Citation Nr: 18153801 Decision Date: 11/28/18 Archive Date: 11/28/18 DOCKET NO. 16-12 669 DATE: November 28, 2018 ORDER Entitlement to service connection for a bilateral shoulder condition is denied. Entitlement to service connection for a left elbow condition is denied. Entitlement to service connection for a low back condition is denied. Entitlement to service connection for an acquired psychiatric disorder, to include depressive disorder, is denied. Entitlement to a rating in excess of 10 percent for bilateral plantar fasciitis is dismissed. Entitlement to a rating in excess of 10 percent for left iliotibial band syndrome with shin splints is dismissed. Entitlement to a rating in excess of 10 percent for right iliotibial band syndrome with shin splints is dismissed. Entitlement to an effective date prior to July 19, 2002 for the grant of service connection for bilateral plantar fasciitis is denied. Entitlement to an effective date prior to July 19, 2002 for the grant of service connection for left iliotibial band syndrome with shin splints is denied. Entitlement to an effective date prior to July 19, 2002 for the grant of service connection for right iliotibial band syndrome with shin splints is denied. REMANDED Entitlement to service connection for a bilateral hip condition is remanded. FINDINGS OF FACT 1. The competent medical evidence does not demonstrate that the Veteran has a diagnosable bilateral shoulder condition that is attributable to his active service or any incident of service. 2. The competent medical evidence does not demonstrate that the Veteran has a diagnosable left elbow condition that is attributable to his active service or any incident of service. 3. The competent medical evidence does not demonstrate that the Veteran has a diagnosable low back condition that is attributable to his active service or any incident of service. 4. The competent medical evidence does not demonstrate that the Veteran’s one instance of reported depression following his discharge from service is a manifestation of an acquired psychiatric disorder that was incurred in service or is otherwise attributable to the Veteran’s active service or any incident of service. 5. The Veteran’s bilateral plantar fasciitis is manifested by mild symptoms of pain and incoordination not fully relieved by orthotics. 6. The Veteran’s left knee condition is manifested by no loss of range of motion flexion as well as no ankylosis, impairment of the tibia or fibula, instability that is more than slight in degree, or dislocated semilunar cartilage. 7. The Veteran’s right knee condition is manifested by no loss of range of motion flexion as well as no ankylosis, impairment of the tibia or fibula, instability that is more than slight in degree, or dislocated semilunar cartilage. 8. The Veteran filed his claim seeking service connection for bilateral iliotibial band syndrome and bilateral plantar fasciitis within one year of his discharge from service on July 18, 2002; the current appeal is a freestanding challenge to the effective date, received in February 2013. CONCLUSIONS OF LAW 1. The criteria for service connection for a bilateral shoulder condition have not been met. 38 U.S.C. §§ 1110, 1112, 1113, 5107; 38 C.F.R. § 3.303. 2. The criteria for service connection for a left elbow condition have not been met. 38 U.S.C. §§ 1110, 1112, 1113, 5107; 38 C.F.R. § 3.303. 3. The criteria for service connection for a low back condition have not been met. 38 U.S.C. §§ 1110, 1112, 1113, 5107; 38 C.F.R. § 3.303. 4. The criteria for service connection for an acquired psychiatric disorder have not been met. 38 U.S.C. §§ 1110, 1112, 1113, 5107; 38 C.F.R. § 3.303. 5. The criteria for a rating in excess of 10 percent for bilateral plantar fasciitis have not been met. 38 U.S.C. § 1155, 5103, 5103A, 5107(b); 38 C.F.R. §§ 3.102, 3.159, 4.1-4.14, 4.21, 4.71a, Diagnostic Code 5299-5276. 6. The criteria for a rating in excess of 10 percent for left knee iliotibial band syndrome with shin splints have not been met. 38 U.S.C. § 1155; 38 C.F.R. §§ 4.3, 4.14, 4.40, 4.59, 4.71a, Diagnostic Code 5299-5257. 7. The criteria for a rating in excess of 10 percent for right knee iliotibial band syndrome with shin splints have not been met. 38 U.S.C. § 1155; 38 C.F.R. §§ 4.3, 4.14, 4.40, 4.59, 4.71a, Diagnostic Code 5299-5257. 8. The criteria for an effective date earlier than July 19, 2002 for the grant of service connection for bilateral plantar fasciitis have not been met. 38 U.S.C. §§ 1155, 5110; 38 C.F.R. §§ 3.155(a), 3.400. 9. The criteria for an effective date earlier than July 19, 2002 for the grant of service connection for left iliotibial band syndrome have not been met. 38 U.S.C. §§ 1155, 5110; 38 C.F.R. §§ 3.155(a), 3.400. 