Citation Nr: 18148124 Decision Date: 11/08/18 Archive Date: 11/06/18 DOCKET NO. 16-07 683 DATE: November 8, 2018 ORDER 1. New and material evidence has not been received to reopen the claim of entitlement to service connection for a right leg disability. 2. Entitlement to service connection for a left hip disability is denied. 3. Entitlement to service connection for a right hip disability is denied. 4. Entitlement to service connection for asthma is denied. 5. Entitlement to service connection for a left wrist disability is denied. 6. Entitlement to service connection for a right wrist disability is denied. 7. Entitlement to an increased rating in excess of 10 percent for degenerative disc disease with osteophytosis of the lumbar spine is denied. REMANDED 8. Entitlement to service connection for right plantar fasciitis is remanded. 9. Entitlement to service connection for left plantar fasciitis is remanded. FINDINGS OF FACT 1. In an unappealed January 2003 rating decision, the RO denied service connection for a right leg disability based on a finding that the Veteran did not have a current diagnosis of a right leg disability. 2. Evidence received subsequent to the January 2003 rating decision is cumulative or redundant of evidence previously of record, does not relate to an unestablished fact necessary to substantiate the claim for service connection for a right leg disability, and does not raise a reasonable possibility of substantiating the claim. 3. The preponderance of the evidence of record is against finding that the Veteran has, or has had at any time during the appeal, a current diagnosis of a left hip disability. 4. The Veteran’s right hip disability did not have its onset in service and is not otherwise related to service. 5. The preponderance of the evidence of record is against a finding that the Veteran has, or has had at any time during the appeal, a current diagnosis of asthma. 6. The Veteran’s left wrist disability did not have its onset in service, was not manifested to a compensable degree within one year of service discharge, and is not otherwise related to service. 7. The Veteran’s right wrist disability did not have its onset in service and is not otherwise related to service. 8. The credible evidence shows that degenerative disc disease with osteophytosis of the lumbar spine does not result forward flexion of the thoracolumbar spine to 60 degrees or less, the combined range of motion of the thoracolumbar spine is not 120 degrees or less, and the Veteran does not have muscle spasm or guarding severe enough to result in an abnormal gait or abnormal spinal contour such as scoliosis, reversed lordosis, or abnormal kyphosis. CONCLUSIONS OF LAW 1. The January 2003 rating decision denying service connection for a right leg disability is final. 38 U.S.C. § 7105(c); 38 C.F.R. § 20.1103. 2. The criteria for reopening the claim for service connection for a right leg disability on the basis of new and material evidence have not been met. 38 U.S.C. § 5108; 38 C.F.R. § 3.156(a). 3. The criteria for service connection for a left hip disability are not met. 38 U.S.C. §§ 1110, 1111, 1131, 5107(b); 38 C.F.R. §§ 3.102, 3.303(a). 4. The criteria for service connection for a right hip disability are not met. 38 U.S.C. §§ 1110, 1111, 1131, 5107(b); 38 C.F.R. §§ 3.102, 3.303(a). 5. The criteria for service connection for asthma are not met. 38 U.S.C. §§ 1110, 1111, 1131, 5107(b); 38 C.F.R. §§ 3.102, 3.303(a). 6. The criteria for service connection for a left wrist disability are not met. 38 U.S.C. §§ 1101, 1110, 1112, 1113, 1131, 1137, 5107(b); 38 C.F.R. §§ 3.102, 3.303(a)-(b), (d), 3.307, 3.309(a). 7. The criteria for service connection for a right wrist disability are not met. 38 U.S.C. §§ 1110, 1111, 1131, 5107(b); 38 C.F.R. §§ 3.102, 3.303(a). 8. The criteria for an increased rating in excess of 10 percent for degenerative disc disease with osteophytosis of the lumbar spine, have not been met. 38 U.S.C. §§ 1155, 5107(b); 38 C.F.R. §§ 4.1-4.14, 4.40, 4.45, 4.59, 4.71a, Diagnostic Code (DC) 5242. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty in the United States Army from August 1997 to January 2003. New and Material Evidence If a claim for service connection has been previously denied and that decision became final, the claim can be reopened and reconsidered only if new and material evidence is presented with respect to that claim. 38 U.S.C. § 5108. New evidence is defined as existing evidence not previously submitted to agency decisionmakers, while material evidence is defined as existing evidence that, by itself or when considered with previous evidence of record, relates to an unestablished fact necessary to substantiate the claim. 