Citation Nr: 18156640
Decision Date: 12/11/18	Archive Date: 12/10/18

DOCKET NO. 16-24 759
DATE:	December 11, 2018
ORDER
Entitlement to service connection for left ankle degenerative joint disease, as secondary to service-connected digital neuroma of the left great toe, is granted.
FINDING OF FACT
The competent evidence is in equipoise as to whether the Veteran’s left ankle degenerative joint disease is related to his service-connected digital neuroma of   the left great toe.
CONCLUSION OF LAW
The criteria service connection for a left ankle degenerative joint disease have been met.  38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.310.
REASONS AND BASES FOR FINDING AND CONCLUSION
The Veteran had active service from June 1993 to March 1994.
This matter is before the Board of Veterans’ Appeals (Board) on appeal from a rating decision of a Department of Veterans Affairs (VA) Regional Office (RO).
1. Entitlement to service connection for a left ankle disability
Service connection may be established for disability that is proximately due to or the result of a service-connected disability.  38 C.F.R. § 3.310(a) (2018).  Further, a disability that is aggravated by a service-connected disability may be service connected to the degree that the aggravation is shown.  38 C.F.R. § 3.310 (2018); Allen v. Brown, 7 Vet. App. 439 (1995).  
The Veteran asserts that his left ankle disability is caused or aggravated by his service-connected digital neuroma of the left great toe.  
VA and private treatment records indicate that the Veteran is diagnosed with      left ankle degenerative joint disease (DJD). Additionally, the Veteran is service-connected for digital neuroma left of the left great toe.  Accordingly, the question is whether the Veteran’s left ankle disability is caused or aggravated by his service-connected disability.  
On this question there are opinions in favor of and against the claim. In this regard, in a December 2013 opinion, a VA clinician opined that it was less likely as not  that the Veteran’s left ankle condition was proximately due to his service-connected digital neuroma of the left great toe.  The examiner explained that the Veteran’s left ankle pain was due to DJD and there was no link between a digital neuroma of the great toe and DJD of the ankle.  
In a June 2015 VA treatment note, the Veteran’s physician opined that his prior foot trauma to the left toe during service lead to his current ankle pain.  In an October 2015, the same physician noted that it she had reviewed the treatment noted and discussed the case with another physician.  She stated that it was her opinion that the most likely explanation for the ankle DJD in such a young individual was that the Veteran suffered trauma to his ankle at the time of his      toe trauma.  
In an August 2017 opinion, Dr. Freeman noted that the Veteran had nerve pain during service that was ultimately concluded to be caused by a service-connected Morton’s neuroma. He opined that abnormal foot posture due to the Veteran’s service-connected Morton’s neuroma had contributed to the development of degenerative arthritis.
Upon review of the competent and probative evidence of record, the Board finds the evidence to at least be in equipoise as to whether the Veteran’s current left ankle degenerative joint disease is due to his service-connected neuroma.  Accordingly, after resolving all doubt in favor of the Veteran, the Board finds     that service connection for the left ankle degenerative joint disease as secondary    to service-connected digital neuroma of the left great toe is granted. 38 C.F.R. § 3.102 (2018). 
 
K. A. BANFIELD
Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD	J. Anderson