10. The criteria for an effective date earlier than July 19, 2002 for the grant of service connection for right iliotibial band syndrome have not been met. 38 U.S.C. §§ 1155, 5110; 38 C.F.R. §§ 3.155(a), 3.400. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from January 2000 to July 2002. Via a March 2016 power of attorney application on a VA Form 21-22a, he appointed the noted attorney as his representative in his appeal before VA. Thereafter, in a June 2016 correspondence, this attorney informed VA that he was withdrawing from his representation of the Veteran. However, VA received this correspondence after the Veteran’s appeal was certified to the Board. Pursuant to 38 C.F.R. § 20.608, after an appeal has been certified to the Board, a representative must file a motion for withdrawal with the Board showing good cause for the withdrawal, with a copy of the motion provided to the Veteran sent via first-class mail. A review of the claims file does not reflect that these measures were taken by the attorney, which the Board informed him of in a September 2018 letter. To date, the Board has not received any response to this letter, to include a proper Motion to Withdraw from representation; as such, the Board finds that the attorney has not withdrawn from his representation, and will continue to be listed as the representative of record. In view of the facts found, and to provide broader consideration on appeal, the Board has recharacterized the claim of entitlement to service connection for depression as one for an acquired psychiatric disorder, to include depressive disorder. The Board notes that it has considered whether a claim for a total rating based on individual unemployability (TDIU) has been raised by the Veteran during the pendency of this appeal. In Rice v. Shinseki, 22 Vet. App. 447 (2009), the United States Court of Appeals for Veterans Claims (Court) held that VA must address the issue of entitlement to a TDIU in increased-rating claims when the issue of unemployability either is raised expressly or by the record. VA treatment records reflect that the Veteran was working part-time as a welder in 2007. A review of the Veteran’s most recent VA examinations evaluating his service-connected disabilities indicates that the Veteran experiences some occupational impairment as due to his various service-connected disabilities, but there is no indication that those disabilities would preclude him from securing and maintaining substantially gainful employment. Accordingly, the Board will not address the issue of entitlement to a TDIU, as it has not been raised by the Veteran or by the record. The Board also notes that neither the Veteran nor his representative has raised any other issues, nor have any other issues been reasonably raised by the record. See Doucette v. Shulkin, 28 Vet. App. 366 (2017). Service Connection 1. Entitlement to service connection for a bilateral shoulder condition The Veteran contends generally that he has a bilateral shoulder condition that began in service and has continued to the present. The question before the Board is whether the Veteran has a diagnosable bilateral shoulder condition that began during service or is at least as likely as not related to an in-service injury, event, or disease. A review of the Veteran’s service treatment records does not reveal any complaints, findings, treatment, or diagnoses specifically concerning any symptoms of a bilateral shoulder condition. The Board acknowledges that on the November 1999 Report of Medical History that accompanied the entrance examination the Veteran reported experiencing a broken right shoulder at the age of 18 prior to entering service. However, the examiner who prepared the report found no evidence of any residual condition or symptomatology attributable to a broken right shoulder at the time of the Veteran’s entrance into service, and so the Veteran is presumed to have been without any defects when he began service. 38 U.S.C. § 1111. Accordingly, service connection on a direct basis pursuant to 38 C.F.R. § 3.303(a) is not warranted. Available VA medical records do not show that the Veteran has specifically sought treatment for any symptoms of a bilateral shoulder condition. The Veteran has not been afforded an examination in connection with the service connection claim for a right shoulder condition, but VA does not have a duty to provide one here, as there is no indication that the condition, even if present, has been present during the pendency of this appeal, or that it may be associated with the Veteran’s service. See McLendon v. Nicholson, 20 Vet. App. 79 (2006). There is no competent evidence to suggest that the Veteran has ever had a bilateral shoulder condition. Moreover, the Veteran has not submitted any evidence or testimony of his own in support of the claim. Accordingly, there is no duty to provide the Veteran with an examination to evaluate the etiology of any such