Citation Nr: 18154867
Decision Date: 11/30/18	Archive Date: 11/30/18

DOCKET NO. 16-28 348
DATE:	November 30, 2018
REMANDED
Entitlement to service connection for a left heel disability, to include as secondary to the Veteran’s service-connected right heel disability, is remanded.
REASONS FOR REMAND
The Veteran honorably served on active duty from February 2002 to January 2005. This matter is on appeal from an October 2012 rating decision by the Department of Veteran Affairs (VA) Regional Office (RO) in Atlanta, Georgia. 
The Board would like to note that the Veteran has been grated service connection for a right heel disability in an April 2016 rating decision. 
1. Entitlement to service connection for residuals, left heel injury is remanded.
Although the Board sincerely regrets the additional delay, a remand is necessary to ensure that there is a complete and accurate record upon which to decide the Veteran’s claim so that every possible consideration is afforded. 
A July 2004 service treatment record (STR) indicates that the Veteran had chronic pain in heel of foot when running.  The Veteran was diagnosed with arthralgia in June 2009.  In his June 2016 substantive appeal, the Veteran asserted that his residuals of left heel injury are secondary to his service-connected right heel disability.  As such, because the Veteran has indicated that there is a potential relationship between his service connected right heel condition and his left heel condition, a VA examination is warranted.  See McLendon v. Nicholson, 20 Vet. App. 79 (2006). 
The matter is REMANDED for the following action:
1. Schedule the Veteran for an examination by an appropriate clinician to determine the nature and cause of any left heel diagnosis(es). 
(a.) The clinician must opine as to whether there is a 50% or greater chance that any diagnosed left heel disability is related to an in-service injury, event, or disease.
(b.) If the clinician finds that that direct service-connection is not warranted then the clinician must also opine as to whether there is a 50% or greater chance that the Veteran’s left heel disability was secondarily CAUSED or AGGRAVATED by the Veteran’s service-connected right foot disability.  
The examiner is advised that AGGRAVATION is defined as a permanent increase in severity of the disability beyond its natural progression. 
The examiner is advised that, BY LAW, the particular facts and circumstances of the Veteran’s case (i.e., the particular medical condition and circumstances) must be addressed.  Detailed rationale and reasoning for all opinions and conclusions provided is required BY LAW.  Providing an opinion without a thorough explanation will delay processing of the claim and may result in a clarification being requested.
If it is not possible to provide any of the requested information, the examiner must state whether this is because of a deficiency in the state of general medical knowledge (that is, no one could respond, given medical science and the known facts), a deficiency in the record (that is, additional facts are required), or the examiner (that is, the examiner does not have the required knowledge or training). 
If the examiner cannot provide answers because further information or diagnostic studies are required, all reasonable steps to obtain this information or diagnostic studies should be exhausted before concluding that the answer cannot be provided.
 
L. BARSTOW
Acting Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD	K. McKone, Law Clerk