Citation Nr: 18161102 Decision Date: 12/28/18 Archive Date: 12/28/18 DOCKET NO. 17-09 493 DATE: December 28, 2018 REMANDED Entitlement to a bilateral foot disorder, including plantar fasciitis, pes planus and pes cavus is remanded. REASONS FOR REMAND The Veteran had active duty from July 1997 to February 1998. The Board sincerely regrets the additional delay but finds that this claim must be remanded for additional development. The Board finds that the medical opinions of record do not adequately address the etiology of the Veteran’s bilateral foot disorder. Although the evidence includes May 2015 and September 2016 VA medical opinions, as well as a July 2015 opinion from the Veteran’s private physician, none of these opinions adequately address or provide sufficient rationale as to whether the Veteran’s preexisting foot diagnoses (mild pes planus and left foot mild pes cavus) were aggravated during her active service, whether the Veteran’s other foot diagnoses (to include bilateral plantar fasciitis, hallux valgus, and calcaneal spur formation) were incurred or caused by her military service, or whether any current foot diagnosis is caused or aggravated by her service-connected low back, left ankle, and bilateral lower radiculopathy disabilities. Moreover, the opinions of record do not adequately address pertinent symptomatology documented in the Veteran’s service treatment records, specifically her reports of foot symptomatology and an altered gait. Therefore, an additional medical opinion is needed to properly consider all the pertinent evidence and to reconcile any conflicting medical evidence or opinions of record. The matter is REMANDED for the following action: 1. Obtain the Veteran’s VA medical treatment records dated from September 2016 forward. 2. Thereafter, schedule the Veteran for a VA orthopedic examination of her feet. The claims file and a copy of this remand must be provided to and be reviewed by the examiner in conjunction with the examination. Any tests or studies deemed necessary should be conducted, and the results should be reported in detail. Following a review of the claims file and examination of the Veteran, the examiner should identify all current foot disorders found to be present, including pes planus and/or pes cavus. The examiner must address the following: (a) Did the Veteran’s pre-existing pes planus and left foot pes cavus worsen during service? The examiner should consider the Veteran’s September 1997, October 1997 and January 1998 service treatment records showing treatment for bilateral feet pain, bilateral ankle pain, complaints of running and marching contributing to pain, altered gait, low back pain and shin splints. (b) If there was an increase in severity of the pes planus or left foot pes cavus during service, is there clear and unmistakable evidence that the increase was due to the natural progress of the condition? (c) For all foot diagnoses that are not found to have preexisted service, is it at least as likely as not (i.e. 50% or greater probability) that the disorder was incurred in or is caused by the Veteran’s military service, to include her in-service reports of and treatment for bilateral feet pain, bilateral ankle pain, complaints of running and marching contributing to pain, altered gait, low back pain and shin splints documented in the service treatment records. (d) For all foot diagnoses, is it at least as likely as not (i.e., 50% or greater probability) that the disorder was caused or aggravated by the Veteran’s service-connected left ankle, low back and/or bilateral lower extremity radiculopathy, to include by any altered gait associated with these conditions. In providing the requested opinions, the examiner should consider and discuss the Veteran’s statements regarding the onset and progression of her foot symptomatology. The examiner should also discuss and reconcile any conflicting medical opinions or evidence of record. (Continued on the next page)   The examiner should discuss the medical rationale for all opinions expressed, whether favorable or unfavorable, if necessary citing to specific evidence in the file supporting conclusions. DELYVONNE M. WHITEHEAD Acting Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD N. Sangster, Counsel