bilateral shoulder condition. The Board has considered this case in light of Saunders v. Wilkie, 886 F.3d 1356 (Fed. Cir. 2018). In Saunders, the United States Court of Appeals for the Federal Circuit (Federal Circuit) concluded that “pain is an impairment because it diminishes the body’s ability to function, and that pain need not be diagnosed as connected to a current underlying condition to function as an impairment.” Id. at 1364. “[A] physician’s failure to provide a diagnosis for the immediate cause of a veteran’s pain does not indicate that the pain cannot be a functional impairment that affects a veteran’s earning capacity.” Id. at 1367. Ultimately, the Federal Circuit in Saunders held that, to establish the presence of a disability, a veteran will need to show that his or her pain reaches the level of functional impairment of earning capacity. Id. at 1368. That having been noted, the Board finds the present case to be readily distinguishable from Saunders. Not only is there no competent medical evidence suggesting functional impairment of earning capacity, the Veteran himself has not provided lay evidence suggesting such impairment. Quite simply, there exists no basis for finding that a threshold of functional impairment of earning capacity has been met. Absent such evidence, there can be no finding of a disability per Saunders. Without any supporting records or testimony, the Board concludes that the preponderance of the evidence is against a determination that the Veteran has had a bilateral shoulder condition at any time during the pendency of the claim. Service connection is denied. Brammer v. Derwinski, 3 Vet. App. 223, 225 (1992). As the preponderance of the evidence is against the Veteran’s claim, the benefit-of-the-doubt standard of proof does not apply. 38 U.S.C. § 5107(b). 2. Entitlement to service connection for a left elbow condition The Veteran contends generally that he has a left elbow condition that began in service and has continued to the present. The question before the Board is whether the Veteran has a diagnosable left elbow condition that began during service or is at least as likely as not related to an in-service injury, event, or disease. A review of the Veteran’s service treatment records does not reveal any complaints, findings, treatment, or diagnoses specifically concerning any symptoms of a left elbow condition other than one isolated instance of the Veteran seeking treatment for left elbow pain in May 2001, with a diagnosis of left elbow strain. However, no further treatment for left elbow pain is documented in the service medical records, and no left elbow pain was noted on either the January 2002 discharge examination or the corresponding January 2002 Report of Medical History. Available VA medical records do not show that the Veteran has specifically sought treatment for any symptoms of a left elbow condition. The Veteran was afforded a VA examination to evaluate the nature and likely etiology of any left elbow condition in June 2013. He detailed that he experienced a sudden onset of left elbow pain in service in May 2001, not precipitated by trauma or injury, but acknowledged that he received no further treatment for left elbow pain following the initial encounter. During the examination he did not endorse experiencing any symptoms of left elbow pain. Following a physical examination, the examiner declined to set forth a diagnosis of a left elbow condition. As such, the examiner found that it was less likely than not that the Veteran had a diagnosable left elbow condition that was incurred in or otherwise attributable to service. The June 2013 examiner’s etiology opinion is highly probative, because it is based on an accurate medical history and supported by a clear rationale. Sklar v. Brown, 5 Vet. App. 140 (1993). Therefore, in light of the apparent lack of any supporting records or testimony, and especially in consideration of the Veteran’s own admission during the June 2013 examination that he did not experience any symptoms of a left elbow condition, the Board concludes that the preponderance of the evidence is against a determination that the Veteran has had a left elbow condition of in-service onset. See Saunders, supra. As the preponderance of the evidence is against the Veteran’s claim, the benefit-of-the-doubt standard of proof does not apply. 38 U.S.C. § 5107(b). 