Citation Nr: 18150180 Decision Date: 11/14/18 Archive Date: 11/14/18 DOCKET NO. 15-45 020 DATE: November 14, 2018 ORDER Entitlement to service connection for a right foot disorder, diagnosed as plantar fasciitis, hallux rigidus/valgus, and per cavus, is granted. FINDING OF FACT Resolving reasonable doubt in favor of the Veteran, his right foot disorder had its onset in active service. CONCLUSION OF LAW The criteria for entitlement to service connection for a right foot disorder, diagnosed a plantar fasciitis, hallux, rigidus/valgus, and pes cavus have been met. 38 U.S.C. § 1110, 1131, 5107 (2012); 38 C.F.R. § 3.102, 3.303, 3.304 (2017). REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served in the United States Army from February 1984 to September 1994. These matters come before the Board of Veterans’ Appeals (Board) on appeal from an August 2013 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO) in Waco, Texas. Service connection may be granted for disability resulting from disease or injury incurred in or aggravated by service. 38 U.S.C. §§ 1110 (2012); 38 C.F.R. § 3.303 (2017). If a condition noted during service is not shown to be chronic, then generally a showing of continuity of symptomatology after service is required for service connection. 38 C.F.R. § 3.303(b) (2017), Walker v. Shinseki, 708 F.3d 1331. (Fed. Cir. 2013). Service connection may also be granted for any disease diagnosed after discharge from service when all of the evidence, including lay evidence, establishes that the disease was incurred in service. 38 C.F.R. § 3.303(d) (2017). In order to establish service connection for a claimed disability, the following three elements must be satisfied: (1) the existence of a current disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship (nexus) between the present disability and the disease or injury incurred or aggravated during service. Hickson v. West, 12 Vet. App. 246 (1999). The requirement of a current disability is satisfied when a claimant has a disability at the time a claim for VA disability compensation is filed or during the pendency of that claim. McClain v. Nicholson, 21 Vet. App. 319 (2007). In evaluating the evidence in an appeal, it is the responsibility of the Board to weigh the evidence and decide where to give credit and where to withhold same and, in doing so, accept certain medical opinions over others. Schoolman v. West, 12 Vet. App. 307 (1999). In this regard, the Board has been charged with the duty to assess the credibility and weight given to the evidence. Jandreau v. Nicholson, 492 F.3d 1372 (2007). Competent medical evidence is the type of evidence provided by a person who is qualified through education, training, or experience to offer medical diagnoses, statements, or opinions. It may also include statements conveying sound medical principles found in medical treatises and/or statements contained in authoritative writings, such as medical and scientific articles and research reports or analyses. 38 C.F.R. § 3.159(a)(1) (2017). Competent lay evidence is any kind of evidence not requiring that the proponent have specialized education, training, or experience. Lay evidence is competent if it is provided by a person who has knowledge of facts or circumstances and conveys matters that can be observed and described by a lay person. 38 C.F.R. § 3.159(a)(2) (2017). This may include some medical matters, such as describing symptoms or relating a contemporaneous medical diagnosis. Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007). When there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, the Secretary shall give the benefit of the doubt to the claimant. 38 U.S.C. § 5107(b) (2012); 38 C.F.R. § 3.102 (2017); Gilbert v. Derwinski, 1 Vet. App. 49 (1990). Entitlement to service connection for a right foot disorder The Veteran and his representative assert that the Veteran is entitled to service connection for a right foot condition because he injured his right foot while on active duty which resulted in his current disabilities of plantar fasciitis, hallux rigidus and pes cavus in the right foot. A condition precedent for establishing service connection is the presence of a current disability. In this regard, the Board notes that the Veteran has been diagnosed with and treated for plantar fasciitis, hallux rigidus and pes cavus in the right foot, according to June 2013 and November 2015 VA examinations. Accordingly, the first element for establishing service connection has been met. With respect to the second element, the Board notes that the Veteran received treatment for foot tenderness of the right heel in April 1990, according to a service treatment record dated April 1990. Accordingly, the Board finds that the second element for establishing service connection has been met. As for the final element of nexus, the Board finds that this element for establishing service connection has also been met. In a lay statement provided by the Veteran in December 2015, he claims his right foot condition began in April 1990, due to an injury to his toes relating to his boots while he was in service. The Veteran explained that he has had surgery due to this condition in April 2013 and that he had been in pain since his time in service. The record also contains competent medical evidence of a nexus between the Veteran's April 1990 treatment to his right foot and his current right foot condition, diagnosed as plantar fasciitis, hallux rigidus/valgus and pes cavus by a VA examiner in June 2013. The Veteran's lay testimony is competent, credible, and persuasive. 38 C.F.R. § 3.159; Jandreau v. Nicholson, 492 F.3d 1372, 1377 (Fed. Cir. 2007) (lay diagnosis is competent if: (1) lay person is competent to identify the medical condition; (2) lay person is reporting a contemporaneous medical diagnosis; or (3) lay testimony of symptoms at the time supports a later diagnosis by a medical professional). In this case, because the lay testimony supports an eventual diagnosis by a medical professional, it must be accorded some weight in the matter. Following a review of the Veteran's records and an in-person examination in June 2013, whereas the RO concluded that the examiner only linked the left foot disability to service, the Board has interpreted the VA examiner’s opinions as specifically determining that the Veteran's plantar fasciitis, hallux rigidus/valgus and pes cavus in both feet are at least as likely as not the end result of his treatment during his military service. The Board finds that the opinion provides probative evidence of a nexus between the Veteran's documented April 1990 in-service treatment for foot tenderness of the right heel and his current right foot condition. This medical opinion is probative because it is based on a review of the record and contains clear conclusions with supporting data connected by a reasoned medical explanation. Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 301-02 (2008). A separate, subsequent VA examination took place in November 2015, primarily focusing on an evaluation to service connect the Veteran’s left foot, however, the examination provided additional information regarding the condition severity of the right foot condition. The examination noted that the Veteran has a burning pain in his great toes bilaterally to dorsum of his first metatarsophalangeal joints also pins and needle sensation medial aspects of his great toes bilaterally, and also some soreness diffusely in his toes plantar aspect bilaterally. The Veteran has pain in both feet, which is accentuated on use and manipulation. The Veteran has residual signs or symptoms due to arthroscopic or other foot surgery, residual pain in his first metatarsophalangeal joints bilaterally. The Veteran also has numbness and tingling in his first toe bilaterally and burning pain dorsum of first toes bilaterally since his bilateral metatarsal head resections. The exam also noted that there is pain on weight-bearing causing decreased ability to walk and stand for prolonged periods. In summary, the Board finds that the most competent evidence of record is at least in equipoise as to a relationship between the Veteran’s currently diagnosed right foot disorders of plantar fasciitis, hallux rigidus/valgus, and pes cavus, and the Veteran’s period of active service. Accordingly, under these circumstances and granting the Veteran the benefit of the doubt in this matter, the Board finds that service connection for a right foot condition, diagnosed as plantar fasciitis, hallux rigidus/valgus, and pes cavus, is warranted. 38 U.S.C. § 1110; 38 C.F.R. § 3.102, 3.303. Michael J. Skaltsounis Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD A. R. Montalvo, Associate Counsel