Citation Nr: 18147714 Decision Date: 11/06/18 Archive Date: 11/05/18 DOCKET NO. 18-03 283 DATE: November 6, 2018 REMANDED Entitlement to service connection for a cervical spine disorder is remanded. Entitlement to service connection for a disorder of the left ankle/left foot is remanded. REASONS FOR REMAND The Veteran contends that he has left ankle/left foot and cervical spine disorders that are related to parachute jumping while in service. His DD-214 shows receipt of a parachute badge. Initially, there appear to be outstanding records that need to be obtained. In a January 2018 VA Form 9, the Veteran stated, “Along with my service records, my doctor’s record from Coastal Neurosurgical Associates and the following articles relating to the connection between jumping and various joint disabilities which I have enclosed today, I believe that my request for service connection for cervical spine condition and left ankle bone spurs should be granted.” Notably, the claims file is negative for any articles discussing a connection between jumping and various joint disabilities. In addition, the Veteran is advised that although the RO has already made two requests to attempt to obtain private medical records from Coastal Neurological Associates, no such medical records are associated with the claims file. If the Veteran has copies of such records, he should submit them. As to the left ankle/left foot, the Veteran contends that he has “left ankle bone spurs” and has described being “diagnosed with [heel] spurs on the backs of bilateral ankles.” In a May 2017 VA Ankle Conditions Disability Benefits Questionnaire, the examiner indicated that there was no current disability. The Veteran denies having received treatment from any VA providers and, as noted above, no records from Coastal Neurological Associates have been received. Although the examiner noted pain on weight bearing, no imaging studies were conducted. Initially, the Board notes that although the Veteran has referred to this disability as relating to his ankle, he appears to be describing a left foot heel spur. Accordingly, if subsequently obtained medical records cannot substantiate a current diagnosis, an examination of the foot may be more appropriate since the May 2017 VA examination focused on the range of motion of the ankle more than any functional impairment arising from a painful condition on the left heel. In addition, while the Board is not competent to make medical conclusions, there is some indication that bone spurs may be diagnosed by imaging studies. See “Bone spurs, Diagnosis & treatment,” Mayo Clinic, available at https://www.mayoclinic.org/diseases-conditions/bone-spurs/diagnosis-treatment/drc-20370216. As such, if any subsequently obtained medical records do not substantiate a diagnosis of a left foot bone spur and the existence of such a current diagnosis remains in question, the examiner should ensure that all appropriate examinations and/or studies are conducted that could confirm such a diagnosis. As to the cervical spine, since the May 2017 VA examiner concluded that there was no nexus to service in part due to the lack of post-service treatment records corroborating the Veteran’s claim of continued pain and treatment for the cervical spine after service, after obtaining any outstanding records and considering the Veteran’s competent reports, an addendum opinion should be obtained. The matters are REMANDED for the following action: 1. Notify the Veteran that the articles he submitted along with his January 2018 VA Form 9 relating to the connection between parachute jumping and various joint disabilities are not of record. Request that he re-submit such records. Notify the Veteran again that records from Coastal Neurological Associates have not been associated with the claims file and that if he has copies of such records, he should submit them. 2. Thereafter, forward the entire claims file in electronic records and a copy of this remand to the May 2017 VA examiner for addendum opinions addressing the etiology of (a) any current left ankle/left foot bone spur and (b) any current cervical spine disorders. If any current left ankle/left foot diagnosis remains in question, schedule an appropriate examination, which may include an examination and/or imaging studies of the left foot. (a) The examiner should identify all current left ankle/left foot disorders. Then, for each diagnosed disability, the examiner should indicate whether it is as least as likely as not (50 percent probability or more) that it is related to the Veteran’s active duty service, to include his parachute jumping. (b) The examiner should identify all current cervical spine disorders. Then, for each diagnosed disability, the examiner should indicate whether it is as least as likely as not (50 percent probability or more) that it is related to the Veteran’s active duty service, to include his parachute jumping. The examiner is advised that the Veteran is competent to report symptoms and treatment, and that his reports must be taken into account in formulating the requested opinions. The rationale for all opinions expressed must be provided. 3. After completion of the above, readjudicate the claims. If any benefit requested on appeal is not granted to the Veteran’s satisfaction, the appellant should be furnished a supplemental statement of the case, and provided an opportunity to respond. The case should then be returned to the Board for further appellate consideration, if in order. GAYLE STROMMEN Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD Matthew Schlickenmaier, Counsel