3. Entitlement to service connection for a low back condition The Veteran contends that he has a low back condition that began in service and has continued to the present. Specifically, he asserts that his pain is secondary to his antalgic gait, which in turn is attributable to sesamoiditis. The question before the Board is whether the Veteran has a diagnosable low back condition that began during service or is at least as likely as not related to an in-service injury, event, or disease. A review of the Veteran’s service treatment records does not reveal any complaints, findings, treatment, or diagnoses specifically concerning any symptoms of a low back condition. Specifically, no back pain was noted on either the January 2002 discharge examination or the corresponding January 2002 Report of Medical History. Accordingly, service connection on a direct basis pursuant to 38 C.F.R. § 3.303(a) is denied. Available VA medical records do not show that the Veteran has specifically sought treatment for any symptoms of a low back condition. The Veteran was afforded a VA examination to evaluate the nature and likely etiology of any low back condition in June 2013. He reported experiencing dull achy pain in his lower back with reduced range of motion, with symptoms beginning in 2009. Range of motion testing revealed no abnormalities, and a further physical examination also did not show any other impairment. Although the Veteran reported that he had received treatment for low back pain in the past, the examiner’s review of the claims file did not reflect that he had ever received any treatment through VA for symptoms of a low back condition. Accordingly, the examiner declined to diagnose any such low back condition. As for the query as to etiology, the examiner first found that it was less likely than not that the Veteran had a diagnosable low back condition that was incurred in service or was otherwise attributable to service, on the basis that the Veteran never received treatment for symptoms of a low back condition while in service and in the over ten years since his discharge from service. The examiner also opined that it was less likely than not that any low back condition was secondary to service-connected plantar fasciitis, as the Veteran’s antalgic gait, which he asserted resulted in his low back pain, was fully attributable to non-service connected sesamoiditis and not the service-connected plantar fasciitis. See 38 C.F.R. § 3.310. The June 2013 examiner’s etiology opinion is highly probative because it is based on an accurate medical history and supported by a clear rationale. Sklar, supra. There is no suggestion in the record of low back pain reaching the threshold of functional impairment of earning capacity. See Saunders, supra. Therefore, in light of the apparent lack of any objective medical evidence reflecting a diagnosis of a low back condition, the Board concludes that the preponderance of the evidence is against a determination that the Veteran has a current and chronic low back condition. Service connection is denied. Brammer, supra. As the preponderance of the evidence is against the Veteran’s claim, the benefit-of-the-doubt standard of proof does not apply. 38 U.S.C. § 5107(b). 4. Entitlement to service connection for an acquired psychiatric disorder The Veteran has received treatment for depression at one point in time through VA, and has filed a claim seeking service connection for an acquired psychiatric disorder manifested by depression. The question before the Board is whether the Veteran has a diagnosable acquired psychiatric disorder that began during service or is at least as likely as not related to an in-service injury, event, or disease. A review of the Veteran’s service treatment records does not reveal any complaints, findings, treatment, or diagnoses relating to a psychiatric disorder. Accordingly, service connection on a direct basis pursuant to 38 C.F.R. § 3.303(a) is denied. VA and private medical records do show that the Veteran reported experiencing depression in November 2007 that he related to his inability to secure a job that allowed him to utilize his educational background. However, a more recent outpatient record dated in June 2012 reflects that the Veteran was denying any history of depressive symptoms. Furthermore, no outpatient records dating from prior to the one instance in November 2007 when he did report experiencing depression reflect that the Veteran had been experiencing depressive symptoms. The Veteran has not been afforded an examination in connection with the service connection claim for an acquired psychiatric disorder, but VA does not have a duty to provide one here, as there is no indication that the condition may be associated with the Veteran’s service. See McLendon, supra. He has not presented any competent evidence or testimony in support of the claim, and there are no records of the Veteran receiving a diagnosis of or treatment for the condition prior to 2007. There is simply no competent evidence to support that the condition first diagnosed five years after the Veteran’s discharge is related to service. Indeed, the Veteran has not presented any lay testimony in support of his general claim seeking service connection for the condition. Accordingly, there is no duty to provide the Veteran with an examination to evaluate the etiology of his acquired psychiatric disorder. Without any evidence in support of the Veteran’s claim, the Board finds that no medical nexus exists between the Veteran’s acquired psychiatric disorder and an in-service injury, event or disease. 