clear and unmistakable’ means that which is undebatable and that which cannot be misunderstood or misinterpreted. The phrase ‘at least as likely as not’ means that the weight of the medical evidence both for and against the claim is so evenly divided that it is as medically sound to find in favor of the claim as it is to find against. K. J. ALIBRANDO Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD S. Vang, Associate Counsel