38 C.F.R. § 3.156(a). New and material evidence can be neither cumulative nor redundant of the evidence of record at the time of the last prior final denial of the claim sought to be reopened, and must raise a reasonable possibility of substantiating the claim. Id. Only evidence presented since the last final denial on any basis (whether by the Board or RO, and whether upon the merits of the case or upon a previous adjudication that no new and material evidence had been presented) will be evaluated in the context of the entire record. The threshold for determining whether new and material evidence raises a reasonable possibility of substantiating a claim is low. Moreover, in determining whether this low threshold is met, consideration need not be limited to whether the newly submitted evidence relates specifically to the reason why the claim was last denied, but also whether the evidence could reasonably substantiate the claim were the claim to be reopened, either by triggering the VA’s duty to assist or through consideration of an alternative theory of entitlement. For purposes of reopening a claim, the credibility of newly submitted evidence is generally presumed. Regardless of the AOJ’s actions, given the previous unappealed denial of the claim on appeal, the Board has a legal duty under 38 U.S.C. §§ 5108 and 7105 to address the question of whether new and material evidence has been received to reopen the claims for service connection. This matter goes to the Board’s jurisdiction to reach the underlying claims and adjudicate the claim on a de novo basis. 1. New and material evidence has not been received to reopen the claim of entitlement to service connection for a right leg disability The claim for service connection for a right leg disability was initially denied in a January 2003 rating based on a finding that the Veteran did not have a diagnosis of a right leg disability. The Veteran was notified of this determination in an February 2003 letter, which included information about her appeal rights. The Veteran did not appeal this decision and has not contended that this rating decision is not final as to this issue. Thus, the January 2003 rating decision is final. See 38 U.S.C. § 7105; 38 C.F.R. § 20.1103. The pertinent evidence of record at the time of the January 2003 rating decision included the Veteran’s DD Form 214, service treatment records (STRs), and VA treatment records. The evidence added to the file since the last final decision are VA treatment records and copies of STRs. The Board has reviewed the entire record, with particular attention to the additional evidence received since the last final decision in January 2003. After reviewing the record, the Board finds that the additional evidence received is not new and material within the meaning of 38 C.F.R. § 3.156. VA treatment records received since the January 2003 decision do not reflect a diagnosis of a right leg disability. Although the Veteran has submitted clinical records that demonstrate evaluation for right leg pain, this evidence does not establish that there is a current disability. The Veteran’s current treatment records do not provide any new and material evidence for the claim of service connection for a right leg disability, as they do not contain any new information relating to the substantiation of the claim at hand. This additional clinical evidence does not relate to an unestablished fact necessary to substantiate the claim. 38 C.F.R. § 3.156. The STRs received are merely duplicates of records that were previously reviewed. Thus, the Board concludes that this evidence is not new and material under 38 C.F.R. § 3.156(a) and does not constitute relevant service department records under 38 C.F.R. § 3.156(c) since they were already of record previously. The evidence received since the last final denial is duplicative or cumulative of prior evidence of record. The Board finds that none of the evidence raises a possibility of substantiating the claim. 38 C.F.R. § 3.156(a). For these reasons, the Board finds that the additional evidence received since the January 2003 decision is not new and material within the meaning of 38 C.F.R. § 3.156(a). Consequently, the claim of service connection for a right leg disability is not reopened. Service Connection Service connection may be granted for a disability resulting from a disease or injury incurred in or aggravated by service. See 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303(a). To establish a right to compensation for a present disability, a veteran must show: (1) the existence of a present disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the present disability and the disease or injury incurred or aggravated during service. Disorders diagnosed after discharge will still be service connected if all the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303(d). When all the evidence is assembled, the Board is then responsible for determining whether the evidence supports the claim or is in relative equipoise, with the Veteran prevailing in either event, or whether the preponderance of the evidence is against the claim, in which case the claim is denied. 