38 U.S.C. §§ 1110, 1131; Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009); 38 C.F.R. § 3.303(a), (d). As the preponderance of the evidence is against the Veteran’s claim, the benefit-of-the-doubt standard of proof does not apply. 38 U.S.C. § 5107(b). Increased Rating Disability ratings are determined by applying the criteria set forth in VA’s Schedule for Rating Disabilities. Ratings are based on the average impairment of earning capacity. Individual disabilities are assigned separate diagnostic codes. See 38 U.S.C. § 1155; 38 C.F.R. § 4.1. In cases in which a claim for a higher initial evaluation stems from an initial grant of service connection for the disability at issue, multiple (“staged”) ratings may be assigned for different periods of time during the pendency of the appeal. See generally Fenderson v. West, 12 Vet. App. 119 (1999). Where entitlement to compensation has already been established, and an increase in the disability rating is at issue, the present level of disability is of primary concern. Although a rating specialist is directed to review the recorded history of a disability in order to make a more accurate evaluation, the regulations do not give past medical reports precedence over current findings. See Francisco v. Brown, 7 Vet. App. 55 (1994); 38 C.F.R. § 4.2. Staged ratings are, however, appropriate for an increased rating claim when the factual findings show distinct time periods where the service-connected disability exhibits symptoms that would warrant different ratings. The relevant focus for adjudicating an increased rating claim is on the evidence concerning the state of the disability from the time period one year before the claim was filed until VA makes a final decision on the claim. See generally Hart v. Mansfield, 21 Vet. App. 505 (2007). Where there is a question as to which of two evaluations shall be applied, the higher evaluation will be assigned if the disability picture more nearly approximates the criteria required for that rating; otherwise, the lower rating will be assigned. See 38 C.F.R. § 4.7. In determining the appropriate rating for musculoskeletal disabilities, particular attention is focused on functional loss of use of the affected part. Factors of joint disability include increased or limited motion, weakened movement, excess fatigability, incoordination, and painful movement, including during flare-ups and after repeated use. DeLuca v. Brown, 8 Vet. App. 202, 206-08 (1995); 38 C.F.R. § 4.45. A finding of functional loss due to pain must be supported by adequate pathology and evidenced by the visible behavior of the claimant. 38 C.F.R. § 4.40. 1. Entitlement to a rating in excess of 10 percent for bilateral plantar fasciitis The Veteran is in receipt of a 10 percent evaluation for bilateral plantar fasciitis. He seeks a higher rating for the entire period of the appeal. The Veteran’s bilateral plantar fasciitis is evaluated under 38 C.F.R. § 4.71a, Diagnostic Code 5299-5276, as analogous to pes planus. Under Diagnostic Code 5276, a noncompensable evaluation is assigned for mild flatfoot, with symptoms relieved by built-up shoe or arch support. A 10 percent evaluation is assigned for unilateral or bilateral symptoms that are moderate, characterized by weight-bearing line over or medial to the great toe, inward bowing of the tendo achillis, and pain on manipulation and use of the feet. A 30 percent disability rating is warranted where the evidence shows that the pes planus symptoms are severe bilaterally as demonstrated by objective evidence of marked deformity (pronation, abduction, etc.), pain on manipulation and use accentuated indication of swelling on use, and characteristic callosities. The maximum 50 percent evaluation is warranted for pronounced bilateral flatfoot demonstrated by marked pronation, extreme tenderness of plantar surfaces of the feet, marked inward displacement and severe spasm of the tendo achillis on manipulation, not improved by orthopedic shoes or appliances. The severity of the Veteran’s bilateral pes planus was evaluated in a June 2013 VA examination, during which he reported experiencing constant pain in his feet precipitated by walking. He acknowledged the use of orthotic inserts in both feet, but he did not believe that they offered him any relief from his bilateral foot pain. A physical examination revealed mild bilateral heel pain as well as a mild antalgic gait, which was attributed to sesamoiditis. It was the examiner’s impression that the bilateral foot pain impaired the Veteran’s ability to walk, which