Citation Nr: 18145414 Decision Date: 10/29/18 Archive Date: 10/29/18 DOCKET NO. 14-08 608 DATE: 1. Entitlement to service connection for bilateral plantar fasciitis (claimed as bilateral foot pain), to include as due to undiagnosed illness. 2. Entitlement to service connection for bilateral pes planus (claimed as bilateral foot pain), to include as due to undiagnosed illness. October 29, 2018 REMANDED Entitlement to service connection for bilateral plantar fasciitis, to include as due to undiagnosed illness, is remanded. Entitlement to service connection for bilateral pes planus, to include as due to undiagnosed illness, is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Marine Corps from September 1983 to July 1991. The Veteran’s DD Form 214 and service personnel records indicate service in Southwest Asia in Operations Desert Shield and Desert Storm. These matters come before the Board of Veterans’ Appeals (Board) on appeal from a May 2011 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO) in Waco, Texas. The Veteran testified before the undersigned Veterans Law Judge (VLJ) at a June 2016 travel Board hearing. A transcript of that hearing has been associated with the record. The Board notes that these matters were last before the Board in February 2017, at which time they were remanded for further development. The Board further notes that service connection for a lumbar strain and a right-hand strain was granted in a July 2017 rating decision. As such, these matters are no longer before the Board. 1. Entitlement to service connection for bilateral plantar fasciitis, to include as due to undiagnosed illness is remanded. The Veteran was afforded a VA foot conditions examination in April 2017. A diagnosis of bilateral plantar fasciitis was noted. The examiner noted that the Veteran’s bilateral foot condition was less likely than not incurred in or caused by his service, with the rationale that his service treatment records do not show any significant evidence of a chronic foot condition. It was noted that his mild to moderate bilateral pes planus more than likely contributed to his plantar fasciitis. The Board notes that the examiner’s rationale was based on the fact that the “do not show any significant evidence of a chronic foot condition” while in service. The Board does not assign any probative value to this inadequate opinion as it fails to take into account the Veteran’s statement at the June 2016 board hearing that he “had foot issues for years while [he] was in the Marine Corps”. See, Dalton v. Nicholson, 21 Vet. App. 23 (2007) (finding that examination was inadequate where the examiner did not comment on the appellant's report of in-service injury and instead relied on the absence of evidence in the service medical records to provide a negative opinion). Furthermore, the Board notes that once VA undertakes the effort to provide an examination when developing a service-connection claim, it must provide an adequate one or, at a minimum, notify the claimant why one will not or cannot be provided. Barr v. Nicholson, 21 Vet. App. 303, 311 (2007). In stating that the Veteran’s “service treatment records do not show any significant evidence of a chronic foot condition”, the VA examiner appears to concede that the Veteran’s service treatment records contain some evidence that the Veteran had a chronic foot condition while in service, but fails to discuss what this ‘insignificant’ evidence is. For the above-stated reasons, the Board remands this matter for a new examination. 2. Entitlement to service connection for bilateral pes planus, to include as due to undiagnosed illness is remanded. The Veteran was afforded a VA foot conditions examination in April 2017. A diagnosis of bilateral, mild pes planus was noted. The examiner noted that the Veteran’s bilateral foot condition was less likely than not incurred in or caused by his service, with the rationale that his service treatment records do not show any significant evidence of a chronic foot condition. The Board notes that the examiner’s rationale was based on the fact that the “do not show any significant evidence of a chronic foot condition” while in service. The Board does not assign any probative value to this inadequate opinion as it fails to take into account the Veteran’s statement at the June 2016 board hearing that he “had foot issues for years while [he] was in the Marine Corps”. See, Dalton v. Nicholson, 21 Vet. App. 23 (2007) (finding that examination was inadequate where the examiner did not comment on the appellant's report of in-service injury and instead relied on the absence of evidence in the service medical records to provide a negative opinion). Furthermore, the Board notes that once VA undertakes the effort to provide an examination when developing a service-connection claim, it must provide an adequate one or, at a minimum, notify the claimant why one will not or cannot be provided. Barr v. Nicholson, 21 Vet. App. 303, 311 (2007). In stating that the Veteran’s “service treatment records do not show any significant evidence of a chronic foot condition”, the VA examiner appears to concede that the Veteran’s service treatment records contain some evidence that the Veteran had a chronic foot condition while in service, but fails to discuss what this ‘insignificant’ evidence is. For the above-stated reasons, the Board remands this matter for a new examination. The matters are REMANDED for the following action: 1. Obtain the Veteran’s VA treatment records for the period from May 2018 to the Present. 2. After, and only after, completion of step one above, schedule the Veteran for an examination by an appropriate clinician to determine the nature and etiology of any bilateral foot disability. The examiner must opine whether bilateral pes planus is at least as likely as not related to an in-service injury, event, or disease. The examiner must opine whether pes planus at least as likely as not (1) began during active service or (2) was noted during service with continuity of the same symptomatology since service. The examiner must opine whether bilateral plantar fasciitis is at least as likely as not related to an in-service injury, event, or disease. The examiner must opine whether plantar fasciitis at least as likely as not (1) began during active service or (2) was noted during service with continuity of the same symptomatology since service. The examiner must opine as to whether diagnosed bilateral plantar fasciitis is at least as likely as not (1) proximately due to pes planus, or (2) aggravated beyond its natural progression by pes planus. The examiner’s attention is invited to a November 1984 service treatment record notes the Veteran reported pain and blisters in both feet after 2 days of running in new shoes. Blisters on the arches of both feet, about the size of a quarter, were noted. The examiner’s attention is invited to the Veteran’s testimony at the June 2016 Board hearing that he “had foot issues for years while [he] was in the Marine Corps”. All opinions provided must be thoroughly explained, and a complete and detailed rationale for any conclusions reached should be provided (a bare conclusory statement will be deemed inadequate). The examiner is reminded that the term “as likely as not” does not mean “within the realm of medical possibility,” but rather that the evidence of record is so evenly divided that, in the examiner’s expert opinion, it is as medically sound to find in favor of the proposition as it is to find against it. It is not sufficient to base an opinion on a mere lack of documentation of complaints in the service or post-service treatment records. 3. After completing the requested actions, and any additional development deemed warranted, readjudicate the claims in light of all pertinent evidence and legal authority. If the benefits sought remain denied, furnish to the Veteran a Supplemental Statement of the Case and afford them the appropriate time period for response before the claims file is returned to the Board for further appellate consideration. Michael Pappas Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD B. P. Keeley, Associate Counsel