Citation Nr: 18144329 Decision Date: 10/25/18 Archive Date: 10/24/18 DOCKET NO. 16-32 899 DATE: October 25, 2018 REMANDED Entitlement to service connection for left foot disorder, to include as secondary to service-connected achilles tendonitis of the left ankle is remanded. Entitlement to a compensable rating for achilles tendonitis of the left ankle is remanded. REASONS FOR REMAND The Veteran served in the United States Army from November 1977 to June 1983. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a June 2013 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO) in Atlanta, Georgia, which granted the Veteran’s claims for service connection for metatarsalgia of the right foot and bilateral Achilles tendonitis and also denied the Veteran’s claim for service connection for a left foot condition. The Veteran filed a Notice of Disagreement with respect to all of the issues decided in the June 2013 rating decision, but on her July 2016 VA Form 9 Substantive Appeal, the Veteran limited her appeal to the issues reflected above. While the Board sincerely regrets additional delay, the additional development is required before the Veteran’s claims may be adjudicated on the merits. 1. Entitlement to service connection for left foot disorder, to include as secondary to service-connected achilles tendonitis of the left ankle is remanded. 2. Entitlement to a compensable rating for achilles tendonitis of the left ankle is remanded. With respect to the Veteran’s claim for entitlement to service connection for a left foot condition, the Board finds the Veteran’s April 2013 VA examination to be incomplete. Specifically, the examination does not address the Veteran’s documented chronic left foot pain, flat foot deformity and plantar fasciitis. The Veteran has continued VA treatment since April 2013 for her left foot and has received an additional diagnosis of hallux valgus. Additionally, on the Veteran’s July 2016 VA Form 9 Substantive Appeal, the Veteran and her representative assert that the Veteran’s current left foot condition is either caused or aggravated by her service connected left ankle disability. Accordingly, an examination is required to determine the Veteran’s specific left foot diagnoses and whether or not any diagnosed disabilities are directly related to her active duty service, or whether they have been caused or aggravated by her service-connected achilles tendonitis of the left ankle. Barr v. Nicholson, 21 Vet. App. 303 (2007). With respect to the Veteran’s claim for a compensable rating for her service-connected achilles tendonitis of the left ankle, the Board notes that while the Veteran’s claim was pending, two precedential decisions were issued which also require the Veteran’s claim to be remanded. In Correia v. McDonald, 28 Vet. App. 158 (2016), the Court of Appeals for Veterans Claims (the Court) held that in order for an examination to be adequate, it must include joint testing for pain on both active and passive motion, in weight-bearing and nonweight-bearing, and, if possible, with range of motion measurements of the opposite undamaged joint. A review of the Veteran’s last VA examination indicates that a new examination is warranted in light of Correia. The Court’s recent holding in Sharp v. Shulkin, 29 Vet. App. 26 (2017) also requires that the claim be remanded. In Sharp, the Court noted that for a joint examination to be adequate, the examiner “must express an opinion on whether pain could significantly limit” a veteran’s functional ability, and that determination “should, if feasible, be portrayed in terms of the degree of additional range of motion loss due to pain on use or during flare-ups. “Furthermore, the Court stated that the examiner must “obtain information about the severity, frequency, duration, precipitating and alleviating factors, and extent of functional impairment [resulting from flare-ups] from the veterans themselves.” Sharp, 29 Vet. App. at 34. The examiner must also “offer flare opinions based on estimates derived from information procured from relevant sources, including the lay statements of veterans,” and the examiner’s determination “should, if feasible, be portrayed in terms of the degree of additional range-of-motion loss due to pain on use or during flare-ups.” Id. at 10. The Veteran’s April 2013 VA examination indicates that the Veteran suffers from flare-ups of her achilles tendonitis of the left ankle, but provided no further opinion or findings on the extent of functional impairment or additional range of motion loss that results from the flare-ups. See, April 2013 VA examination. The matters are REMANDED for the following action: 1. Obtain any outstanding VA treatment records and associate them with the Veteran’s claims file. 2. Once any outstanding records have been obtained, schedule the Veteran for a VA examination with the appropriate medical personnel to determine the etiology of any diagnosed left foot disability and to determine the current severity of her service-connected achilles tendonitis of the left ankle. The Veteran’s entire claims file, to include a copy of this remand, should be provided to the examiner. Following a complete review of the record, the examiner is asked to provide the following opinions: a. Determine if the Veteran has a current left foot disability. If no disability is found, the examiner is asked to explain why no diagnosis was provided given the Veteran’s previous diagnoses reflected in her VA treatment records. b. For any left foot disability diagnosed, determine whether it is at least as likely as not that the disability is related to the Veteran’s active duty service. c. For any left foot disability diagnosed, determine whether it is at least as likely as not that the disability was either caused or aggravated by the Veteran’s service-connected achilles tendonitis of the left ankle. d. Determine the current severity of the Veteran’s achilles tendonitis of the left ankle. Report the range of motion in degrees. In accordance with Correia, the range of motion should be tested actively and passively, in weight bearing, and after repetitive use. If the examiner is unable to conduct the required testing or concludes that the required testing is not necessary in this case, he or she should clearly explain why this is so. In providing this opinion, the examiner should consider the Veteran’s lay statements regarding her decreased range of motion. The extent of any weakened movement, excess fatigability and incoordination should also be described by the examiner. The examiner should assess the additional functional impairment due to weakened movement, excess fatigability, or incoordination in terms of the degree of additional range of motion loss. The examiner should also express an opinion concerning whether there would be additional functional impairment on repeated use or during flare-ups. The examiner should further assess the additional functional impairment on repeated use or during flare-ups in terms of the degree of additional range of motion loss. The examiner should consider all procurable and assembled data by obtaining all tests and records that might reasonably illuminate the medical analysis. This includes the Veteran’s statements regarding the extent of functional loss during flare-ups. All opinions must be supported by a complete rationale. If the examiner must resort to speculation for any of the requested opinions, an explanation as to why this is so is required. Michael J. Skaltsounis Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD P. Daugherty, Associate Counsel