in turn could decrease his occupational functioning. The examiner also opined that it was less likely than not that the Veteran would experience increased pain and incoordination during a flare-up. A review of VA medical records shows that the Veteran has received treatment for bilateral plantar fasciitis since an initial consultation in 2002 after his discharge from service. The most contemporary available records, dated in June 2012, reflect that the Veteran was still experiencing bilateral foot pain at this point in time that was largely not relieved by the use of orthotics. His treating physician recommended that the Veteran receive a pericapsular injection to the plantar medial and plantar lateral joint. Upon consideration of the available evidence of record, the Board finds that an initial evaluation in excess of 10 percent is not warranted for the plantar fasciitis pursuant to Diagnostic Code 5276. The June 2013 examiner evaluated the bilateral plantar fasciitis as being mild in severity, with the primary symptom being pain in the feet precipitated by ambulation. The Veteran wears orthotics in his shoes, but he has continued to only report experiencing pain in his right foot without any other functional impairment. There is no evidence that either foot has a marked deformity or callosities, and there is also no suggestion that either foot swells up after use. These symptoms would have to be present to warrant a 30 percent rating, and without evidence of any of them, a rating in excess of 10 percent for bilateral plantar fasciitis must be denied. 38 C.F.R. § 4.7. Consistent with DeLuca, the Board finds that this evaluation fully adequately contemplates any pain and functional loss. The Board also notes that it has considered whether any other potentially applicable diagnostic codes could be applied to provide the Veteran with an increased rating; however, all of the following diagnostic codes pertaining to the foot and potentially providing for greater than a 10 percent evaluation do not apply in this case, as the evidence does not demonstrate clawfoot (Diagnostic Code 5278), unilateral anterior metatarsalgia (Diagnostic Code 5279) or malunion or nonunion of the tarsal or metatarsal bones (Diagnostic Code 5283). 38 C.F.R. § 4.71a. While the Board could alternatively apply the potentially higher ratings available under Diagnostic Code 5284, which are general rating criteria for “other foot injuries”, a higher 20 percent rating under these criteria is warranted only for a moderately severe foot injury, which the evidence does not reflect is the case. Accordingly, the Board finds that the preponderance of the available evidence is against a finding that a rating in excess of 10 percent for bilateral plantar fasciitis is warranted. 2. Entitlement to an increased rating for left and right iliotibial band syndrome with shin splints The Veteran is in receipt for separate 10 percent ratings for both left and right iliotibial band syndrome. He seeks an increased rating for both conditions for the entire period of the appeal. The separate 10 percent ratings were assigned pursuant to Diagnostic Code 5299-5257. Hyphenated diagnostic codes are used when a rating under one diagnostic code requires the use of an additional diagnostic code to identify the basis for the rating assigned; the additional code is shown after the hyphen. 38 C.F.R. § 4.27. Diagnostic Code 5299 refers to an unlisted disability of the musculoskeletal system, while Diagnostic Code 5257 pertains to other impairment of the knee as well as knee instability. Under Diagnostic Code 5257, recurrent subluxation or lateral instability, a 10 percent rating is assigned when the impairment is slight, while a 20 percent rating is assigned for moderate impairment and a 30 percent rating is for severe impairment. The Board will consider additional diagnostic codes pertinent to the evaluation of knee disabilities in order to determine the highest possible evaluation for the separate knee conditions during the entire period of the appeal. However, in considering the applicability of those diagnostic codes, the Board finds that Diagnostic Codes 5256 (ankylosis of the knee), 5258 (dislocated semilunar cartilage), 5259 (symptomatic removal of semilunar cartilage) and 5263 (genu recurvatum) are not applicable in this instance, as the medical evidence does not show that the Veteran experiences these conditions. 38 C.F.R. § 4.71a, Diagnostic Codes 5256, 5258, 5259, 5263. Limitation of motion of the knee is rated under Diagnostic Code 5260, for limitation of flexion, and 5261, for limitation of extension. Under Diagnostic Code 5260, limitation of flexion of the leg, a noncompensable rating is assigned when flexion is limited to 60 degrees; a 10 percent rating is assigned when flexion is limited to 45 degrees; a 20 percent rating is assigned when flexion is limited to 30 degrees; and a 30 percent rating is assigned when flexion is limited to 15 degrees. 