Citation Nr: 18147852
Decision Date: 11/06/18	Archive Date: 11/06/18

DOCKET NO. 12-17 557A
DATE:	November 6, 2018
REMANDED
The claim for service connection for bilateral pes planus is remanded.
REASONS FOR REMAND
The Veteran served on active duty from February 1980 to March 1981.
This matter comes before the Board of Veterans’ Appeals (Board) on appeal from an October 2011 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO).  
1. The claim for service connection for bilateral pes planus is remanded.
A new medical opinion is warranted.  The Veteran’s pes planus was noted at entry into active service.  In the October 2011 VA examination report, the examiner stated that an opinion as to the whether the Veteran’s pre-existing pes planus was aggravated beyond its natural progression during service could not be provided without resort to mere speculation.  The examiner discussed pertinent evidence, but did not explain why the cited evidence prevented an opinion without resort to speculation, or state whether there was missing information that if obtained would enable a non-speculative opinion.  
A medical opinion addressing whether the Veteran’s pes planus has been aggravated by his service-connected right lower extremity radiculopathy, which involves the crural nerve, should also be obtained.  See 38 C.F.R. § 3.310(b) (2017) (providing for secondary service connection on the basis of aggravation).  In a December 2014 statement (VA Form 21-4138), the Veteran’s treating podiatrist at VA stated that the Veteran’s service-connected crural nerve condition contributed to his foot pathology.  The podiatrist did not provide an explanation, and so the opinion is not sufficient to make an informed decision.  See Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 301 (2008).  However, based on this statement, there is at least an indication that the Veteran’s pes planus may have been aggravated by his service-connected right lower extremity radiculopathy such that an opinion on the issue is warranted.  See 38 C.F.R. § 3.159(c)(4) (2017).  
The matter is REMANDED for the following action:
1. Obtain any outstanding VA treatment records dated since May 2017.
2. Arrange for VA medical opinions addressing direct and secondary service connection for the Veteran’s pes planus, as specified below. 
Direct service connection: The examiner is asked to provide an opinion as to the following: 

(a.) Whether it is at least as likely as not (50% probability or more) that there was an increase in disability during service with respect to the Veteran’s pre-existing pes planus, and if so, whether the increase was due to the natural progress of this condition.
(b.) If the examiner finds an increase in disability during service, whether it is at least as likely as not that the Veteran’s current pes planus is linked to the aggravation during active service.  

Secondary service connection: The examiner is asked to provide an opinion as to whether it is at least as likely as not that the Veteran’s pes planus was aggravated (i.e. there was an increase in severity beyond a medically established baseline) by his service-connected right lower extremity radiculopathy.  
The examiner must provide complete explanations in support of the conclusions reached.  If the examiner is unable to provide an opinion without resort to speculation, the examiner must explain why the evidence is not sufficient to render the above opinions.  In this regard, the examiner should state whether there is missing information that if obtained would enable an opinion, and specify the nature of such information. 
 
P.M. DILORENZO
Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD	J. Rutkin, Counsel