Citation Nr: 18145751
Decision Date: 10/30/18	Archive Date: 10/30/18

DOCKET NO. 15-06 531
DATE:	October 30, 2018
REMANDED ISSUES
The Veteran served in the Army from August 1997 to January 1998; and from April 1998 to October 2002.
1. Entitlement to a rating greater than 20 percent for right foot hallux valgus with bunion, post-operative, with surgical scar is remanded.
2. Entitlement to a rating greater than 10 percent for a left foot bunion is remanded.
The Veteran is seeking an increased rating for her service-connected bilateral foot bunion disabilities. The Veteran was most recently afforded a VA examination in January 2015, almost fours year ago.  While the examination mostly complies with the requirements in Correia v. McDonald, 28 Vet. App. 158 (2016), the examination does not address the impact of the flare-ups of pain in her bilateral feet in the rating of her disabilities.  Specifically, the Veteran states that she has flares of pain where she cannot put weight on her feet and has to sit down.
Further, although the Veteran has been awarded a 20 percent rating for moderately-severe symptomology for her right foot and a 10 percent rating for moderate symptomology for her left foot under 38 C.F.R. § 4.71a, Diagnostic Code 5284, the examiner failed to give an explanation as to why the Veteran’s symptomology resulted in “mild to moderate symptomology” despite her functional limitations.  The examiner noted a right-sided neuroma and metatarsalgia, right-sided decreased movement and incoordination, and bilateral excess fatigability, pain on movement, pain on weight-bearing and non-weight-bearing, deformity, instability of station, disturbance of locomotion, and interference with standing.  In addition, the Veteran has complained of complications from her neuroma and the examiner should determine if a separate neurological examination is required. 
While a new examination is not required simply because of the time which has passed since the last examination, VA’s General Counsel has indicated that a new examination is appropriate when there is evidence of an increase in severity since the last examination. VAOPGCPREC 11-95 (1995).   The Veteran complains that the scars in her right foot are symptomatic and her condition has, in general, worsened.  In light of the above, the Board finds that a new VA examination is necessary to determine the current severity of the Veteran’s right foot disability. See Snuffer v. Gober, 10 Vet. App. 400 (1997); Caffrey v. Brown, 6 Vet. App. 377 (1994); VAOPGCPREC 11-95 (1995).
Lastly, the Veteran receives continuing treatment for her service-connected disabilities at the VA. The most recent records associated with the claims file are from October 2011.  The Veteran has since moved to Virginia and in light of the need to remand, these records should be associated with the Veteran’s file.  
The matters are REMANDED for the following action:
1. Obtain VA treatment records from October 2011 to the present.
2. The Veteran should be afforded an appropriate examination to determine the current nature and severity of her bilateral foot conditions.  The examiner should specifically note (a) the current symptoms of each foot, (b) the level of such symptomology (mild, moderate, moderately-severe, or severe), (c) the reasoning behind such a rating, and (d) why a higher rating is not warranted.  Further, the examiner should note whether the Veteran’s post-surgery neuroma and scars warrant a separate examination. 
(Continued on the next page)
 
3. Readjudicate the appeal.
 
R. FEINBERG
Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD	I. M. Hitchcock