Citation Nr: 18146571 Decision Date: 11/01/18 Archive Date: 10/31/18 DOCKET NO. 16-26 227 DATE: November 1, 2018 ORDER An initial 10 percent rating percent for right ankle lateral collateral ligament sprain is granted, subject to the laws and regulations governing the payment of benefits. A rating in excess of 30 percent for bilateral pes planus is denied. FINDINGS OF FACT 1. The Veteran had active service from February 2003 to May 2007. 2. Throughout the entire appeal period, a right ankle disability has been manifested by subjective complaints of pain; objective findings include a normal range of motion. 3. Throughout the entire period on appeal, bilateral pes planus has been manifested by subjective complaints of pain, fallen arches, difficulty walking and using stairs, and walking on uneven ground; objective findings include decreased longitudinal arch height, marked deformity, and marked pronation but no extreme tenderness of plantar surfaces of the feet or marked inward displacement and severe spasm of the achilles tendon on manipulation. Improvement is shown with the use of orthotics. CONCLUSIONS OF LAW 1. The criteria for an initial 10 percent rating for lateral collateral ligament sprain, right ankle have been met. 38 U.S.C. § 1155 (2012); 38 C.F.R. §§ 4.1, 4.3, 4.31, 4.59, 4.7, 4.71a, Diagnostic Codes (DCs) 5270, 5271, 5272, 5273, 5274 (2017). 2. The criteria for bilateral pes planus in excess of 30 percent have not been met. 38 U.S.C. §§ 1155 (2012); 38 C.F.R. §§ 4.1, 4.3, 4.71a, DC 5276 (2017). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS Disability evaluations are determined by the application of a schedule of ratings which is based on average impairment of earning capacity. Generally, the degrees of disability specified are considered adequate to compensate for considerable loss of working time from exacerbations or illnesses proportionate to the severity of the several grades of disability. 38 C.F.R. § 4.1. Separate diagnostic codes identify the various disabilities. 38 U.S.C. § 1155; 38 C.F.R. Part 4. Right Ankle The Veteran contends that she experiences pain upon the use of her right ankle when walking and going up flights of stairs. She is currently rated non-compensable under DC 5271 for limitation of motion of right ankle and is seeking a higher rating. Under the relevant regulations, a higher rating will be warranted when the objective medical evidence shows the following: • ankylosis of the ankle in plantar flexion, less than 30 degrees (20 percent rating under DC 5270); • moderate limitation of motion (10 percent under DC 5271); • ankylosis of the subastragalar or tarsal joint in good weight-bearing position (10 percent under DC 5272) or in poor weight-bearing position (20 percent under DC 5272); • moderate deformity and malunion of os calcis or astragalus (10 percent under DC 5273) or marked deformity and malunion of os calcis or astragalus (20 percent under DC 5273); or • astragalectomy (20 percent under DC 5274). First, a July 2015 VA examination failed to show that the Veteran’s ankle was ankylosed during the appeal period. Neither has she alleged that the ankle was ankylosed. As such, a higher rating under DCs 5270 and 5272 is not warranted. Next, a higher rating is not warranted under DC 5271 for marked limited motion of the ankle. Specifically, the July 2015 VA examination indicated that the initial range of motion for the right ankle was normal, with dorsiflexion to 20 degrees and plantar flexion to 45 degrees. The Veteran was able to perform repetitive use testing with at least three repetitions without additional loss of function or range of motion. Muscle strength testing revealed no reduction in muscle strength, as both plantar flexion and dorsiflexion of the right ankle were rated at 5/5. As such, this evidence does not support a higher rating based on limitation of motion. Next, the same VA examination failed to show malunion of the os calcis or astragalus with marked or moderate deformity. Similarly, astragalectomy was not noted in any medical evidence. Therefore, a higher rating under DCs 5273 and 5274 is not warranted. However, the provisions of 38 C.F.R. § 4.59 establish that the Veteran is entitled to a minimum compensable evaluation for painful motion. See also Burton v. Shinseki, 25 Vet. App. 1 (2011). The Veteran reported pain upon use of the ankle and stated that she has problems walking on uneven ground and going up flights of stairs. The July 2015 VA examiner noted objective evidence of localized tenderness or pain on palpation of the right ankle joint. Therefore, the medical evidence supports a minimum compensable rating of 10 percent for a right ankle disability. Bilateral Pes Planus The Veteran is in receipt of a 30 percent rating for acquired flatfeet under DC 5276. In order to warrant a higher 50 percent rating, the evidence must show pronounced flatfoot as manifested by marked pronation, extreme tenderness of plantar surfaces of the feet, and marked inward displacement and severe spasm of the Achilles tendon on manipulation. Additionally, there must be no improvement of the disability by orthopedic shoes or appliances. In a July 2015 VA examination, the Veteran reported pain upon use of the feet but not upon manipulation. There was no indication of swelling on use and no characteristic callouses. There was marked pronation on both feet, but the examiner noted no extreme tenderness of the plantar surfaces of the feet. The Veteran did not have marked inward displacement or severe spasm of the Achilles tendon on manipulation of one or both feet. She reflected that she wore orthotics on both feet and that they improve her pain for about an hour or two. Based on the above, the medical evidence does not support a higher rating. Although she has marked pronation on both feet, the balance of the evidence does not support a higher rating. The Board has also considered the Veteran’s lay statements that her disability is worse. While she is competent to report symptoms because this requires only personal knowledge as it comes to her through her senses, Layno v. Brown, 6 Vet. App. 465, 470 (1994), she is not competent to identify a specific level of disability of this disorder according to the appropriate diagnostic codes. Such competent evidence concerning the nature and extent of the Veteran’s feet disability has been provided by the medical personnel who have examined her during the current appeal and who have rendered pertinent opinions in conjunction with the evaluations. The medical findings (as provided in the examination reports and other clinical evidence) directly address the criteria under which this disability is evaluated. Moreover, as the examiner has the requisite medical expertise to render a medical opinion regarding the degree of impairment caused by the disability and had sufficient facts and data on which to base the conclusion, the Board affords the medical opinion great probative value. As such, these records are more probative than the Veteran’s subjective complaints of increased symptomatology. In sum, after a careful review of the evidence of record, the benefit of the doubt rule is not applicable and the appeal is denied. Finally, the Veteran has not raised any other issues, nor have any other issues been reasonably raised by the record, for the Board’s consideration. See Doucette v. Shulkin, 28 Vet. App. 366, 369-370 (2017) (confirming that the Board is not required to address issues unless they are specifically raised by the claimant or reasonably raised by the evidence of record). L. HOWELL Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD T. Kokolas, Associate Counsel