38 U.S.C. § 5107; 38 C.F.R. § 3.102. Service connection may also be established under 38 C.F.R. § 3.303(b), if a chronic disease or injury is shown in service, and subsequent manifestations of the same chronic disease or injury at any later date, however remote, are shown, unless clearly attributable to intercurrent causes. Service connection may also be established under 38 C.F.R. § 3.303(b), where a disability in service is noted but is not, in fact, chronic, or where a diagnosis of chronicity may be legitimately questioned. The continuity of symptomatology provision of 38 C.F.R. § 3.303(b) has been interpreted as an alternative to service connection only for the specific chronic diseases listed in 38 C.F.R. § 3.309(a). The Veteran currently has carpal tunnel syndrome, which is a chronic disease under 38 C.F.R. § 3.309(a); thus, 38 C.F.R. § 3.303(b) is applicable. Additionally, where a veteran served 90 days or more of active service, and certain chronic diseases become manifest to a degree of 10 percent or more within one year after the date of separation from such service, such disease shall be presumed to have been incurred in service, even though there is no evidence of such disease during the period of service. 38 U.S.C. §§ 1101, 1110, 1112, 1113; 38 C.F.R. §§ 3.307, 3.309(a). While the disease need not be diagnosed within the presumption period, it must be shown, by acceptable lay or medical evidence, that there were characteristic manifestations of the disease to the required degree during that time. However, where the evidence does not warrant presumptive service connection, a veteran is not precluded from establishing service connection with proof of direct causation. 2. Entitlement to service connection for a left hip disability The question for the Board in this case is whether the Veteran has a current disability that began during service or is at least as likely as not related to an in-service injury, event, or disease or is caused or aggravated by a service-connected disability. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. §§ 3.303, 3.310. In order for service connection to be established, there needs to be competent evidence of a current disability. The Board concludes that the Veteran does not have a current diagnosis of a left hip disability and has not had one at any time during the pendency of the claim or recent to the filing of the claim. 38 U.S.C. §§ 1110, 1131, 5107(b), 38 C.F.R. § 3.303(a), (d). Further, despite consistent treatment from October 2002 to April 2017, VA treatment records do not contain a diagnosis of a left hip disability. For example, in a March 2013 VA treatment record, x-rays of the Veteran’s hips showed no abnormal findings in the left hip, despite the presence of abnormal findings in the right hip. While the Veteran believes she has a current diagnosis of a left hip disability, she is not competent to provide a diagnosis in this case. The issue is medically complex, as it requires specialized medical education. Consequently, the Board gives more probative weight to the competent medical evidence. In sum, without competent evidence of a current disability, the Board concludes that the preponderance of the evidence of record is against the Veteran’s claim for service connection for a left hip disability, and the claim is denied. 3. Entitlement to service connection for a right hip disability The Board has carefully reviewed the evidence of record and finds that the preponderance of the evidence is against the award of service connection for a right hip disability. The reasons follow. The Veteran has been diagnosed with a right hip disability, and thus there is evidence of a current disability. For example, the Veteran was found to have mild right gluteus medius tendinosis and partial chronic avulsive findings associated with the right greater trochanter. However, as to direct service incurrence, the Veteran’s claim fails on both the in-service disease or injury and the nexus to service. The service treatment records (STRs) do not support any complaints, symptoms, diagnosis or treatment related to a right hip disability, which tends to weigh against a finding of a right hip disability during service. As to a nexus to service, according to a March 2013 VA treatment record, the Veteran first complained of problems related to her hip after she injured her right hip in a February 2013 fall. In an October 2002 VA examination, the Veteran was found to have a normal evaluation of her hip after diagnostic studies were performed. The fact that the Veteran was found to have a normal diagnostic study of her right hip in 2002, and only began complaining about symptoms related to her right hip after a 2013 fall, which tends to establish that the Veteran’s right hip disability did not have its onset in service and is not otherwise related to service. To the extent that the Veteran has stated that a right hip disability had its onset in service, her service treatment records do not support such a finding. Additionally, the Veteran is not medically trained and is therefore not qualified to competently opine about medical etiology. Although the Veteran claims that her right hip disability is related her service, it is well established that a layperson without medical training is not qualified to render medical opinions regarding the etiology of certain disorders and disabilities. 