38 C.F.R. § 4.71a, Diagnostic Code 5260. Under Diagnostic Code 5261, limitation of extension of the leg, a noncompensable rating is assigned when extension is limited to 5 degrees; a 10 percent rating is assigned when extension is limited to 10 degrees; a 20 percent rating is assigned when extension is limited to 15 degrees; a 30 percent rating is assigned when extension is limited to 20 degrees; a 40 percent rating is warranted for extension limited to 30 degrees; and a 50 percent rating is assigned when extension is limited to 45 degrees. 38 C.F.R. § 4.71a, Diagnostic Code 5261. The standardized description of joint measurements is provided in Plate II under 38 C.F.R. § 4.71a. For VA purposes, “normal” extension and flexion of the knee is from zero to 140 degrees, and references to normal motion below indicate that the Veteran, in fact, had motion from zero to 140 degrees. 38 C.F.R. § 4.71a, Plate II. The Board notes that separate ratings under Diagnostic Code 5260 and Diagnostic Code 5261 may be assigned for disability of the same knee joint. See VAOPGCPREC 9-2004. The severity of the Veteran’s left and right knee conditions was evaluated in a June 2013 VA examination. He reported experiencing constant dull achy pain in both knees, with flare-ups of more severe pain precipitated by walking, especially after walking up an incline. Range of motion testing revealed no loss of range of motion in either knee, even following repetitive use testing. No localized tenderness, ankylosis, or instability was noted. The examiner stated that imaging studies had been performed, and degenerative or traumatic arthritis had not been documented. See VAOPGCPREC 23-97. In conclusion, the examiner found that the bilateral knee conditions resulted in a decreased capacity to walk, especially up inclines. The examiner also opined that it was less likely than not that the Veteran would experience increased pain and incoordination during a flare-up. A review of VA medical records shows that the Veteran has received treatment for bilateral iliotibial band syndrome since an initial consultation in 2002 after his discharge from service. The most contemporary available records, dated in June 2012, reflect that the Veteran was still experiencing bilateral knee pain. Upon consideration of the evidence, the Board finds that a rating in excess of 10 percent is not warranted for either the left or right knee iliotibial band syndrome at any point during the pendency of the appeal. The available evidence, to specifically include the June 2013 examination, does not reflect that the Veteran experiences any of the symptomatology that would warrant a compensable rating for either knee under any of the possible applicable diagnostic criteria. He has not exhibited a loss of flexion or extension that would warrant a compensable rating. 38 C.F.R. § 4.71a, Diagnostic Codes 5260, 5261. The 10 percent rating was initially awarded for slight instability noted on a prior examination, and, as reflected on the June 2013 examination, there is no contemporary evidence to suggest that the Veteran continues to experience any instability that is attributable to iliotibial band syndrome in either knee. That being said, the Veteran is still entitled to a minimum compensable rating (i.e. 10 percent) for the pain he experiences in both knees. See 38 C.F.R. §§ 4.10, 4.40, 4.45, 4.59; DeLuca, 8 Vet. App. at 202. However, a rating in excess of the already assigned 10 percent is not warranted pursuant to any of the potentially applicable rating criteria. Earlier Effective Date The Veteran seeks an earlier effective date for the grant of service connection for his bilateral plantar fasciitis condition as well as his separate iliotibial band syndrome conditions. Each condition was assigned an effective date of July 19, 2002, one day following the date of the Veteran’s discharge, pursuant to an unappealed and final April 2003 rating decision. That effective date was assigned pursuant to VA regulation which holds that the effective date for an award of service connection is the day following separation from active service if the claim is received within one year after separation from service. 