Citation Nr: 18104591 Decision Date: 05/22/18 Archive Date: 05/22/18 DOCKET NO. 10-22 746 DATE: May 22, 2018 ORDER Entitlement to service connection for a foot disorder other than gout is denied. FINDING OF FACT The evidence of record does not support a finding of a current diagnosis of a right foot disorder other than gout. CONCLUSION OF LAW The criteria for service connection for a right foot disorder other than gout have not been met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. § 3.303. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty in the United States Army from May 1984 to September 1992, from August 1999 to April 2000, from February 2001 to October 2001, from February 2003 to April 2004, and from August 2010 to December 2011. In September 2015 the Veteran appeared before the undersigned via video conference hearing. A transcript of that hearing is of record. In April 2017, the Board remanded the Veteran’s claim for an addendum opinion. 1. Entitlement to service connection for a foot disorder other than gout The Veteran argues that he is entitled to service connection for a right foot disorder other than gout. His disorder was originally claimed as “Arthritic R foot.” See October 2008 statement. According to his September 2015 hearing testimony his disorder “has been claimed as a pain problem” and “[t]he pain radiates out from the foot but it covers the entire sole.” The Veteran is already service-connected for three foot-related disorders: gout, post-operative right ankle fracture with loose body removal, and degenerative joint disease of the left metatarsophalangeal joints. The question for the Board is whether the Veteran has any other current foot disability that began during service or is at least as likely as not related to an in-service injury, event, or disease. Service connection will be granted if the evidence demonstrates that a current disability resulted from an injury or disease incurred in or aggravated by active military service, even if the disability was initially diagnosed after service. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303(a). Establishing service connection generally requires (1) medical evidence of a current disability; (2) medical or, in certain circumstances, lay evidence of in-service incurrence or aggravation of a disease or injury; and (3) evidence of a nexus between the claimed in-service disease or injury and the present disability. Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004). Service connection may be granted for any disease initially diagnosed after service when all the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303(d). The Board concludes that the Veteran does not have a current diagnosis of a right foot disorder other than gout and has not had one at any time during the pendency of the claim or recent to the filing of the claim. 38 U.S.C. §§ 1110, 1131, 5107(b); 38 C.F.R. § 3.303(a), (d). The July 2017 VA examiner evaluated the Veteran and determined that “[n]o foot disorders were found in the medical records besides a left plantar wart.” As the first element is not satisfied, entitlement to service connection for a right foot disorder other than gout must be denied. In reaching this conclusion, the Board has considered the Veteran’s lay statements. One such statement is that medical professionals previously told the Veteran that he has right foot arthritis. See, e.g., April 2012 VA examination (page 30 of 75). The Veteran is competent to testify regarding what a doctor told him because such information is within the knowledge and personal observations of lay witnesses. Barr v. Nicholson, 21 Vet. App. 303, 309 (2007). Consistent with this, an October 2011 private medical record (received 4/9/12, page 2 of 97) indicates “[l]ocalized osteoarthritis of the ankle/foot” and other medical records indicate arthritis in the lower extremities. An April 2012 VA arthritis examination identifies gouty arthritis (received 4/16/12, page 62 of 75). Unfortunately, there is no medical evidence of record of an arthritic disorder of the foot other than gout, for which the Veteran is already service-connected. A December 2004 VA examination (received 12/10/04, page 6 of 12) indicates “mild left knee arthritis” but states that an x-ray of the right ankle “is normal.” A January 2009 VA joints examination notes hip arthritis only (received 1/13/09, page 13 of 21). Consistent with this, an April 2012 VA examiner (received 4/16/12, page 55 of 75) says: “there is no diagnosis of right foot arthritis but there is actual diagnosis of DJD of first MTP joints.” An April 2012 VA ankle examination (received 4/17/12, pages 8–9 of 51) indicates no arthritis of the ankles. Importantly, while other April 2012 VA examinations note arthritis of the shoulder, hips, knees, and back, there is no other mention of right foot arthritis other than gouty arthritis, for which the Veteran is already service-connected. More recently, a February 2016 VA foot examination (received 2/8/16, page 2 of 7) indicates “gouty arthritis of the great toe,” but does not report arthritis for any other part of the foot. In addition, to the extent the evidence reflects that gout it simply a type of arthritis, the Veteran is already service connected for such disability. Therefore, taken together, the preponderance of the evidence is against entitlement to service connection for an arthritis-related foot disorder other than gout. The Board has also considered the Veteran’s lay testimony about pain, including his September 2015 hearing testimony that “pain radiates out from the foot but it covers the entire sole.” The Veteran is competent to testify about pain because this symptom is within the knowledge and personal observations of lay witnesses. Barr, 21 Vet. App. at 309. There is no reason to question the Veteran’s credibility. Unfortunately, the Veteran is not competent to testify regarding the existence of a right foot disorder other than gout because such a diagnosis requires specialized medical education and knowledge. Jandreau v. Nicholson, 492 F.3d 1372, 1377 n.4 (Fed. Cir. 2007). Consequently, greater weight is to be ascribed to the consistent examination findings that there is no right foot disorder other than gout. The Veteran’s claim must be denied because the preponderance of the evidence is against a finding that the Veteran has a current diagnosis of a right foot disorder other than gout. Michael J. Skaltsounis Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD B. Cannon, Associate Counsel