38 C.F.R. § 3.159(a)(1). In certain instances, lay testimony may be competent to establish medical etiology or nexus. However, hip disabilities require specialized training for determinations as to diagnosis and causation, and is therefore, not susceptible to lay opinions on etiology. The origin or cause of the Veteran’s right hip disability is not a simple question that can be determined based on mere personal observation by a lay person, the Veteran’s lay assertion is not competent to establish a nexus. In sum, the Board concludes that the preponderance of the evidence of record is against the Veteran’s claim for service connection for a right hip disability. The benefit-of-the-doubt doctrine enunciated in 38 U.S.C. § 5107(b) is not applicable, as there is no approximate balance of evidence. 4. Entitlement to service connection for asthma The question for the Board in this case is whether the Veteran has a current disability that began during service or is at least as likely as not related to an in-service injury, event, or disease or is caused or aggravated by a service-connected disability. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. §§ 3.303, 3.310. In order for service connection to be established, there needs to be competent evidence of a current disability. The Board concludes that the Veteran does not have a current diagnosis of asthma and has not had one at any time during the pendency of the claim or recent to the filing of the claim. 38 U.S.C. §§ 1110, 1131, 5107(b), 38 C.F.R. § 3.303(a), (d). Further, despite consistent treatment from October 2002 to April 2017, VA treatment records do not contain a diagnosis of asthma, and, in fact, show findings that she does not have asthma. For example, in a November 2013 VA treatment record, the Veteran was found to have no asthma. In an October 2012 VA treatment record, the Veteran denied ever having a history of asthma. While the Veteran believes she has a current diagnosis of asthma, she is not competent to provide a diagnosis in this case. The issue is medically complex, as it requires specialized medical education. Consequently, the Board gives more probative weight to the competent medical evidence, which either does not show a diagnosis of asthma or a specific finding of no asthma. In sum, without competent evidence of a current disability, the Board concludes that the preponderance of the evidence of record is against the Veteran’s claim for service connection for asthma, and the claim is denied. 5. Entitlement to service connection for a left wrist disability The Board has carefully reviewed the evidence of record and finds that the preponderance of the evidence is against the award of service connection for a left wrist disability on either a direct or presumptive basis. The reasons follow. The Veteran has been diagnosed with a left wrist disability, and thus there is evidence of a current disability. For example, the Veteran was diagnosed with carpal tunnel syndrome (CTS) in her left wrist. However, as to direct service incurrence, the Veteran’s claim fails on both the in-service disease or injury and the nexus to service. The STRs do not support any complaints, symptoms, diagnosis or treatment related to a left wrist disability, which tends to weigh against a finding of a left wrist disability during service. As to a nexus to service, in a February 2017 VA treatment record, the examiner noted that the Veteran was diagnosed with CTS in January 2017, which is approximately 14 years following service discharge, and tends to establish that a left wrist disability did not have its onset in service. The Veteran also indicated that she had a new job that was exacerbating her left wrist disability. The Board notes a July 2014 VA treatment record indicating a complaint of left wrist pain, but no diagnosis of a left wrist disability was entered. Even if the record was found to be evidence of a left wrist disability, it would establish a diagnosis of a left wrist disability approximately 11 years after service discharge, and would still tend to show that the disability did not have its onset in service. To the extent that the Veteran has alleged that a left wrist disability had its onset in service, her service treatment records do not support such a finding. Additionally, the Veteran is not medically trained and is therefore not qualified to competently opine about medical etiology. Although the Veteran claims that her left wrist disability is related her service, it is well established that a layperson without medical training is not qualified to render medical opinions regarding the etiology of certain disorders and disabilities. 