38 U.S.C. § 5110; 38 C.F.R. § 3.400. The Veteran’s current claim arises from a February 2013 application and is, in essence, a freestanding claim for an earlier effective date. In that regard, in Rudd v. Nicholson, 20 Vet. App. 296 (2006), the United States Court of Appeals for Veterans Claims (Court) held that where a rating decision that established an effective date becomes final, an earlier effective date can only be established by a request for a revision of that decision based on clear and unmistakable error (CUE). In essence, the Court in Rudd held that there is no “freestanding” earlier effective date claim that could be raised at any time. Id.. at 299. The Court made it abundantly clear in Rudd that under these circumstances dismissal is required due to the lack of a proper claim. Id. at 300. Therefore, the Board finds that the Veteran’s earlier effective date claim for the grant of service connection for his bilateral plantar fasciitis condition as well as his separate iliotibial band syndrome conditions must be dismissed. REASONS FOR REMAND Entitlement to service connection for a bilateral hip condition is remanded. The Veteran contends that he has a bilateral hip condition that began in service and has continued to the present. Specifically, he asserts that his pain is secondary to his antalgic gait, which in turn is attributable to his bilateral plantar fasciitis. The Veteran was afforded a VA examination to evaluate the nature and likely etiology of any bilateral hip condition in June 2013. Range of motion testing revealed no abnormalities, and a further physical examination also did not show any other impairment of either hip, although the examiner did note the possibility of a mild sacroiliac joint dysfunction. The examiner’s review of the claims file did not reflect that he had ever received any treatment through VA for symptoms of a bilateral hip condition. Ultimately, the examiner declined to diagnose a bilateral hip condition. Regarding etiology, the examiner first found that it was less likely than not that the Veteran had a diagnosable bilateral hip condition that was incurred in service or was otherwise attributable to service, on the basis that the Veteran never received treatment for his left hip condition in service after the one month of treatment in June 2000. The examiner also opined that it was less likely than not that any bilateral hip condition was secondary to service-connected plantar fasciitis, as the Veteran’s antalgic gait, which he asserted resulted in his hip pain, was fully attributable to non-service connected sesamoiditis and not the service-connected plantar fasciitis. As a reminder, secondary service connection is permitted based on aggravation, such that compensation is payable for the degree of aggravation of a nonservice-connected disability caused by a service-connected disability. 38 C.F.R. § 3.310(b); Allen v. Brown, 7 Vet. App. 439 (1995). Consequently, there exist two potential theories of entitlement to secondary service connection — namely, causation under § 3.310(a) and instead aggravation under § 3.310(b). The June 2013 VA examiner’s opinion only addressed direct causation, and did not discuss whether the potential sacroiliac joint dysfunction was aggravated by a service-connected disability, to specifically include the bilateral plantar fasciitis. On remand, the RO should provide the claims file to the June 2013 VA examiner or to another qualified physician in order to elicit an addendum opinion regarding the etiology of the bilateral hip condition that includes a discussion of whether the condition was aggravated by his service-connected disabilities. The matter is REMANDED for the following action: Provide the claims file to the examiner who administered the June 2013 VA examination, or to another qualified examiner if they are not available, for the purpose of eliciting an addendum opinion regarding the etiology of the bilateral hip condition. The chosen examiner should note in the examination report that the claims folder and the remand have been reviewed. The examiner should provide an opinion as to whether it is at least as likely as not (50 percent probability or greater) that any diagnosed bilateral hip condition was caused or aggravated by one or more service-connected disabilities (listed in a January 2014 rating decision, and specifically to include bilateral plantar fasciitis) or a combination therefrom. In setting forth this opinion, the examiner should operate on the assumption that the Veteran has sacroiliac joint dysfunction as suggested in the June 2013 VA examination. The examiner should note that the term “aggravated by” refers to a chronic or permanent worsening of the underlying condition, as contrasted to mere temporary or intermittent flare-ups of symptoms that resolve and returned to the baseline level of disability. If the opinion is that a service-connected disability or combination of service-connected disabilities aggravated the bilateral hip condition, the examiner should specify, so far as possible, the degree of disability resulting from such aggravation. The examiner must provide any and all opinions as to etiology in the form of a probability, and must provide a complete rationale for any opinion expressed. A. C. MACKENZIE Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD Christopher M. Collins, Associate Counsel