Citation Nr: 18144462 Decision Date: 10/25/18 Archive Date: 10/24/18 DOCKET NO. 14-09 788 DATE: October 25, 2018 ORDER Service connection for tinea pedis of the bilateral feet, is granted. Service connection for onychomycosis of the bilateral feet, is granted. Service connection for fungal paronychia of the bilateral feet, is granted. Service connection for polyneuropathy of the bilateral feet is granted. Service connection for neuralgia of the bilateral feet is granted. Service connection for arthritis of the right foot is granted. FINDINGS OF FACT 1. The evidence is at least in equipoise that the Veteran’s current tinea pedis, onychomycosis, fungal paronychia, polyneuropathy, neuralgia, affecting both feet, is due to frostbite sustained during a period of ACDUTRA. 2. The evidence is at least in equipoise that the Veteran’s current right foot arthritis, is due to frostbite sustained during a period of ACDUTRA. CONCLUSIONS OF LAW 1. The criteria for service connection for tinea pedis of the bilateral feet are met. 38 U.S.C. §§ 1110, 5103, 5103A, 5107 (2012); 38 C.F.R. §§ 3.102, 3.159, 3.303, 3.304 (2018). 2. The criteria for service connection for onychomycosis of the bilateral feet are met. 38 U.S.C. §§ 1110, 5103, 5103A, 5107 (2012); 38 C.F.R. §§ 3.102, 3.159, 3.303, 3.304 (2018). 3. The criteria for service connection for fungal paronychia of the bilateral feet are met. 38 U.S.C. §§ 1110, 5103, 5103A, 5107 (2012); 38 C.F.R. §§ 3.102, 3.159, 3.303, 3.304 (2018). 4. The criteria for service connection for polyneuropathy of the bilateral feet are met. 38 U.S.C. §§ 1110, 5103, 5103A, 5107 (2012); 38 C.F.R. §§ 3.102, 3.159, 3.303, 3.304 (2018). 5. The criteria for service connection for neuralgia of the bilateral feet are met. 38 U.S.C. §§ 1110, 5103, 5103A, 5107 (2012); 38 C.F.R. §§ 3.102, 3.159, 3.303, 3.304 (2018). 6. The criteria for service connection for arthritis of the right foot are met. 38 U.S.C. §§ 1110, 5103, 5103A, 5107 (2012); 38 C.F.R. §§ 3.102, 3.159, 3.303, 3.304 (2018). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran had active service from March 1978 to June 1978 as well as periods of active duty for training (ACDUTRA) and inactive duty for training (INACDUTRA). In October 2016, the Board reopened the Veteran’s claim for service connection for disabilities of the bilateral feet and remanded the appeal for further development. Service Connection Service connection may be granted for a disability resulting from disease or injury incurred in or aggravated by service. 38 U.S.C. § 1110; 38 C.F.R. § 3.303(a). Service connection may also be granted for any disease diagnosed after discharge, when all the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303(d). Direct service connection may not be granted without evidence of (1) a current disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a nexus between the claimed in-service disease or injury and the present disease or injury. 38 U.S.C. § 1112; 38 C.F.R. § 3.304. See Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004). To warrant service connection, a claimed disability must have been incurred in or aggravated by active military service (or be secondary to a service-connected disability). 38 U.S.C. §§ 1110; 38 C.F.R. § 3.303, 3.310. The term “active service” includes active duty, any period of ACDUTRA in which the individual concerned was disabled or died from a disease or injury incurred in line of duty, and any period of INACDUTRA during which the individual concerned was disabled or died from an injury incurred or aggravated in line of duty or from myocardial infarction, cardiac arrest, or cerebrovascular accident which occurred during such training. 38 U.S.C. § 101 (24). The determination as to whether the requirements for service connection are met is based on an analysis of all the evidence of record and the evaluation of its credibility and probative value. 38 U.S.C. § 7104 (a) (2012); Baldwin v. West, 13 Vet. App. 1 (1999); see 38 C.F.R. § 3.303 (a). When there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, the Secretary shall give the benefit of the doubt to the claimant. 38 U.S.C. § 5107; 38 C.F.R. § 3.102; see also Gilbert v. Derwinski, 1 Vet. App. 49, 53 (1990). Entitlement to service connection for bilateral foot disabilities. The Veteran asserts that his current bilateral foot disabilities are due to cold exposure during a two-week period of ACDUTRA in January 1994. For the reasons explained below, the Board agrees. As an initial matter, the Board notes the Veteran has the following current foot disabilities: arthritis in the right foot, documented by November 2005 X-ray, as well as tinea pedis, fungal paronychia, polyneuropathy, neuralgia, onychomycosis affecting both feet. See January 2017 VA examination report. Service records confirm that the Veteran was diagnosed with superficial frostbite due to cold exposure during a two-week period of ACDUTRA in January 1994. See January 1994 service treatment record as well as January 1994 training calendar, confirming his ACDUTRA period. Thus, the question before the Board is whether the Veteran’s current foot disabilities are at least as likely as not related to the cold exposure during the period of ACDUTRA in January 1994. The Board finds that the evidence is at least in equipoise on this point. Weighing in favor of the claim is the January 2017 VA examiner’s report citing the aforementioned current foot disabilities and opining that the Veteran’s current foot disabilities are at least as likely as not related to the cold exposure during service. The examiner explained that the disabilities could be sequela of superficial frostbite, with which the Veteran was diagnosed in January 1994. The Veteran has also provided favorable statements noting that he had no other foot problems prior to the cold exposure. His friend, K.J., also submitted a statement on his behalf in September 2016 reporting that in the six years she had known him, he had constantly had problems with his feet and legs, complained of not being able to sleep at night because of tingling and aching in the feet, and mentioned that he felt numb. She also reported having observed him limping and reporting that he needed prescription shoes because of his toes. Weighing against the claim is the June 2017 VA opinion. Following development which confirmed that the Veteran served during a period of ACDUTRA when he was exposed to cold that resulted in the diagnosis of frostbite, the Agency of Original Jurisdiction (AOJ) sought an addendum opinion from a different VA examiner. The June 2017 VA examiner reviewed the record and determined that it was less likely than not that the Veteran’s current disabilities were due to the cold exposure in service. The examiner reasoned that the superficial frostbite was “self-limiting” and had resolved. Significantly, the examiner did not clearly explain how he reached the conclusion that the frostbite had resolved in light of the Veteran’s ongoing lay assertions of symptomatic feet, or otherwise offer any explanation to reconcile his findings with that of the January 2017 VA examiner’s favorable conclusion that the current disabilities were at least as likely as not sequela of frostbite. After review of the evidence discussed above, the Board finds that the evidence both for and against the Veteran’s claims are at the very least in relative equipoise. Resolving all doubt in the Veteran’s favor, the claims are granted. V. Chiappetta Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD Donna D. Ebaugh, Counsel