38 C.F.R. § 3.159(a)(1). In certain instances, lay testimony may be competent to establish medical etiology or nexus. However, wrist disabilities require specialized training for determinations as to diagnosis and causation, and is therefore, not susceptible to lay opinions on etiology. The origin or cause of the Veteran’s left wrist disability is not a simple question that can be determined based on mere personal observation by a lay person, the Veteran’s lay assertion is not competent to establish a nexus. Given the above evidence, the Board finds that the Veteran did not incur an event, injury, or disease related to her current a left wrist disability in service and that her left wrist disability disorder did not manifest during service or within one year of separation from service. Furthermore, the evidence of record does not demonstrate that the Veteran’s symptoms have been continuous since separation from service in January 2003. See 38 C.F.R. §§ 3.303(b), 3.307, 3.309(a). The February 2017 VA examiner stated that the Veteran was first diagnosed with CTS in January 2017, approximately 14 years following service discharge. The absence of post-service complaints, findings, diagnosis, or treatment for approximately 14 years after service is one factor that tends to weigh against a finding of continuous symptoms since separation from service. The Board may weigh the absence of contemporaneous medical evidence as one factor in determining credibility of lay evidence. A prolonged period without medical complaint can be considered, along with other factors, as evidence of whether an injury or a disease was incurred in service which resulted in any chronic or persistent disability. In sum, the Board concludes that the preponderance of the evidence of record is against the Veteran’s claim for service connection for a left wrist disability. The benefit-of-the-doubt doctrine enunciated in 38 U.S.C. § 5107(b) is not applicable, as there is no approximate balance of evidence. 6. Entitlement to service connection for a right wrist disability The Board has carefully reviewed the evidence of record and finds that the preponderance of the evidence is against the award of service connection for a right wrist disability. The reasons follow. The Veteran has been diagnosed with a right wrist disability, and thus there is evidence of a current disability. For example, the Veteran has been diagnosed with DeQuervain’s tenosynovitis on the right side. The Board notes that a February 2017 VA treatment record specifically found that the Veteran’s right carpal tunnel was diagnostically normal. However, as to direct service incurrence, the Veteran’s claim fails on both the in-service disease or injury and the nexus to service. The STRs do not support any complaints, symptoms, diagnosis or treatment related to a right wrist disability, which tends to weigh against a finding of a right wrist disability during service. As to a nexus to service, in a February 2017 VA treatment record, the Veteran indicated that her right wrist disability began ten months prior, which is approximately 13 years following service discharge, and tends to establish that a right wrist disability did not have its onset in service. The Veteran also indicated that she had a new job that was exacerbating her right wrist disability. A prolonged period without medical complaint can be considered, along with other factors, as evidence of whether an injury or a disease was incurred in service which resulted in any chronic or persistent disability To the extent that the Veteran has asserted that a right wrist disability had its onset in service, her service treatment records do not support such a finding. Additionally, the Veteran is not medically trained and is therefore not qualified to competently opine about medical etiology. Although the Veteran claims that her right wrist disability is related her service, it is well established that a layperson without medical training is not qualified to render medical opinions regarding the etiology of certain disorders and disabilities. 38 C.F.R. § 3.159(a)(1). In certain instances, lay testimony may be competent to establish medical etiology or nexus. However, wrist disabilities require specialized training for determinations as to diagnosis and causation, and is therefore, not susceptible to lay opinions on etiology. The origin or cause of the Veteran’s right wrist disability is not a simple question that can be determined based on mere personal observation by a lay person, the Veteran’s lay assertion is not competent to establish a nexus. In sum, the Board concludes that the preponderance of the evidence of record is against the Veteran’s claim for service connection for a right wrist disability. The benefit-of-the-doubt doctrine enunciated in 38 U.S.C. § 5107(b) is not applicable, as there is no approximate balance of evidence. Increased Rating Disability evaluations are determined by evaluating the extent to which a Veteran’s service-connected disability adversely affects the Veteran’s ability to function under the ordinary conditions of daily life, including employment, by comparing the Veteran’s symptomatology with the criteria set forth in the Schedule for Rating Disabilities. 38 C.F.R. Part 4. The percentage ratings represent as far as can practicably be determined the average impairment in earning capacity resulting from such diseases and injuries and the residual conditions in civilian occupations. Generally, the degree of disabilities specified are considered adequate to compensate for considerable loss of working time from exacerbation or illness proportionate to the severity of the several grades of disability. 38 U.S.C. § 1155; 38 C.F.R. § 4.1. Any reasonable doubt regarding the degree of disability will be resolved in favor of the Veteran. 38 C.F.R. § 4.3. Disability of the musculoskeletal system is primarily the inability, due to damage or infection in parts of the system, to perform the normal working movements of the body with normal excursion, strength, speed, coordination, and endurance. It is essential that the examination upon which ratings are based adequately portray the anatomical damage, and the functional loss, with respect to all these elements. The functional loss may be due to absence of part, or all, of the necessary bones, joints and muscles, or associated structures, or to deformity, adhesions, defective innervations, or other pathology, or it may be due to pain, supported by adequate pathology and evidenced by the visible behavior of the claimant undertaking the motion. Weakness is as important as limitation of motion, and a part that becomes painful on use must be regarded as seriously disabled. A little used part of the musculoskeletal system may be expected to show evidence of disuse, either through atrophy, the condition of the skin, absence of normal callosity or the like. 38 C.F.R. § 4.40. Evidence of pain, weakened movement, excess fatigability, or incoordination must be considered in determining the level of associated functional loss, taking into account any part of the musculoskeletal system that becomes painful on use. The provisions regarding the avoidance of pyramiding, see 38 C.F.R. § 4.14, do not forbid consideration of a higher rating based on greater limitation of motion due to pain on use, including flare ups. However, those provisions should only be considered in conjunction with the DCs predicated on limitation of motion. 38 C.F.R. §§ 4.40, 4.45. The intent of the rating schedule is to recognize painful motion with joint or periarticular pathology as productive of disability. Painful motion is an important factor of joint disability, which is entitled to at least the minimum compensable rating for the joint. 38 C.F.R. § 4.59. However, the evaluation of painful motion as limited motion only applies when the limitation of motion is noncompensable under the applicable DC. 7. Entitlement to an increased rating in excess of 10 percent for degenerative disc disease with osteophytosis of the lumbar spine is denied. In a January 2003 rating decision, service connection for degenerative disc disease with osteophytosis of the lumbar spine (lumbar spine disability) was granted, and a noncompensable evaluation was assigned effective January 30, 2003. In March 2015, the Veteran filed a claim for increase. In the July 2015 rating decision on appeal, the Veteran was assigned a 10 percent evaluation, effective March 25, 2015. The Veteran’s lumbar spine disability is rated under DC 5242. With or without symptoms such as pain (whether or not it radiates), stiffness, or aching in the area of the spine affected by residuals of injury or disease, a 10 percent evaluation is assigned for forward flexion of the thoracolumbar spine greater than 60 degrees but not greater than 85 degrees; or the combined range of motion of the thoracolumbar spine is greater than 120 degrees but not greater than 235 degrees; or, muscle spasm, guarding, or localized tenderness not resulting in abnormal gait or abnormal spinal contour; or, vertebral body fracture with loss of 50 percent or more of the height. 38 C.F.R § 4.71a, DCs 5235 to 5242. A 20 percent evaluation is assigned for forward flexion of the thoracolumbar spine greater than 30 degrees but not greater than 60 degrees; or, the combined range of motion of the thoracolumbar spine not greater than 120 degrees; or, muscle spasm or guarding severe enough to result in an abnormal gait or abnormal spinal contour such as scoliosis, reversed lordosis, or abnormal kyphosis. Id. A 40 percent evaluation is assigned for forward flexion of the thoracolumbar spine 30 degrees or less; or favorable ankylosis of the entire thoracolumbar spine. Id. A 50 percent evaluation is assigned for unfavorable ankylosis of the entire thoracolumbar spine. Id. A 100 percent evaluation is assigned for unfavorable ankylosis of the entire spine. Id. For VA compensation purposes, normal forward flexion of the thoracolumbar spine is zero to 90 degrees, extension is zero to 30 degrees, left and right lateral flexion are zero to 30 degrees, and left and right lateral rotation are zero to 30 degrees. The combined range of motion refers to the sum of the range of forward flexion, extension, left and right lateral flexion, and left and right rotation. The normal combined range of motion of the thoracolumbar spine is 240 degrees. The normal ranges of motion for each component of spinal motion provided in this note are the maximum that can be used for calculation of the combined range of motion. Id. The Board has carefully reviewed the evidence of record and finds that the preponderance of the evidence is against the award of an increased rating in excess of 10 percent for the lumbar spine disability. The reasons follow. The evidence shows that the Veteran’s lumbar spine disability is manifested with pain and limitation of motion, but does not result forward flexion of the thoracolumbar spine to 60 degrees or less; or, the combined range of motion of the thoracolumbar spine to 120 degrees or less; or, muscle spasm or guarding severe enough to result in an abnormal gait or abnormal spinal contour such as scoliosis, reversed lordosis, or abnormal kyphosis, to warrant a 20 percent rating. At worst, the Veteran’s forward flexion was limited to 85 degrees, and her combined range of motion of the thoracolumbar spine was found to be 210 degrees, as found in the July 2015 VA examination. The Board notes an April 2017 disability and benefits questionnaire (DBQ) was completed by the Veteran’s private chiropractor S.D. According to S.D.’s findings, forward flexion was limited to 25 degrees, and there was pain to palpation of the lumbar and sacral areas, interference with sitting and standing, an inability to do the regular activities of living, a positive straight leg test on the left, paresthesias and/or dysthesias, and the Veteran required the regular use of a brace for locomotion. However, in a March 20, 2017 VA treatment record, the Veteran complained of chronic low back pain only, denied any motor deficits, and did not mention any other symptoms. In a March 29, 2017 VA treatment record, the Veteran was fitted for a lumbosacral corset to manage her pain, but did not mention the use of a brace for locomotion. The Veteran did not mention any of the symptoms recorded on the April 2017 DBQ to her VA treatment providers in March 2017 or at any other time, despite several treatment visits. Accordingly, the Board finds that the April 2017 DBQ in inconsistent with other medical evidence of record, and assigns it no probative value. The Board has considered the effects of the Veteran’s symptoms, including pain and functional loss, and the Board concludes that the preponderance of the evidence is against a finding of forward flexion of the thoracolumbar spine greater than 30 degrees but not greater than 60 degrees; or, the combined range of motion of the thoracolumbar spine not greater than 120 degrees, which is the criteria needed for a 20 percent rating. Examination results throughout the appeal period show that the Veteran had normal muscle strength and reflexes in her lower extremities, and had forward flexion between 85 degrees. Taking into account the evidence of record indicating the Veteran’s regular complaints of pain and other findings of functional loss, the Board finds that the credible evidence does not reflect that such pain and functional limitations resulted in forward flexion of the thoracolumbar spine to 60 degrees or less; or, the combined range of motion of the thoracolumbar spine to 120 degrees or less, which would be required for a finding that the Veteran was entitled to a 20 percent disability rating. Thus, a higher rating under the provisions of 38 C.F.R. §§ 4.40, 4.45, and 4.59 criteria is not approximated in the Veteran’s disability picture for this appeal period. In sum, the evidence does not show that a disability rating in excess of 10 percent for the Veteran’s lumbar spine disability is warranted. As the preponderance of the evidence is against the claim for a higher rating, the benefit of the doubt doctrine is not for application, and the Veteran’s claim for an increased rating is denied. See 38 U.S.C. § 5107(b); 38 C.F.R. §§ 3.102, 4.3. REASONS FOR REMAND 8. Entitlement to service connection for right foot plantar fasciitis is remanded. 9. Entitlement to service connection for left foot plantar fasciitis is remanded. While further delay is regrettable, additional development is warranted before the Veteran’s claims may be decided. In the April 2017 VA examination, the examiner indicated that there is no record of a complaint of plantar fasciitis while in the military. The examiner opined that the Veteran’s plantar fasciitis was related to military activities of running and ruck marching. However, the STRs show that the Veteran complained of pain and other problems with her feet in July 1999 and August 1999; and that she was diagnosed with bilateral plantar fasciitis in September 1999. As the April 2017 VA examiner relied upon an incorrect medical history, and did not comment on the fact that 14 years had elapsed since seperation and the Veteran’s current plantar fasciitis, the Board finds that the April 2017 VA medical opinion needs to be supplemented . Accordingly, a new VA examination is necessary to ascertain if the Veteran’s bilateral plantar fasciitis is related to service. The matters are REMANDED for the following action: Schedule the Veteran for an examination by an appropriate clinician to determine the nature and etiology of her bilateral plantar fasciitis disability. The examiner must opine whether it is at least as likely as not related to an in-service injury, event, or disease, including the September 1999 diagnosis of bilateral plantar fasciitis. If the examiner finds that the Veteran’s current bilateral plantar fasciitis is related to service, the examiner must discuss the fact that approximately 14 years has passed since service and the Veteran’s current diagnosis in explaining the rationale for a nexus. A. P. SIMPSON Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD R. Husain, Associate Counsel